A series of transient ischemic attacks have caused an older adult ...

[jerry coleman]

A series of transient ischemic attacks have caused an older adult to become dysphagic. Despite failing a swallowing assessment, the client is opposed to eating a minced and pureed diet and wishes to eat a regular diet.
 
  How should the care team respond to this request?
 
  A) Insert a feeding tube to provide nutrition while eliminating the risk of aspiration.
  B) Continue providing a minced and pureed diet to the client in order to ensure safety.
  C) Defer responsibility for feeding to the client's friends and family.
  D) Provide the client's requested diet after ensuring the client understands the risks.

Question 2

The children of a resident of a nursing home have approached the nurse because they believe their parent is being manipulated by a person who also lives in the facility.
 
  Their parent has a diagnosis of early-stage Alzheimer disease and various comorbidities that affect mobility and function. How should the care team appraise the parent's decision-making capacity?
 
  A) Her decision-making ability is nullified by the presence of a dementia.
  B) Her decision-making capacity should be determined according to objective criteria.
  C) She should be asked to demonstrate sound decision making in minor matter before being allowed to make more important decisions.
  D) A surrogate should be appointed to make her decisions because she has been diagnosed with Alzheimer disease.

[tandmlomax84]

Answer to Question 1

Ans: D
A common ethical dilemma is a client's or client's family's desire to continue an activity at risk. In general, an individual has the autonomy to choose this unless he or she is declared incompetent.

Answer to Question 2

Ans: B
The presence of dementia does not necessarily render a person incapable of all decision-making ability. Rather, this ability should be analyzed according to criteria of understanding, reasoning, choice, and expression.