December 31, 2022

John is an 85 years-old male who has moderate dementia. His mini-mental score is 18.

John is an 85 years-old male who has moderate dementia. His mini-mental score is 18. He lives

at the local Nursing Home, on the Dementia Ward. It is a locked unit. He has few visitors except

for his daughter and son who live far away and can only visit in person once per year. Otherwise,

they do talk on the phone every 6 weeks. John is otherwise healthy physically. He has been

diagnosed with depression in addition to his moderate dementia. He has been a resident at the

Nursing Home for 2 years. He doesn’t talk much about his life before moving into the home.

Bill is an 87 years-old male. He has been admitted to the local Nursing Home, also on the

Dementia Ward, within the past month. He was brought to the home after leaving his stove on

and nearly burning down his home. He had been increasingly agitated at home, arguing with his

wife of 60 years, Mary. He has two sons and one daughter who are prominent members with

their community, who live busy lives and who are concerned about how others within their

community perceive the family.

Over the past 2 weeks it has been noticed that John and Bill keep ‘finding each other’ on the unit.

They have gone from following one another to holding hands. This past week they were caught

cuddling in the dining room. Staff have expressed concern that Bill may confused, and that John

is instigating the interactions with Bill. They also note that Bill seems less agitated, less confused

and, appears to be happy.

As the Manager-in-Charge of this Dementia Ward you have tried to make your own assessment

of the situation by talking with staff and residents; in addition, you reach out and contact both

families to discuss the issue. Both families are the substitute decision makers for the residents

and must be-in-agreement with any future care planning. John’s family is supportive of their

father being ‘happier’ and finding some meaning in his life, however Bill’s children are not

prepared to accept his emerging friendship with John. They want this to stop. Now. You have

however, noticed some understanding from Bill’s wife, Mary, although she understands that her

children are confused and upset.

Unfortunately, both John and Bill require a secure unit, and the Nursing Home only has one

available. Staff have also expressed their opinion, and you have identified a split amongst how

they feel about this issue (some for leaving things as they are, and some demanding John and Bill

be separated). They have no problem telling both families what they think. In addition, there are

some rumblings about the Unit that some of the other family members of residents are making

comments to Bill’s family.

How will you assess the situation, evaluate the issues and what decision(s) will you make?

SUMMATIVE A ASSESSMENT

SUMMARY OF THE ISSUE BEING REVIEWED

(Facts only)

ETHICAL ISSUES

(Present at least two opposing ideas or perspectives to this issue based on the facts)

BENEFICENCE