Question

Answer the following questions based on aging/elderly

1- Should people have the choice to end their lives?

               

3 What happened during the important Terry Schiavo Case? Why was this case so important?

4 Explain the following:

Advanced directives

Living will

Health care proxy

Durable power of attorney

5 Talk about the impact of depression on suicide for the elderly

6 What is the generational equity debate? What does this debate say about inheritance?

7 Can you describe some of the effects of race, class and gender on aging?

8/9 Should age or need be the basis for entitlement?

                Give the arguments that could be made and also your own view

10 What are the effects of politics, networking, interest groups on our current views of aging?

Answer 1

  

Ans 1)

In these times, many seniors and elderly are contemplating the idea of ending their lives on their own terms with dignity. The concept of rational suicide is highly controversial as it runs counter to many societal norms, religious and moral convictions. Although some elderly people might decide that the suffering and indignity that characterize their lives are not sufficient reasons to end their lives, other people in the same situation will deem their condition unbearable. The decision about whether to continue living in such conditions is amongst the most important that one can make and the end decision is highly subjective. Allowing people the right to end their lives might Not be the right approach. The balance between the wish to die and the wish to live is a dynamic one that shifts frequently, moment to moment, week to week. Suicide prevention experts infer that while it is normal to think about death as we age, the contemplation of suicide indicates that people need help. They rightly argue that all suicides should be avoided by addressing mental health issues and helping seniors live a rich fulfilling life. Promoting rational suicide is not the right thing to do as it will create a sense of obligation for older people to use that method rather than accept better alternatives that address their concerns in other ways.

Ans 3)

Terry Schiavo, a severely brain damaged woman from Florida, became a national symbol for 'how not to die in America'. At its core, the case was a family matter. Schiavo had been kept alive by a feeding tube after collapsing in 1990 from full cardiac arrest that deprived her brain of oxygen. She was diagnosed as being in a persistent vegetative state. Her husband Michael Schiavo argued that his wife would never want to live like that and attempted to get her feeding tube removed. Her parents disagreed and fought to keep her alive. The case languished inside courtroom for years. It all culminated with President George W. Bush signing a bill that would allow the case to be heard in federal courts. Eventually the courts agreed with Michael and allowed her feeding tubes to be removed. Schiavo died on March 31, 2005. After her death, Congress all but stopped trying to pass a law banning aid in dying. A majority of Americans at that time disapproved the President's role in the issue saying that politicians should stay away from a relationship involving families and physicians. The Terri Schiavo case was a turning point for Americans thinking about their own end-of life decisions. Her case brought into question the role of the government in end-of-life choices. In the months following Schiavo's death there was an increase in written advance directives - documents that instruct family members on what to do in end-of-life situations. It also sparked debates about the benefits of prolonging life at all costs. In the wake of Schiavo's case, it became abundantly clear that most Americans supported the idea that state and federal governments should allow people to make end-of-life choices for themselves.

Ans 4)

a) Advanced Directives - These directives are related to treatment choices and the role of a surrogate decision-maker in the event that a person is incapable of making medical decisions on their own.

b) Living Will - This is a written document the specifies the desired medical treatment. A living will can be very specific or very general. The most common statement in a living will is to state that : 'If I suffer an incurable, irreversible condition and my attending physician deems my condition terminal, I direct the discontinuation of life-sustaining measures that would prolong my dying.' More specific living wills may include information regarding an individual's desire for such services such as analgesia, antibiotics, hydration, feeding and the use of ventilators.

c) Health Care Proxy - It is a legal document in which an individual designates another person to make healthcare decisions for the individual in case he or she is rendered incapable of making their wishes known.

d) Durable power of Attorney - It is the third type of Advanced Directive . Individuals may draft legal documents providing power of attorney to others in the case of an incapacitating medical condition. It enables an individual to make financial transactions on behalf of the individual who is medically incapacitated.

Ans 5)

Depression is common in the elderly and is a major public health problem. Depression in later life is associate with significant morbidity, including deficits in a range of cognitive functions and considerable function influence on functional impairment and disability. In the case of the elderly, suicide ideations, suicide attempts and completed suicides occur most frequently in the context of severe depression. Psychological autopsy studies have found depression to be the most common psychiatric diagnosis in elderly suicide victims and suicide attempters. Life problems for the elderly do not occur in isolation. Suicide is the end-point of prolonged physiological and psychological problems. Depression is a common mediating factor between life problems and suicides in older people. In such cases an individual's personality factors might determine how he or she reacts. The detection of depression that ends in suicide in the elderly is more challenging as they are less likely to communicate their moods and intents with others. Hence it is essential to encourage communication with the elderly in order to gauge any stress or depressive moods that they might be experiencing. It is imperative that the elderly are exposed and made aware of suicide prevention teams, hotline services, NGO's , centres for the elderly and general practitioners that can greatly benefit them in testing times. In conclusion, depression is a common but frequently neglected condition in the elderly. Improved detection and early interventions are crucial in preventing suicides and suicide attempts.