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Introduction
Imagine you are a home healthcare worker employed by Ministering Angels Health Services. You have been assigned a new client, and we’ll call her Mrs. Evans. She is 86 years old and suffered a stroke. She was recently at a skilled nursing facility but her Medicare benefits ran out and she is now receiving home health care. She needs a lot of assistance with daily living activities and is mostly wheelchair-bound.
Mrs. Evans lives in a trailer home with her 88-year-old husband, who, shortly after Mrs. Evans was assigned a home health worker, suffered a heart attack and is now in a nursing home.
Mrs. Evans is concerned about her husband and depressed about her situation. She insists on visiting her husband every day for 4 to 6 hours; she is driven there by friends and family. No one can convince her to visit less often or for shorter times. These lengthy visits are interfering with her own rehabilitation, and she is increasingly missing appointments with you and with other care providers. She maintains that her husband was always with her while she was hospitalized, and she can do no less for him. She becomes agitated and upset at any suggestion she should curtail these visits. She has become very attached to you and begs you not to “abandon” her, as she puts it, and struggles to comply with your directions for her care and safety. Mrs. Evan has repeatedly asked you to juggle her appointments with other care providers to allow visits to her husband.
Medicare’s guidelines for clients to receive home health under Part-A Insurance Plan require them to meet certain “homebound” criteria. Homebound status is officially described as,
There exists a normal inability to leave home and, consequently, leaving home would require a considerable and taxing effort. If the patient does in fact leave the home, the patient may nevertheless be considered homebound if the absences from the home are infrequent or for periods of relatively short duration, or are attributable to the need to receive health care treatment. (Home Health Services, 1989)
Medicare is a federal health insurance program for people who are 65 or older. Although a Medicare tax is deducted from workers’ pay, these premiums do not begin to cover the cost of Medicare. Steuerle and Quakenbush (2018) estimate that by 2030, male retirees will receive $221,000 more in lifetime benefits than they paid into Medicare, while female retirees will take home $263,000 on top of what they contributed.
Ministering Angels also has specific requirements that you document facts and events as you go about your daily work, including concerns about the client’s environment, safety hazards, and anything out of the ordinary that happens with the client while you are with her.
As an ethical critical thinker, how should you respond to Mrs. Evans?
In this assignment, you will consider your personal ethics as you evaluate a real-life situation that might be presented to you as a healthcare professional.
Respond to each of the following elements:
Laws, Rules, and Regulations: List all the laws, rules, or regulations you believe apply to this situation.
Stakeholders: List the stakeholders—those who will be affected by any decision you make.
Obligations: List those to whom you believe you have a personal or professional obligation—for example, Mrs. Evans, in rank order, with the highest obligation first, then in descending order to lowest obligation.
Priorities: Briefly explain the choices you made in Three. For example, why is Mrs. Evans—if she is your first obligation—highest in priority? Why is the lowest-named entity in last place? No more than 80–100 words.
Ethical Approach: Briefly discuss the approach you see as most appropriate here —rule-based, consequence-/outcome-based, or virtue-based. If you believe more than one applies, so state. Briefly explain your choice. No more than 80–100 words.
Your Decision: Having considered the rules and the consequences of following or not following them, discuss what course of action you believe you are obliged to take. Of all the courses of action she might take, what course of action do you think she should take? Explain why you think this is what you must do. No more than 150–200 words.
Writing Requirements Length: 1.5-2 pages (all six elements)
1-inch margins
Double spaced
12-point Times New Roman font
Title page
References page (lesson/textbook citation and outside source citation in APA format)
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