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Elder Abuse and Stress Coping Strategies
1. Stress and coping in elderly –
Elderly abuse
ABDELRAHMAN AL KILANI
MSN – 15906012
2. Objectives
By reading the end of this seminar, you’ll be able to:
Define stress and coping
Identify age-related changes that affect psychological
function
Discuss the factors that influence coping in older adults
Describe the risk factors that may lead to poor coping
Explain the coping strategies for the psychosocial challenges
of older adulthood
Discuss the nursing care provided to elder people with
stress.
3. Objectives
Define elder mistreatments
Review international elderly abuse statistics
Describe the types of elder abuse
Discuss the risk factors for elder abuse and neglect
Discuss the nursing care provided to elder people with abuse
or neglect.
4. Stress and coping
Stress: is a state of mental tension and worry caused by
problems in your life, work, etc.
Coping: is the process of contending with life difficulties in
an effort to overcome or work through them.
5. Age-related changes affecting
psychological function
1. Retirement:
Loss of income
Loss of identity/role
Loss of status/authority
loss of purpose in life
loss of peer contacts
2. Death of friends:
loss of companions
threats to own mortality
loss of social activities
6. Age-related changes affecting
psychological function
3. Widowhood:
loss of helper
loss of companion
loneliness, grief
changes in responsibility
dependency on others
4. Relocation from family
homestead:
loss of space
changes of neighborhood
move from friends
7. Age-related changes affecting
psychological function
5. Chronic illnesses
functional impairments
sensory decline
medications
dependency
loss of money
6. Ageist stereotypes
devaluation
negative attitudes
age-determined
expectations
stereotypes and myths
8. Factors that influence coping in
older adults
Religion and spirituality
widely recognized as major coping resources that have a
positive effect on many aspects of psychosocial function
for older adults.
Cultural considerations:
Definition of mental health and mental illness
Belief about the causes of mental health and illness
Expression of symptoms or clinical manifestations of
mental health and illness
9. Risk factors that may lead to poor
coping
Poor physical health
Weak social supports
Lack of economic resources
Narrow range of coping skills
The occurrence of unanticipated events
The occurrence of several major life events in a short duration
10. Coping strategies
1. Retirement:
Develop new skills
Use time for hobbies and
personal pursuits
Become involved with
meaningful volunteers
activities
2. Death of friends:
Allow yourself to grieve
appropriately
Establish new
relationships
Renew old friendships.
11. Coping strategies
3. Ageist stereotypes
Develop a firm self-
identity
Challenge the myths
Question any behaviors
that are based on age-
determined expectations
4. Relocation from family
homestead
Appreciate the relief from
the responsibilities of
home ownership
12. Coping strategies
5. Changes in cognitive skills
Take advantage of
educational opportunities
Enroll in classes
Keep mentally stimulated
Join a discussion group
6. Declining physical health
Maintain good health
practices (nutrition
exercise, rest)
13. Recent study
Title: Caregiver Coping Strategies Predict Cognitive and
Functional Decline in Dementia: The Cache County Dementia
Progression Study
Author: Tschanz, J. , at el.
Design: Longitudinal, prospective cohort study. (6 years)
Sample: A total of 226 persons with dementia, and their
caregivers
Tool: Ways of Coping Checklist–Revised, Mini-Mental State
Examination (MMSE), and Clinical Dementia Rating (CDR).
Conclusion: Caregiver coping strategies are associated with
slower dementia progression.
14. Nursing process for patients with
stress
Nursing assessment
Because psychosocial function encompasses a broad range of
social, cognitive, and emotional aspects, a comprehensive
assessment is needed.
Nursing diagnosis
Usually covers the self-esteem disturbance, the social
interaction, ineffective coping, sometimes about spiritual
well-being, and other diagnoses according to situation.
