1. 275 words
As a professional counselor, it is possible that you may experience the death of an older adult client due to natural causes, suicide, or other circumstances. What are some potential ethical and confidentiality issues that may arise in the event of an older adult client death? For example, someone may seek client records due to the death of the client. What are some ways that counselors can cope with a client death? Please list at least two resources counselors can use to cope with a client death to share and discuss with the class.
2. 275 words
Write a short scenario that gives a fictional example of an ethical or legal issue you could encounter when working with an aging or vulnerable adult client. Describe what you could do to protect yourself in a situation similar to the scenario you describe.
Human Sexuality
Question 1
In therapy, counselors develop an authentic connection with their clients hence when a client dies, it is normal to grieve. An ethical issue that may arise when a client dies is if a family member or spouse requests to view the client’s records. Even in death, the counselor is expected to uphold the privacy and confidentiality of the client’s information. All counselors should resist disclosing any private information discussed during counseling sessions except in cases where a court order is provided or when the client had specifically stated that the information should be disclosed upon his or her death (Sperandio et al., 2022).
Confidentiality issues may also arise if the counselor chooses to openly mourn the death of a client. For instance, when a counselor goes to the funeral, the relatives and friends of the deceased may want to know how the counselor knew the deceased and this may create an uncomfortable situation where the counselor may be forced to lie or break confidentiality. If a counselor chooses to cross the professional boundary by visiting the family members or going to the funeral ceremony, precautions such as consultation, supervision, and documentation must be taken. The documentation should provide the rationale for the action and any anticipated benefits and consequences that may arise. Documentation can be used in case unintentional harm occurs to the clients’ family members. Counselors can grieve their clients by talking to their supervisors, seeking for support from their peers, or even attending therapy sessions to help process the grief. Engaging in self-care by getting more rest, exercising, and eating well can also be effective (Sperandio et al., 2022).
Resources for Counselors
- The American Counselling Association knowledge center provides grief and loss resources for counselors and members of the public. https://www.counseling.org/knowledge-center/mental-health-resources/grief-and-loss-resources
- Hospice and Community Care is an organization that provides online grief resources for adults.
https://www.hospiceandcommunitycare.org/grief-and-loss/grief-links/
References
Sperandio, K. R., Goshorn, J. R., Moh, Y. S., Gonzalez, E., & Johnson, N. G. (2022). Never ready: Addictions counselors dealing with client death. Journal of Counseling & Development. https://doi.org/10.1002/jcad.12440
Question 2
Scenario
Patrick is an 80-year old man who was brought in for counseling sessions due to severe anxiety and depression associated with his wife’s death. Before the death, Patrick was fairly independent due to good physical and cognitive health. He could perform all tasks of daily living with no help. However, after his wife’s death, he stopped eating or taking his medication. His appearance was disheveled and he seemed weak, starved, and dehydrated. In one of the counseling sessions, he revealed to me that he stopped taking his medicine because he wanted to die and join his wife. He also revealed that he no longer cared about food or cleaning himself up because he did not was no longer motivated to do so. Moreover, he said that he trusts me to keep his secret because he no longer has the will to live and as his counselor, I am expected to do so.
Course of Action
The ethical issue in the scenario is confidentiality. Jones and Knowles (2021) explain that when working with older clients, counselors are expected to maintain the confidentiality of any information discussed. However, counselors are also mandated reporters of cases involving elder abuse and neglect. In the scenario, the client has neglected himself and his actions are an example of self-harm. The client has stopped taking his medication because he wanted to die hence he demonstrated suicide risk. As a counselor, the best course of action is to report the case as self-harm and suicide risk to the relevant authorities. I would also inform the client that one of my roles as a counselor is to ensure that he does not harm himself or others and that breaking confidentiality was a way of protecting him.
References
Jones, D., & Knowles, A. (2021). Ethical dilemmas working with older adults: In-depth interviews with Australian psychologists. Australian Psychologist, 56(6), 472–484. https://doi.org/10.1080/00050067.2021.1990734