Elder Abuse/Ageism

An 80-year-old client with dementia of the Alzheimer type is admitted to a nursing home. A family member visits and remarks how thin and wrinkled the client has become. Which response by the nurse will help the family member most to understand the aging process?

"As we age, we lose the tissue that helps puff out the skin." Collagen tissue, which is the support tissue, decreases with aging. This client's weight loss is not related to aging but to inadequate intake. Older adults should maintain an ideal body weight, not be underweight. The response "This is typical of older adults; they really don't eat well" stereotypes older adults; some may eat less and lose weight, but this is not true of all older adults. Stating that the client must have been in the sun a lot is an assumption. Everyone loses subcutaneous tissue as aging occurs.

A nurse is educating an older adult for the purpose of promoting wellness. What instruction should the nurse give to reduce the risk of disability?

"Engage in physical activities to stay fit." The nurse should instruct the older adult to engage in physical activities as a means of extending the years of active independent life and reducing the risk of disability. To promote a healthy lifestyle, the nurse should encourage the older adult to engage in physical activities. The nurse should understand that the willingness of the older adult to participate in health promotion activities depends in part on socioeconomic factors; moreover, the nurse should not provide financial advice to the client. The nurse should ensure that the older adult has social support to promote health and provide access to resources.

A nursing student is listing points to remember about wellness promotion in older adults. Which points mentioned by the nursing student need correction?

"It is necessary to consider the older adult's social environment and ensure that he or she lives in social isolation to prevent stress." "It is necessary to prevent older adults from taking part in physical activities to keep them from sustaining injuries." "It is essential to focus on curing diseases or other illnesses completely in older adults to promote wellness." When promoting health in older adults, the nurse must focus on achieving the highest level of health in the presence of a disease instead of curing the disease completely. When providing care, the nurse should take the social environment into consideration and strengthen support as a means of promoting health and ensuring access to healthcare resources. To promote health and extend the years of independent active life, the nurse should encourage older adults to engage in physical activities. When caring for older adults, the nurse should remember that preventing injuries is the key mechanism in promoting and improving health. A nurse should understand that older adults refrain from taking up physical activities because they fear falling. The nurse should therefore assess the fear and provide support to reduce the risk of falls.

A cognitively impaired older adult is brought to the emergency department for treatment of a cut on the forehead. Based on the following assessment information, the nurse concludes that the individual's priority need is what?

Assessment for possible physical abuse Elder abuse is a possible cause of this cognitively impaired elderly client's dehydration, bruising, and weight loss. Assessment of such a possibility is advisable and takes priority over assessments of fluid intake and nutrition and implementation of fall-prevention precautions.

A nurse is caring for depressed older adults. What precipitating factors for depression are most common in the older adult without cognitive problems?

Declines in health Multiple losses Depression in the older adult is most often associated with the loss of family members and friends (e.g., death, relocation) and declines in mobility, health, and income. A decline in health, particularly when associated with a chronic illness, frequently precipitates depression in older adults. Dementia is a cognitive problem. Research does not correlate the onset of depression with a milestone birthday in older adults. A traumatic injury does not precipitate the onset of depression in the older adult as often as does a chronic illness.

A nurse is assessing an older adult during a regular checkup. Which findings during the assessment are normal?

Decreased mobility of ribs Decreased night vision Loss of turgor In older adults, the skin loses its turgor or elasticity and there is fat loss in the extremities. Visual acuity declines with age; therefore, decreased night vision is a normal finding in older adults. Decreased mobility of the ribs is found in older adults due to calcification of the costal cartilage. Urinary incontinence is an abnormal finding in older adults. In older adults, diminished sensitivity to odor, not increased sensitivity, is often found.

While assessing an older adult, the nurse observes visual impairment in the client. Which technique should the nurse use to communicate?

Encourage the older adult to use assistive devices such as glasses If an older adult has visual impairment, the nurse should encourage the older adult to use assistive devices such as glasses. The nurse should face the older adult while speaking and should not cover his or her mouth. The light should be bright and non-glaring so that the older adult can see properly. The nurse should stand or sit closely in front of the client in full view so that the client is able to identify.

The home healthcare nurse visits an elderly couple living independently. The wife cares for the husband who has dementia. Which interventions should the nurse implement for them?

Identify social support within the community. Assess the husband for signs of physical abuse. Assess the wife for caregiver burden. An older caregiver should be assessed for caregiver burden. Anxiety, depression, relationship tension, or health changes are indicators of caregiver burden. The nurse should assess the client for any unexplained bruises or skin trauma; these are signs of physical abuse. These findings must be reported to the state protective agencies. The nurse should also help the couple identify social support within the community. Terminally ill clients who need pain management require hospice care. The nurse need not arrange hospice care for a client with dementia. The nurse should not make healthcare decisions for the client. The client and spouse should be consulted in all healthcare decisions.

Which age-related change should the nurse consider when formulating a plan of care for an older adult?

Increased sensitivity to glare & diminished sensation of pain Changes in the ciliary muscles, decrease in pupil size, and a more rigid pupil sphincter contribute to an increased sensitivity to glare. Diminished sensation of pain may make an older adults unaware of a serious illness, thermal extremes, or excessive pressure. There should be no interference with swallowing in older adults. Older adults tend to feel the cold and rarely complain of the heat. There is a decreased response to stimuli in older adults.

While assessing an older adult during a regular health checkup, a nurse finds signs of elder abuse. Which physical findings would further confirm the nurse's suspicion?

Presence of unexplained bruises on the wrist(s) Presence of bed sores Presence of burns from cigarettes A physical finding of abuse in older adults can be the presence of burns from cigarettes. The physical presence of bed sores also indicates client abuse. Unexplained bruises on the wrist(s) may also be an indication of abuse in older adults. The presence of hyoid bone damage is an indication of intimate partner violence. The presence of cognitive impairment is a behavioral finding in older adult abuse.