What Caregivers need to know about Ethics

The Declaration of Human Rights as outlined by the United Nations highlights a number of principles that should be followed in life and in the caregiver role. These principles include respecting the beliefs, dignity and freedom of choice of others. The Global Alliance for the Rights of Older People outlines human rights that are particularly relevant to older adults. They are as follows:

• right to freedom of discrimination
• right to freedom of violence
• right to choice and to make informed decisions
• right to social security
• right to health and the empowerment of persons with disabilities
• right to work, equal opportunity and integration into society
• right to property and inheritance

Our rights do not change as we grow older. What does change is that older women and men are considered to be inherently less valuable to society. At the same time, as people get older, they face increasing barriers to their participation, become more dependent on others and lose some or all of their personal autonomy. These threats to their dignity can make them more susceptible to neglect, abuse and violation of their rights.

Older people face very specific threats to their rights in relation to age discrimination, for example, in access to health care, in employment, in property and inheritance rights, in access to information and education and in humanitarian responses. Older people also face particular forms of violence and abuse. They face particular threats to their rights in care settings and as carers themselves.

The Global Alliance for the Rights of Older PeopleCommon Terms and Definitions

Age discrimination: Age discrimination occurs when a person is treated differently, with an unreasonable or disproportionate impact, because of their age. For example, upper age limits on credit cards or programs that prohibit older adults access to financing is considered age discrimination.

Ageism: Ageism is stereotyping of and prejudice against older people that can lead to age discrimination. We see ageism when people are patronised on TV and in advertising or talked down to in care settings.

Multiple discrimination: Older men and women often face discrimination that is based on two or more factors, such as age, gender, ethnic origin, economic status, disease status and literacy level. Older women are typically more vulnerable to this type of discrimination than older men.The Care Receiver As A Whole Person

Sometimes, without noticing it, the caregiver may begin to view the care recipient through the lens of his or her illness rather than as a whole person. The traditional relationship with the medical system, which places emphasis on treating conditions and diseases, reinforces this.

In your role, it is necessary to take a more holistic approach. Remind yourself that medical terms and procedures do not define the person in your care. Rather, the person in your care should be seen as a whole person—with an identity and a rich background of life experiences. Here are three ways you can encourage a holistic relationship:

1. Encourage independence: For both your sake and the care recipient’s, try not to “over-care.” You will need to find the right balance in providing necessary care without taking away the care recipient’s self-respect.
2. Reward independence: Acknowledge the care recipient when he or she manages a challenging task, which may or may not be challenging for you or others.
3. Respect the nature of the relationship: When, particularly, adult children become the caregivers, there can be an odd sense of trading places. But it’s critical to remember that your parents are not children. They may not function as well as they once did, but they have mature adult minds. The job of the adult child is to respect, assist and offer support.

Cultural Differences

Depending on your cultural background, giving and receiving care can be practised in a variety of ways. For example, factors such as whether the care recipient speaks the language of his or her origin, how long the care receiver has lived in Canada, his or her value system and cultural perceptions of health can all influence caregiving.

It’s crucial to be sensitive to and respect your care recipient’s culture and values. When caring for another person, try not to assign values such as better, worse, right or wrong to their beliefs. The person’s beliefs may be different than yours, but they belong to the individual (and are very important to him or her).

Differing values

You may find that the person you care for has a different set of values than you do. These may include:

•  Emphasis on family responsibility
  Many cultures value family as a whole above individual members of the family. So, caregiving is considered a function and expectation of children. In certain parts of Canadian culture, however, there is less visible pressure on children to care for their aging parents.
•  Privacy
  Many cultures prefer to keep medical matters within the family if they consider them private. Talking about private issues to a support group, therapist or even a family physician can be uncomfortable. This situation puts many aging adults at risk of social isolation.

•  Past and future
  Some older adults may idealize the past, while the care receiver may be more focused on the future possibilities. For example, the caregiver may not want the care receiver to discuss issues of the past and may discourage this, which can lead to social isolation.
•  Language barriers
  In the case of language barriers, you may avoid looking for respite over fear that the respite care worker will not be able to understand the care receiver. In this case, it may be helpful to provide both your care recipient and the respite care worker with a list of basic words in the languages used so that the care receiver can point at what they need.