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Using multidisciplinary teams to address ethical dilemmas with older adults who hoard
- Authors:
- KOENIG Terry L., CHAPIN Rosemary, SPANO Richard
- Journal article citation:
- Journal of Gerontological Social Work, 53(2), February 2010, pp.137-147.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Resolving conflicts between older people’s freedom to hoard versus their or the public’s safety, often falls to multi-disciplinary teams of professionals to address the ethical dilemmas posed. This article considers the current use of hoarding task force or team interventions, proposes an ethical decision making framework for use by these teams and others, and discusses the practice implications whilst implementing this framework. The authors present a case vignette of Mrs M, developed as a composite of hoarding cases analysed in the literature reviewed, and analyse it using the ethical decision making framework they advocate in this paper. Important factors to be considered are who is the client - Mrs M or Mrs M and her neighbours, what are the facts, whose account is to be believed, what motivates differing accounts, who should intervene, what will be the consequences, and what are the alternatives to intervention? Three key implications for practice are discussed. Effective ethical decision making must balance the rights and responsibilities of the multiple actors involved, say the authors. In addition, competent practice relies on a realisation that interpersonal relationships between professionals and clients and amongst professionals are the vehicles which create probable solutions to such ethical dilemmas. Finally, the use of a consistent framework by teams changes practice from individual interventions to the development of policies and system change based on good practice.