ACC Ethical and Legal Considerations 2 ā Questions and Answers
Question 1: A person with moderate Alzheimer's refuses to take a prescribed medication. What is the caregiver's most appropriate first response?
- Crush the medication and hide it in food without telling the person
- Respect the refusal, document it, and notify the healthcare provider (Correct answer)
- Insist the person take the medication immediately for their safety
- Contact the family to override the person's refusal
Correct answer: Respect the refusal, document it, and notify the healthcare provider
Documenting and notifying the healthcare provider respects autonomy while ensuring the care team can address the refusal appropriately.
Question 2: Which legal document specifically designates someone to make financial decisions on behalf of a person who can no longer do so themselves?
- Healthcare proxy
- Living will
- Durable power of attorney for finances (Correct answer)
- Advance directive
Correct answer: Durable power of attorney for finances
A durable power of attorney for finances grants a designated agent authority to manage financial matters when the principal lacks capacity.
Question 3: A caregiver notices that a family member has been withdrawing large sums of money from an Alzheimer's patient's account. This is an example of:
- Acceptable family financial management
- Financial exploitation and elder abuse (Correct answer)
- Conservatorship in action
- Durable power of attorney use
Correct answer: Financial exploitation and elder abuse
Unauthorized or exploitative withdrawal of funds from a vulnerable adult's account constitutes financial elder abuse.
Question 4: What is 'therapeutic fibbing' in Alzheimer's care?
- Lying to patients about their diagnosis to avoid distress
- Using gentle, reality-based redirection to avoid unnecessary distress (Correct answer)
- Providing false information to family members about the patient's condition
- Documenting inaccurate information in medical records
Correct answer: Using gentle, reality-based redirection to avoid unnecessary distress
Therapeutic fibbing involves using compassionate redirection rather than harsh reality correction to reduce distress without causing harm.
Question 5: When a person with Alzheimer's disease lacks decision-making capacity, who has the legal authority to consent to medical treatment?
- The attending physician alone
- The person's legally authorized representative or surrogate decision-maker (Correct answer)
- Any family member who is present
- The long-term care facility administrator
Correct answer: The person's legally authorized representative or surrogate decision-maker
A legally authorized representativeāsuch as a healthcare proxy or legal guardianāholds authority to consent to treatment when capacity is lost.
Question 6: A caregiver suspects a colleague is neglecting a resident with Alzheimer's. Under mandatory reporting laws, what must the caregiver do?
- Wait to gather more evidence before acting
- Confront the colleague privately first
- Report the suspicion to Adult Protective Services or the appropriate authority (Correct answer)
- Discuss concerns only with the facility's administration
Correct answer: Report the suspicion to Adult Protective Services or the appropriate authority
Mandatory reporters are legally required to report reasonable suspicions of neglect or abuse to protective authorities, not to investigate themselves.
Question 7: Which ethical principle is upheld when caregivers ensure a person with Alzheimer's is protected from harm and unsafe situations?
- Autonomy
- Justice
- Non-maleficence
- Beneficence (Correct answer)
Correct answer: Beneficence
Beneficence refers to the duty to act in the patient's best interest by promoting their wellbeing and protecting them from harm.
ACC Ethical and Legal Considerations 2
A person with moderate Alzheimer's refuses to take a prescribed medication.
What is the caregiver's most appropriate first response?