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Long Term Care and Alzheimers Disease

Develop 2-4 pages Memorandum to evaluate the managerial issue and to answer the questions. Make sure to provide credible evidence supporting your recommendations and conclusions. Do not copy the case in the memo, but make sure to refer to its number for the faculty to have a reference for grading.
Mr. Parker is an 88-year-old resident of your LTC home with end-stage Alzheimer’s. He is wheelchair bound and spends most of his days sleeping in his wheelchair near a window facing the garden. He needs to be spoon fed but has recently started to refuse to eat. Mr. Parker has three children, one of whom is very involved in the care of her father. The team approaches the daughter about her father refusing to eat, and feels that his refusal is legitimate. Thus, they propose changing the plan of care to palliation. The daughter absolutely refuses, claiming that “you cannot kill my father, I want everything done to keep him living!”
What are some of the ethical issues in this case?
 Do we know whether the resident is capable to make his own health care decisions?
 Are there any known wishes from Mr. Parker? What would he want? What are his values?
 Is his daughter the substitute decision-maker? Can she, in this role, demand treatment and expect that you comply

Sample Solution

a) The auditor should acquire knowledge of the regulatory environment in which the bank operates. Thus, the auditor should familiarize himself with the relevant provisions of applicable laws and ascertain the scope of his duties and responsibilities in accordance with such laws. He should be well acquainted with the provisions of the Banking Regulation act, 1956 in the case of audit of a banking company as far as they relate of preparation and presentation of financial statements and their audit. b) The auditor should also acquire knowledge of the economic environment in which the bank operates. Similarly, the auditor needs to acquire good working knowledge of the services offered by the bank. In acquiring such knowledge, the auditor needs to be aware of the many variation in the basic deposit, loan and treasury services that are offered and continue to be developed by banks in response to market conditions. To do so, the auditor needs to understand the nature of services rendered through instruments such as letters of credit, acceptances, forward contracts and other similar instruments. I. Obtaining internal audit reports, inspection reports, inspection reports and concurrent audit reports pertaining to the bank/branch. II. Obtaining the latest report of revenue or income and expenditure audits, where available. III. In the case of branch auditors, obtaining the report given by the outgoing branch manager to the incoming branch in the case of change in incumbent at the branch during the year under audit, to the extent the same is relevant for the audit. c) RBI has introduced and offsite surveillance system for commercial banks on various aspects of operations including solvency, liquidity, asset quality, earnings, performance, insider trading etc., and has indicated that such reports shall be submitted at periodic intervals from the year commencing 1-04-1995. It will be appropriate to be familiar with the reports submitted and to review them to the event that they are relevant for the purpose of audit. d) One set of tests that the auditor at both the branch level and head office level may apply fo
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