Case Study: Dementia
John Beauford is a 77-year-old divorced male. He moved to Florida after his divorce and has no contact with his former wife. He has no children, and his only sister lives in a distant state. They talk weekly on the phone but have not seen each other in several years. He attends church and volunteers at a community organization. He has several acquaintances but no close friends. Recently he has become increasingly forgetful but passes it off as a sign of aging. He is staying home alone more and more frequently, and often cannot remember whether he ate. He missed several meetings at the community agency because he forgot. When someone from the agency called him about his absence, he became angry and defensive, stating nobody told him there was a meeting. While driving home from church one day on a route he had taken numerous times, he became disoriented and lost. Trying to find his way home, he drove for more than 2 hours, failed to notice a traffic light, and was involved in a motor vehicle collision. He is transported to the emergency department of the closest hospital. He is unable to answer questions about his health history and becomes belligerent when different staff members ask him the same questions. However, he does not have life-threatening injuries, only some minor contusions. The emergency department staff find his driver’s license and Medicare card in his wallet, but no health information is available. There are business cards from the community agency. There is no information about Mr. Beauford in the computer system of the medical center. The healthcare team needs more information about his health history, current medications, allergies, and emergency contact(s). A computerized tomography (CT) scan of the head shows no head injury that would explain his behavior. A psychiatrist and social worker are consulted.
Discussion Questions
- How can the healthcare team obtain necessary information without breaching confidentiality?
- What are some ways the healthcare team can use to attempt to establish a trusting relationship with Mr. Beauford?
- Use a formal ethical decision-making process to determine what should be done regarding Mr. Beauford’s case and eventual discharge.