15. Nursing process for patients with
stress
Nursing planning and interventions:
Usually the plans will be directed to:
Enhance self-esteem
Promote a sense of control
Involve the older adults in decision making
Address role less
Encourage life review and reminiscence
Foster social support
Address spiritual needs
16. Elder abuse and neglect
According to the national research council:
Elder mistreatments: are intentional actions that cause harm
or create a serious risk of harm, whether or not intended, to a
vulnerable elder by a caregiver or other person who stands in
a trust relationship to the elder
17. Elder abuse and neglect
According to National Center on Elder Abuse, 2016
Average number of elderly abuse cases each year: 2,150,000
in USA (9.5% of elderly population)
Neglect 58.5 %
Physical Abuse 15.7 %
Financial Exploitation 12.3 %
Emotional Abuse 7.3 %
Sexual Abuse 0.04 %
All other types 5.1 %
Unknown 0.06 %
18. Types of elder abuse
1. Physical abuse: use of physical force that may result in
bodily injury, physical pain, or impairment.
2. Sexual abuse: nonconsensual sexual contact of any kind
with an elderly person
3. Emotional abuse: infliction of anguish, pain, or distress
through verbal or non-verbal acts
19. Types of elder abuse
4. Neglect: refusal or failure to fulfill any part of a person’s
obligations or duties to an elderly person
5. Abandonment: desertion of an elderly person by an
individual who has assumed responsibility for providing care
for the elder, or by a person with physical custody of the
elder.
6. Financial or material exploitation
7. Self-neglect: behavior of an elderly person that threatens
his own health and safety.
20. Risk factors for elder abuse and
neglect
1. Invisibility of the problem (majority of cases are not
reported)
Older people have less contact with community
Older people are reluctant to admit to being abused or
neglected.
Vulnerability if the older person:
Dementia, depression, and mental illness
Absence of close relatives
21. Risk factors for elder abuse and
neglect
2. Psychological factors
Impaired cognitive function
Dementia or impaired judgment increase the risk for
self-neglect, psychological and physical abuse
Aggressive behavior of the person with dementia or
depression.
3. Caregiver factors
Personality characteristic of caregiver
Caregiver’s anxiety
22. Nursing process of abused or
neglected adults
Assessment
Elder abuse is not much assessed as it detected.
Assessment begins with a suspicion about its existence
If it is suspected, the immediate assessment focus on the
safety of the older person.
After basic life-sustaining needs are addressed, we can
consider the other needs:
Physical health, activities of daily living, psychological function, and
others.
23. Nursing process of abused or
neglected adults
Nursing diagnosis:
Because elder abuse and neglect is so broad and complex,
various nursing diagnoses are applicable depending on
situation.
24. Nursing process of abused or
neglected adults
Planning and interventions:
The nursing interventions are made to:
Improve the quality of life
Abuse cessation, protection, recovery status
Risk control
Family coping and social support
25. Summary
Stress is a state of mental tension and worry caused by
problems in your life, work, etc.
Coping is the process of contending with life difficulties in an
effort to overcome or work through them.
There are many factors influence coping in older adults as
there are some lead to poor coping.
Comprehensive nursing assessment is required for optimum
nursing care.
26. Summary
Elder mistreatments are intentional actions that cause harm
or create a serious risk of harm, whether or not intended, to a
vulnerable elder by a caregiver or other person who stands in
a trust relationship to the elder
It has several types; physical, sexual, emotional, neglect,
abandonment, and financial.
The main risk factor for abuse in elderly is the invisibility of
the problem.
The main purpose in nursing assessment is to detect the
existence of abuse or neglect.
27. Conclusion
Comprehensive and careful nursing assessment is an
important part in caring of elderly patient to identify the
stressors and the possible existence of abuse.
28. References
Miller, C. (2012). Nursing wellness in Older Adults. Wolters Kluwer Health.
Merriam-Webster online dictionary: http://www.merriam-
webster.com/dictionary/stress retrieved on 04/11/2016
LeMone, P., & Burke, K. M. (2008). Medical-surgical nursing: Critical thinking
in client care. Upper Saddle River, NJ: Pearson/Prentice Hall.
Statistic brain. (2016). Elderly abuse statistics. Retrieved from
http://www.statisticbrain.com/elderly-abuse-statistics/ on 17/11/2016
JoAnn, T., Fauth, E., Norton, M. C., & Rabins, P. V. (2013). Caregiver Coping
Strategies Predict Cognitive and Functional Decline in Dementia: The Cache
County Dementia Progression Study.