Question

A gerontological nurse is caring for an 85-year-old female patient who is a victim of elder abuse. During the initial history and physical examination, the patient shared that she had recently moved in with her adult alcoholic son, his wife, and their three children. Over the past few months, however, she had been noticing many of her personal items missing, including her wedding ring, a set of crystal figurines, and her bank statements and checkbook. She also shared that her son told her not to worry about anything because he will be taking good care of her. When the patient’s son arrived during the interview, the gerontological nurse noticed that the patient became anxious and refused to answer any more questions.

1. What type of elder abuse is identified in this situation? Explain.

2. Elder mistreatment is an umbrella term that covers abuse, neglect, exploitation, and abandonment. A. True B. False

3. In most states and U.S. jurisdictions, licensed nurses are required to report suspicions of abuse to the state. Identify resources the gerontological nurse can use to report suspicions of elder abuse.

4. Caregivers are considered to be “the hidden patient” with many experiencing stress and caregiver burden. What tips can the gerontological nurse provide to family members in the caregiving role to reduce caregiver stress?

5. Family members and other unpaid caregivers provide the majority of care for older adults in the United States. A. True B. False

An 87-year-old white woman is diagnosed with end-stage liver disease and is requesting to be discharged to her home to die. The gerontological nurse consults with the health care provider to arrange a referral for hospice care.

1. The gerontological nurse’s decision is based on the knowledge that hospice care is indicated when

A. preparation for death with palliative care and comfort are the goals of care.

B. clients and families are having difficulty coping with grief reactions.

C. clients have unmanageable pain and suffering as a result of a physical condition.

D. family members can no longer care for dying loved ones at home.

2. Identify and describe the types of grief that the older adult may experience.

3. Explain the Patient Self-Determination Act (PSDA).

Answer 1

Scenario 1:

1) The type of elder abuse in the above scenario is Financial abuse or financial exploitation.

This means illegal or improper use of an elders funds, properties or assets. It is the misappropriation of financial resources by family members, caregivers, or strangers, or the use of financial means to control the person or facilitate other types of abuse.

Here in this situation the Patient was complaining that her valuable things are missing for past few months. This clearly shows an example of financial abuse.

2) True

Yes, Elder mistreatment is same as elder abuse. It covers all type of abuse, neglect, exploitation and abondonment.

3) In this situation the following are the evidence for the nurse to report the suspicion of elder abuse:

* The patient who was explaining everything to the nurse suddenly became anxious and refused to answer further questions.

* Patient was complaining of missing of her personal and valuable items which happened only after she started living with her Son and family

* Her son is an alcoholic. Maybe her son would have misused her valuable items to buy alcohol.

4) To reduce care giver tips the nurse can give the family members the following tips:

• Practice acceptance
• Don't let caregiving take over your life
• Learn better ways to her your loved ones
• Join a support group for caregivers
• Get organized
• Find caregiving resources in your community to help you
• Take care of your own health
• Embrace your caregiving choice
• Imagine how your loved one would respond if they were healthy.

5) False

In US, the elderly are mostly taken care in care homes or nursing homes which is runned by the Government. Caregivers working there are paid for taking care of the elderly.

Scenario 2:

1) A

Preparation for death with palliative care and comfort are the goals of care.

2) Types of grief that older adult can experience are:

- Anticipatory grief

This is felt prior to the loss of someone you love, often due to terminal illness or diagnosis but can be sparked by a variety of circumstances.

- Delayed grief

It is the delayed onset of grief followed by death or divorce etc.

- Complicated grief

It is characterized by the inability to accept the death of loved ones and the feeling of intense sadness for years.

- Disenfranchised grief

It occurs when you lack social recognition.

- Chronic grief

It is prolonged grief that doesn't seem to reduce in severity over a period of time

3) Patient self determination act (PSDA)

The Patient Self-Determination Act (PSDA), passed in 1990 and instituted on December 1, 1991, encourages all people to make choices and decisions now about the types and extent of medical care they want to accept or refuse if they become unable to make those decisions due to illness.

This law made many hospitals, nursing homes, home health agencies, hospice providers, health maintenance organizations (HMOs), and other health care institutions to provide information about advance health care directives to adult patients upon their admission to the healthcare facility.

The purpose of this act to ensure that a patient's right to self-determination in health care decisions be communicated and protected.