Human Rights of Vulnerable Elderly Adults in Healthcare
This essay examines the ethical and human rights dimensions of care for vulnerable elderly adults in healthcare settings, using a vignette case study of Mr. Jones, a 74-year-old man with terminal lung cancer who chooses to die at home under hospice care. Drawing on the biopsychosocial model of healthcare delivery, the paper explores tensions between physical needs and patient autonomy, the adequacy of clinical versus home-based palliative care, and broader systemic issues including understaffing, lack of resources, and family involvement. The essay identifies key ethical concerns—autonomy, chronic disease, pain management, fear, and human rights—as fundamental to best practices in elderly care.
- Introduction: Overview of ethical issues and essay approach
- Case Study: Mr. Jones, Age 74, End-Stage Cancer: Clinical vignette of terminal elderly patient
- An Issue of Human Rights: Systemic human rights concerns in elder care
- Autonomy, Palliative Care, and Patient Rights: Patient choice versus institutional care pressures
- Conclusion: Summary of ethical themes and future proposals
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What makes this paper effective
- Uses a concrete vignette case study to anchor abstract ethical and human rights arguments, making the analysis accessible and grounded in real clinical detail.
- Integrates multiple ethical dimensions simultaneously — autonomy, pain, fear, resource scarcity, and family dynamics — without losing the thread of the central argument.
- Applies the biopsychosocial framework explicitly, demonstrating awareness of holistic care models in gerontological and palliative care contexts.
Key academic technique demonstrated
The paper employs a case-study-driven ethical analysis: it introduces a realistic clinical scenario and then uses it as a lens through which broader policy and human rights questions are examined. This technique allows the writer to move fluidly between the particular (Mr. Jones's situation) and the general (systemic failings in elder care), giving both descriptive and normative dimensions to the argument.
Structure breakdown
The essay opens with a framing introduction that states its purpose and perspective. It then presents the case study with clinical specificity before shifting into a broader discussion of human rights and systemic care quality issues. The final section synthesises the case study's implications for policy, identifying key ethical themes as the basis for future best-practice proposals. References follow APA formatting throughout.
Introduction
This essay discusses the ethical issues surrounding vulnerable adults in healthcare settings. It adopts the perspective of a vulnerable adult who is given a choice between a formal healthcare setting and the healthcare setting of his own home during his final days. Using a vignette case study, the human rights of an elderly patient are examined. Often, the issue of elder care involves questions of whether an adult's biophysical needs supersede their psychological needs, essentially coming down to a tension between autonomy and physical care requirements. The rights of elderly patients in healthcare are explored through the case study, with relevant discussion of human rights for elderly individuals requiring health services.
Case Study: Mr. Jones, Age 74, End-Stage Cancer
End-of-life issues for the elderly present a range of ethical challenges for elder care management. The biopsychosocial model of healthcare delivery offers a holistic approach to addressing the issues faced by elderly patients (Matsuoka, Otsuka, Koyama, Hatabe, Funai, & Tanaka, 2010). While health concerns are certainly of great interest — especially those relating to the unique physiological needs of aging — another primary concern is the psychological health of the patient, including their rights in healthcare decision-making (Monod & Sautebin, 2009).
Mr. Jones is a 75-year-old widower diagnosed with terminal cancer — specifically, adenocarcinoma of the left lung, which has metastasized to his liver, brain, and spleen. He lives alone, though he has two grown children. He has expressed a desire to die at home and has engaged hospice services for palliative care during his final days. Despite living in an affluent area, he appears to have little food available and limited funds for medication. Mr. Jones does not wish to have his children involved in his care. He is experiencing pain, shallow breathing, impaired bowel function, impaired gas exchange due to his diagnosis, and impaired home management.
Crisis intervention by the hospice nurse helps secure his pain prescription using Medicare funds. Though Mr. Jones is aware of the limitations of hospice care and understands the nature of his illness, he refuses to be admitted to a sub-acute care unit. He also refuses to sign a Do Not Resuscitate (DNR) form. Mr. Jones takes Percocet and Duragesic for pain management. Other interventions include obtaining a supply of Ativan and Roxanol, though Mr. Jones is advised not to use them without explicit instructions. Oxygen is also ordered. Daily home health aide visits are requested, along with a social worker consultation. Daily nursing visits are planned for medication instruction and evaluation. The on-call nurse is advised of the situation and asked to telephone Mr. Jones in the evening to answer questions and to make a visit if needed. A team meeting of hospice workers follows the next day.
An Issue of Human Rights
An increase in the aging population is occurring throughout the world (Kelly, 1997). Longer lifespans bring with them the diseases of aging, often requiring intensive care for the elderly patient (Voelker, 2010). Older people are associated with an increased risk of hospitalisation due to illness or trauma (Seymore & Cannon, 2010). The nature and burden of illness that an older person faces is related to the quality of healthcare services they may receive when admitted to a hospital or other clinical setting (Dossa & Capitman, 2010). In terminal cases, the patient may choose to engage hospice services, either in the clinical setting or at home. The human rights of such patients are ethically fundamental to their quality of care through palliative care services (Brenna, Carr, & Cousins, 2007).
The care received in clinical healthcare settings for elderly patients may be substandard due to staffing and regulatory issues (Maas, Specht, Buckwalter, Gittler, & Bechen, 2008). There is a need to identify failings in quality of care and to promote the human rights of elderly patients in healthcare settings (Gittler, 2008).
Conclusion
The ethical issues surrounding vulnerable elderly adults in healthcare settings are multifaceted, encompassing autonomy, resource access, pain management, and the right to dignified end-of-life care. Mr. Jones's case illustrates how the biopsychosocial needs of an elderly patient — his desire to die at home, his refusal to involve his family, and his insistence on directing his own care — can come into tension with institutional practices and resource constraints. Addressing these tensions requires that healthcare providers, policymakers, and hospice workers commit to recognising and upholding the human rights of elderly patients as a foundational principle of quality care.
References
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Brenna, F., Carr, D., & Cousins, M. (2007). Pain management: A fundamental human right. Anesthesia and Analgesia, 205–221.
Dossa, A., & Capitman, J. (2010). Community-based disability prevention programs for elders: Predictors of program completion. Journal of Gerontological Social Work, 235–250.
Gittler, J. (2008). Governmental efforts to improve quality of care for nursing home residents and to protect them from mistreatment: A survey of federal and state laws. Research in Gerontological Nursing, 264–284.
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Kelly, D. (1997). Our future society: A global challenge. Circulation, 2459–2464.
Maas, M., Specht, J., Buckwalter, K., Gittler, J., & Bechen, K. (2008). Nursing home staffing and training recommendations for promoting older adults' quality of care and life: Part 1. Deficits in the quality of care due to understaffing and undertraining. Research in Gerontological Nursing, 123–133.
Matsuoka, H., Otsuka, M., Koyama, A., Hatabe, S., Funai, S., & Tanaka, A. (2010). The role of psychosomatic medicine doctors in palliative care medicine — two case reports. Cancer and Chemotherapy, 359–362.
Monod, S., & Sautebin, A. (2009). Aging and becoming vulnerable. Revue Medicale Suisse, 2353–2360.
Seymore, C., & Cannon, S. (2010). Student-facilitated health promotion intervention for chronic disease self-management at-risk elders: Reflections from the field. Journal of Allied Health, 120–128.
Voelker, R. (2010). Ethnic shifts raise issues in elder care. Journal of the American Medical Association, 303–321.
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