Veith L R, Blair C A, Leonard N V, Bouma R, Pazda H H
National Case Management Partnership, Bristol, CT 06011-2360, USA.
J Case Manag. 1996 Fall;5(3):115-20.
The complex issues of long-term care are everchanging, with no one discipline having the corner on all the intricate options, regulations, and ethical choices that often confront an aging person. This is most critical when a person's incompetence requires the appointment of a conservator or guardian. When the probate court finds it necessary to appoint a conservator/guardian for an older adult, and family or other informal caregivers are unavailable or unable to assume the role, the responsibility is often delegated to an attorney. However, an attorney's expertise is in the field of law, not necessarily in the complex and intricate long-term health care system. Maintaining a mentally incompetent and functionally disabled person in the safest and least restrictive environment is demanding. It requires a thorough knowledge and understanding of the physical and emotional changes associated with the aging process, an area of expertise of long-term care case managers. Combining the clinical proficiency of the case manager with the legal and financial expertise of the attorney benefits the conserved older adult. This article illustrates this collaborative approach to long-term care through the use of several case histories.
长期护理的复杂问题不断变化，没有哪一个学科能垄断所有复杂的选择、规定以及常常困扰老年人的伦理抉择。当一个人的无行为能力需要指定一位财产监管人或监护人时，这一点最为关键。当遗嘱检验法庭认为有必要为一位老年人指定财产监管人/监护人，而家人或其他非正式护理人员无法提供或无法承担这一角色时，责任往往就会委托给一名律师。然而，律师的专业领域是法律，不一定是复杂且精细的长期医疗保健系统。将一名无行为能力且功能残疾的人安置在最安全且限制最少的环境中是一项艰巨的任务。这需要对与衰老过程相关的身体和情感变化有全面的了解，而这正是长期护理个案管理员的专业领域。将个案管理员的临床专业知识与律师的法律和财务专业知识相结合，对被监管的老年人有益。本文通过几个案例历史说明了这种长期护理的协作方法。
