Ethical issues in the nursing home.

The nursing home is the site of many ethical dilemmas. The majority of these are linked to the high prevalence of dementia and other disorders that affect decisional capacity, thus dictating the need for surrogate decision-making. Even when nursing home residents have utilized advance directives to guide their future care, many issues remain in the decision-making process. This article explores the challenges of medical decision-making for a frail elderly population.