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Ethical Considerations When Working With Older Adults in Psychology

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The article, “Ethical Considerations When Working with Older Adults in Psychology” by McGuire discusses some of the ethical considerations that practitioners, specifically psychotherapists, should consider, when providing psychological assistance to elderly people. McGuire can be said to have been driven by the projected increase of the elderly population in the United States of America by the year 2030, when writing this article. According to the US Bureau of the Census, the population of the elderly in the United States of America is projected to double by the year 2030 from the current number.

In the year 2000, the Census report indicated that there were 35 million elderly people in the United States of America. This is projected to increase to 70 million within the next two decades. In fact, the number of the elderly people above the age of 85 is projected to comprise the highest percentage in the total number of elderly people above the age of 65. For this reason, McGuire indicates the need for psychotherapists to gain knowledge concerning how to deal with psychological problems that affect the elderly in an ethical manner. McGuire points that currently, many psychotherapists do not have the required knowledge of dealing with psychological problems that affect the old people. This can be true, because over the past decades, since the end of the Second World War, the population of the United States of America has been characterized by a large number of young people, due to the effects of what is commonly referred as ‘the baby boom generation.’

It is, therefore, clear that many psychotherapists have been concentrating on acquiring psychological knowledge concerning dealing with psychological problems facing individuals in their young-age and adulthood: before they approach the old age. Nevertheless, McGuire refers to the guidelines provided by the American Psychological Association, which psychotherapists can use when dealing with psychological problems, which affect the old people. These guidelines are “attitudes, general knowledge about adult development, clinical issues, assessment, intervention, and education” (p.112).

In the literature review, McGuire observes that many elderly people suffer from cognitive disorders as they age. In fact, the prevalence rate of cognitive disorder increases, as the elderly people grow older and older. Medical reports indicate that the percentage of prevalence rate of cognitive disorders among the elderly is between 24 and 47 percent for those above the age of 75. Moreover, the prevalence rate of cognitive impairment among old people in acute medical facilities is between 40 and 50 percent. For the old people in long-term care settings, 65 to 90 percent suffer from psychiatric disorders, such as personality disorders, depression, and organic brain syndromes, such as dementia (McGuire, 2009, p. 113).

In the article, I have learnt that the vulnerability of older adults to psychological problems may be increased due to exposure to certain situations. For instance, McGuire points that chronic or disabling diseases, feelings of loneliness, or financial difficulties may increase an individual’s level of vulnerability to psychological problems. For this reason, McGuire points that psychologists should first assess the level of vulnerability of an elderly person, before allowing them to participate in research. This is because; individuals with high levels of vulnerability are likely to depend on their health care providers, thus participate in a research with limited knowledge concerning its implications.

Moreover, I have learnt that contrary to what many health professionals recommend to old people: that they should refrain from physical activities, old people should engage in physical activities, because they assist them in increasing their wellbeing. Studies indicate that engagement in physical activities is beneficial to all age groups, including the old people. Therefore, for old people to reduce their levels of vulnerability to problems associated with old age, they should engage themselves with physical activities, such as less aggressive exercises and light domestic tasks.

In addition, I have also learnt that people can stay sexually active even in their old age. Therefore, as medical professionals deliver health care services to old people, they should consider addressing their sexual needs. According to McGuire, many medical professionals ignore this bit, because they think that old people do not engage in intimate relationships. However, this is all a misconception. Such misconceptions may result to wrong diagnosis, which in return, results in poor treatment hence increasing an individual’s level of vulnerability. In my opinion, medical professionals, specifically psychotherapists should embark on acquiring more knowledge concerning how they can do away with these misconceptions by developing simple and applicable ways of fulfilling physical (engagement in physical activities) and sexual needs of the elderly persons in order to reduce their levels of vulnerability to old age related problems.

McGuire also addresses age-related bias that is associated with providing health care to old people. Studies indicate that old people experience different kinds of age-related biases. The APA ethics Code, which provides ethical guideline to medical professionals, states that a psychologist should desist from engaging in any form of age-related biasness. However, interestingly, studies indicate that a lot of ageism: stereotyping of, or discrimination against people based on their age, is very high among medical professionals. A self-report survey conducted in 1989 by Pillemer indicated that a significant percentage of medical professions engaged in physical and/or verbal abuse when providing health care to old people.

This is astonishing, because medical professionals are usually entrusted with the responsibility of not only providing health care services (diagnosis and consequent treatment of a disease being suffered from), but also providing holist care, which entails fulfilling the mental, social, emotional, spiritual, and physical needs of the patients. By depicting such a behavior: ageism, medical professionals encourage other people in the society to engage in it as well. This is the reason as to why cases of inadequate health care, verbal and physical abuse and discrimination of old people by their family members or relatives are very common. Aging is a natural process, which human being has no control over. Therefore, instead of abusing or discriminating old people, when providing them with health care, medical professionals as well as other members of the society should practice good ethical behaviors bearing in mind that one day, they will also require somebody to take care of them in an ethical manner.

McGuire’s article is consistent to what we have learnt in class. For instance, McGuire states that medical professionals should adhere to medical ethics concerning obtaining of informed consent, disclosure of patient’s medical information, privacy, and confidentiality of patients. In addition, McGuire acknowledges that cognitive impairment increases with increase in old age, thus while providing medical and health care, medical professionals as well as caregivers should assess the cognitive ability of their patients in order to increase the probability of making the right diagnosis and consequently providing the right treatment.

It was interesting to find out that many psychologists do not have sufficient knowledge about the aging process and the issues related to old age. This raised a very interesting question to me, because, at first, I thought that psychologists should be aware of all aspects, which involve human beings since their main responsibility is to study human behavior and provide psychological assistance to individuals suffering from conditions, which are related to human behavior. This can be compared a teacher who does not have sufficient knowledge about the subject he/she specializes in. Nevertheless, in my opinion, during their training, psychologists should endeavor to learn everything about human behavior and issues surrounding human behavior for all age groups. This could help them acquire sufficient knowledge for dealing with psychological problems related to all age groups.

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