There are some places where a patient cannot be discharged because of an ethical doctrine called mercy killing. Mercy killing refers to the practice of giving an elderly person a poison pill to prevent them from having to go outside and die.
This doctrine states that if someone is close to home who can safely be discharged, the facility must keep them on a life-support system until they receive definitive treatment. This treatment may be hospitalization or home care, depending on the patient’s condition.
There are two kinds of mercy killing: direct, legal; and indirect, illegal. Directly refusing medical assistance to someone in pain is illegal, though many believe it happens less than people think it does not care.
Indirectly refusing medical assistance can lead up to death by torture or pressure, depending on the doctor or manager involved. As such, it is considered illegal.
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They bring up important ethical questions
As our society becomes more mobile and technology-oriented, questions of ethics and justice are ever-more-closely approached. As a healthcare professional, you should be prepared to respond to such questions!
Today, there is a growing focus on good governance and patient well-being. Policy makers are looking for evidence-based answers to difficult questions such as what constitutes an ethical response to the needs of one’s elderly patients.
As medical professionals, we cannot give out prescriptions or perform surgery. But by virtue of our professional roles and responsibilities, we can offer suggestions for how to help patients feel better and function better.
Policy makers are interested in our responses to patient needs because they determine whether a facility is “legal” or “ethic”. If the administrator decides that providing minimal care is the best response to patients’ needs, then he or she will require advanced education in ethics in order to continue this practice.
The patient must be stable
If the patient is not stable, the home must let the hospital discharge the patient. This is called a non-discharge decision.
If the patient is stable, the home can refuse to discharge the patient. This is known as a non- refuse decision. If the patient refuses to go home and needs help getting out of their homes, then this may be a refuse decision.
If it is needed, the patient may go to the hospital or another healthcare system. This can be difficult for families, who have expectations about what happens at this stage of care.
Sometimes in medicine, you hear things called factors that seem like they should mean something else just doesn’t mean anything different in different systems so it’s important to discuss these with your system knows if there are issues with that facility.
The new location must be suitable
If your patient needs to be discharged from the hospital, there are a few things to take into account.
A skilled nurse can help her patient decide if this is a suitable time in their life to continue practicing what they love and helping others.
It is important that the patient has enough motivation and confidence in themselves to make this decision. Luckily, there are many hospitals that can help them with this.
If thepatient finds satisfaction with other tasks or services they can be discharged from the hospital at an appropriate time. If not, then it is time for them to decide if they want to stop nursing or if they want to continue as a nurse.
If the patient does not feel confident in making this decision, then it is necessary for them to go through a discharge review.
The patient must consent to the move
Before a patient can be refused discharge from a nursing home, he or she must consent to the move. If the patient does not consent, then it is up to the governing body of the home to determine if they can refuse admission.
If the patient cannot consent, then it is up to the practitioner to try and find another place for them to stay. This may mean going beyond the usual surroundings for patients and visiting patients, or even placing them in a care facility or group home.
In either case, there must be a good reason why the patient needs help in getting ready for retuning to society and what that requires. There must also be evidence that this helps prevent re-hospitalization or re-admission due to what they suffered at home.
Family members should try to arrange a move long before it occurs
When a patient is close to being discharged, there are several things family members can do.
Family members can try to arrange a move to another setting or even attempt to get the patient admitted into a nearby hospital. If the patient is in good condition, they may be able
to discharge the patient at their place of residence or a nursing home. At this point, both patients should be happy and comfortable with the other. A successful discharge is key to keeping the calm and confidence of both patients and family members.
If the patient is not in good condition or if it is too late for them to go transfer them, then family members should try to decide what would be best for them. Some people want certain care settings, and others do not. If one was not available, perhaps they could find another setting that was acceptable for them.
A doctor must confirm that the patient is stable for transport
When a patient is refused hospitalization or discharging by a nursing home, there may be a legal requirement for the doctor to confirm that the patient is stable for transport.
This law requires that hospitals ensure that patients who are refusing admission or who are not making progress when trying to recover are transferred to another hospital in case they need medical attention.
If the doctor does not believe that the patient is stable for transfer, he or she must notify the next-level health care provider such as a hospital or an ambulance service. This may help uncover an unrecognized problem at the nursing home such as breathing problems or sedation effects.
If transportation is required, it should be done as quickly as possible to prevent further complications such as confusion, fainting, and poor breathing.
The nursing home should discuss the possibility of a move with the family member(s)
When a patient is discharged from the hospital, it is important for the patient and family to discuss what steps they would like to take after discharge.
Some patients are comfortable moving around a little while before they feel ready, or if they have some other health condition that prevents them from walking. If this is the case for this patient, then it is best for them to be able to walk out of the nursing home in good health.
If this patient does not have a family member or person in good shape who can help set up care at another location, then it is best for the patient to be able to stay in the same place where they are comfortable.
A possible way for a patient who cannot safely stay at a nursing home but wants independence or a safe transfer to another location can go through an Assistance and Disability Determination (ADD) Process.
Before attempting to discharge a patient, the nursing home should have a plan in place for discharge
When a patient is ready to leave the facility, they should have a plan for that. This includes determining what services the patient will need while at home, how much help the patient will need at home, and how much money they will need.
There are several reasons why a nursing home may refuse to discharge a patient. One of them is when the patient has trouble transferring to an alternative care setting or independent living situation and another facility can help them regain independence.
Another reason why a nursing home may refuse to discharge a patient is when the patient has severe health problems that could not be treated in the facility and maybe there was an expectation that they would be treated at this patients home.
If the owner of the nursing home can no longer meets their patients needs at home, then it is time for them to go. A lot of people find this out around retirement years or after that had been their main care setting.