Ethical dilemmas working with older adults: in-depth interviews with Australian psychologists

Objective As Australia ages there are increasing opportunities for psychologists to contribute to the wellbeing of older adults. These clients have particular vulnerabilities that need to be considered when dealing with ethical issues. This study aimed to gain an in-depth understanding of how Australian psychologists manage ethical dilemmas when working with older adults. Method Eighteen psychologists participated in semi-structured interviews during which they provided 30 cases which were identified as suitable for analysis. Interviews were transcribed and analysed using interpretative content analysis. Results The 30 case studies included a range of residential situations and professional settings. The findings indicated that: (1) Ethical dilemmas presented by psychologists reflect the ethical principles of respect, dignity and propriety, (2) Many considerations are taken into account by psychologists when deciding how they manage ethical dilemmas, and (3) Elder abuse is a challenging and prevalent ethical issue for psychologists. Conclusions This study demonstrates that psychologists use a sophisticated process of ethical decision making when working with older adults and provides a new resource for research and training psychologists in applied ethics. What is already known about this topic: (1) Australia has an increasing older adult population. (2) Currently most psychologists have limited experience working with older adults. (3) Client's age impacts on psychologists' attitudes and behaviours. What this topic adds: (1) In this study psychologists provided cases from their clinical experience that highlight the complexity of working with older adults. (2) When managing ethical dilemmas psychologists are mindful of the tension that exists between respecting client autonomy and acting in the client's best interests. (3) Elder abuse is a challenging and prevalent issue for Australian psychologists.