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This webinar will focus on ethical and legal issues faced by physical therapists and physical therapist assistants when working with older adults. Rehabilitation of older adults is complicated by multiple issues, including frailty, cognitive impairment, diminished family and social support systems, access to resources, and issues related to living environment and safety. Decisions that need to be made for these older adults are not exclusively related to clinical issues. Rather, decisions must also take into consideration the complex interplay of issues related to contextual factors, as defined in the ICF model of Functioning and Disability, and must include sensitivity and expertise in identifying and responding to ethical and legal issues that impact geriatric care. Emphasis will focus on concerns that impact the patient, family, and caregivers, as well as mega-concerns including discharge planning decisions, issues in long term care, and end-of-life decisions. Reflection will be provided for the use of traditional and contemporary ethical theories, Codes of Ethics, and compassionate care. Legal concerns related to the impact of cognitive decline on autonomy, capacity and competency will be addressed, as well as discussion about the rights and limitations of various models of surrogate decision-making. Course participants will learn to recognize signs of elder abuse and will be given resources and information related to reporting of elder abuse. Strategies for addressing ethical and legal challenges to achieve a caring response will be discussed.
Course Objectives:
At the conclusion of this webinar, participants will be able to:
Identify ethical and legal concerns that impact on everyday physical therapy care of older adults
Apply a framework for ethical problem-solving that establishes the responsibility of the PT and PTA to identify, understand, and enact a course of action when working with older adults.
Apply contemporary ethical theories to guide decisions in the rehabilitation of older adults.
Identify and apply ethical principles contained in APTA's Code of Ethics, and Standards of Ethical Conduct for the Physical Therapist Assistant to ethical situations when working with older adults.
Recognize that the ability for older adults to make sound ethical and legal judgments about their healthcare may be compromised by frailty and cognitive decline, which may negatively affect judgment.
Differentiate capacity from competency.
Understand the need to balance respect for autonomy within the context of the older individual’s capacity to understand and make sound, safe ethical and legal decisions that take into account the impact on family, caregivers, and society at large.
Ethically apply validation and therapeutic lying in rehabilitation of persons with cognitive decline.
Distinguish the rights and responsibilities of surrogate decision-makers to participate in rehabilitation decisions for older adults
Recognize select ethical and legal concerns related institutional and societal constraints on the provision of physical therapy care for older adults.
Apply concepts of moral reasoning and ethical theory to a case study involving an older adult wishing to make a risky decision.
Recognize signs of elder abuse and understand reporting requirements in Pennsylvania.
Mary Ann Wharton, PT, MS - Mary Ann Wharton is currently a Physical Therapy Consultant, and also serves as Faculty for the University of Pittsburgh Medical Center’s Geriatric Physical Therapy Residency Program and Adjunct Faculty in the Physical Therapist Assistant program at the Community College of Allegheny County, Boyce Campus, Monroeville, PA. She is a physical therapy graduate of Ithaca College, and received a Master of Science degree in Leadership, with an emphasis in Geriatric Physical Therapy from the University of Pittsburgh. She served on the Pennsylvania Physical Therapy Association’s Ethics Committee for 26 years and as Chair for 24 years, with her term ending in January, 2019. She currently serves as Chair of PPTA’s Geriatric Special Interest Group.
Ms. Wharton has been an invited speaker on ethics for the American Physical Therapy Association’s Ethics and Judicial Committee, at APTA Combined Sections meetings, and at PPTA Chapter meetings. She has authored two book chapters addressing ethical issues in physical therapy: “Enhancing Professional Accountability: Inquiry into the Work of a Health Profession’s Ethics Committee,” in Educating for Moral Action: A Sourcebook in Health and Rehabilitation Ethics, edited by Ruth Purtilo, Gail Jensen, and Charlotte Royeen; and “Ethics” in Geriatric Rehabilitation Manual, 3rd edition, edited by Timothy Kauffman. She recently submitted a chapter, “Ethical Issues in the Rehabilitation of Geriatric Patients” for publication in the upcoming book, Rehabilitation Ethics for Interprofessional Practice, edited by Laura Lee Swisher and Charlotte Royeen. She also authored a self-study monograph, “End of Life Ethics” that is currently published on the APTA Learning Center. She has also published over 40 articles on ethics in various publications, including the PPTA Newsletter, GeriNotes, and Topics in Geriatric Rehabilitation.
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