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Big Issues

conditions surrounding their medical situation will involve the kind of medical attention required, and the capability of the caregiver to administer the requirements.
Does the primary medical professional have the right to decide? William Coch believes so. Firstly, if an elderly has no relative, he should be in a nursing home. However, when there are relatives involved, a lengthier and more complex decision-making process takes place. Based on Coch’s experience, most of his patients look to him for the final decision. He positions it as “doctor’s orders.” If such is the paradigm, it takes away the emotions involved from the point-of-view of abandonment vs. capability to care. It objectifies the decision, and makes it a part of the elderly patient management (Frontline, 2006).
Does the immediate relative have the right to decide? If the presence of a relative is available, then by all means should be consulted. However, the primary medical professional still gets involved with the conversation, if at a minimum to provide a professional prognosis of the elderly’s medical condition, and if requested, can provide a professional medical opinion as an advocate (Frontline, 2006).
In conclusion, the best decision will be made by the three players: the sensible elderly, the primary health provider and the primary caregiver relative. It should be a decision based on consensus, where all parties will agree to an objective – the level of quality for end-of-life.
US Bureau of Census (2010). Persons 65 Years Old and Over--Living Arrangements and Disability Status: 2007. Retrieved on May 2, 2010 from ...Show more


Based on the US Census of adults aged 85 and above, 45.2% of the 4.9 Million population were living in institutionalized care while the rest shows the elderly living alone or with a relative (2004). Given the almost 50-50 split, who is the right person to decide for the living…
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