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By Charles W. Lidz

In few areas in American society are adults so depending on others as in nursing houses. Minimizing this dependency and selling autonomy has turn into a huge concentration of coverage and ethics in gerontology. but every one of these discussions are divorced from the day by day fact of long term care and are implicitly in accordance with strategies of autonomy derived from acute therapy settings. selling autonomy in long term care, despite the fact that, is a fancy job which calls for shut consciousness to daily exercises and a primary rethinking of the that means of autonomy. This well timed paintings relies on an observational research of 2 sorts of settings which offer long term take care of the aged. The authors provide a close description of the organizational styles that erode autonomy of the aged. Their observations bring about a considerable rethinking of what the concept that of autonomy capability in those settings. The ebook concludes with concrete feedback on ways to bring up the autonomy of aged members in long term care associations.

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Rather, as urban areas grew in size and complexity, providing assistance for dependents in these areas became increasingly difficult. Consequently, larger dwellings were established for the more efficient care of this population. The first almshouses (or poor houses) were seen in cities like Boston, New York, and Philadelphia. These almshouses housed people so ill or disabled that they could not be maintained in the community, visitors who became too sick or incapacitated to travel, and an increasing number of dependents not manageable by less formal means.

There would no longer be any point to changing one's mind, of developing new interests, or of guiding the pursuit of old interests into new channels. "The self-monitoring and self-critical capacities, so essential to human nature, might as well dry up and wither; they would no longer have any function" (Feinberg 1984:211-212). 18 THE EROSION OF AUTONOMY IN LONG-TERM CARE Up to a certain point, greater amounts of liberty are, like health or economic wealth, generally valued. Feinberg offers three reasons why liberty has value (Feinberg 1986).

The rest of this book 38 THE EROSION OF AUTONOMY IN LONG-TERM CARE will focus on the impact of these institutions on the autonomy of the elderly individuals who live in them. NOTES 1. Of course, nursing homes are not the exclusive residence of the elderly. Many young and middle-aged disabled persons reside in these care settings. Our interest, however, is in the elderly receiving long-term care in nursing facilities. 2. Several theories have been proposed to explain this change in approach from community management to institutionalization.

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