Topic 5: Transitions and Stories

Ageism

● to describe the deep and profound prejudice in society against the older person.

*Similar to discriminating the elderly

● It is a process of systematic stereotyping of and discrimination against people.

● Old people are sick and disabled.

● Most old people are in nursing homes.

● Dementia comes with old age.

● Old people have lower intelligence and are resistant to change.

● There are few satisfaction in old age.

Misconception Among The Elderly

Older parents

are expected to have limited input into the lives of their adult children

Children

are not required to meet the needs of their aging parents for financial support.

Parents

increasingly do not depend on their children for their needs

Grandparenting

is not usually as active role as in the past.

Parenting

● During middle and later life, parents must adjust to the independence of their children as they become responsible adult citizens.

● Today's older woman has been influenced by a historical period that emphasized the role of wife and mother.

*Women are more successful than men.

● Changes in family function of older adults are not necessarily negative.

Grandparenting

*learned role together with parenting

● Most are baby boomers, more likely to be college educated and employed.

● They are spending more on grandchildren than previous generations.

● Older adults have to adapt to new family lifestyles and structure.

● Changes in the family structure and activities present new challenges to today's grandparents.

1. Respecting their children as parents

2. Calling before visiting

3. Establishing rules for babysitting

4. Allowing their children to establish their own traditions within their family

Older adults may need to be guided in thinking through issues such as:

Nursing Responsibilities:

(Older adults may need to be guided in thinking through issues)

Nurses can help families locate resources.

1. Nurses can suggest activities that can help grandparents be connected with their grandchildren. VC, chat through messenger and viber

2. Older adults can be encouraged to keep files of memory. Scrapbook, diary or recipe of the family

Loss of Spouse

● The death of a spouse is a common event that alters family life for many older persons.

because life expectancy of women are longer than men

● The unemployed widow may learn that sources of income may be reduced.

● Most widows adjust quite well. revive by friends

women

● The death of a spouse affects more _________ than men.

1. May facilitate the adjustment.

2. Reassuring the widow to enjoy her new freedom

Nursing Responsibilities: (Loss of Spouse)

Retirement

● 60-65 yrs old in the Philippines (withdrawal in any position)

● Major adjustments of an aging individual.

Loss of the work role

*An individual's first experience of the impact of aging.

1. Pre retirement Phase

2. Retirement Phase

3. Disenchantment Phase

4. Reorientation Phase

5. Retirement Routine Phase

6. Termination of Retirement

Phases of Retirement

Pre retirement Phase

- train somebody to replace your position, stay at home or travel, continue to work

Retirement Phase

honeymoon stage of retirement, free of any responsibility

Disenchantment Phase

- As life begins to stabilize, a letdown, sometimes as depression is experienced

Reorientation Phase

- developing a lifestyle that provides one satisfaction

Retirement Routine Phase

- accept and understand situation

Termination of Retirement

- decision to continue work or stay at home

1. Assisting aging individuals with their retirement preparations

2. Counselling

3. Supportive

4. Helping them identify new sources of satisfaction

5. Appreciating and promoting the strengths

6. Tactful management

Nurse’s Roles:

Assisting aging individuals with their retirement preparations

- advice for regular

Counselling

- retirement period can be done

Supportive

- disenchantment period

Helping them identify new sources of satisfaction

- reorientation period

Appreciating and promoting the strengths

- retirement routine phase

Tactful management

- termination of retirement

Retirement

often requires older adults to live on a reduced income

Reduced Income

Only minority of the older population has income from a private pension plan

A reduction in income is a significant adjustment for many older person - least priority is healthcare

Making financial preparations for old age many years before retirement

is important - advise to double amount of money for saving

↓ height, fear of being disabled

Adjusting to new body image -

Changes in Health and Functioning

The manner in which individuals perceive themselves and their functional abilities can determine the roles they play

illness and disability

Common results of declining function are

Nurses

should help aging persons understand and face the common changes.

1. Shrinking Social World

2. Awareness of Mortality

Cumulative Effects of Life Transitions

Shrinking Social World

● Loss of social connections and increasing risk of loneliness.

● Nurses should attempt to intervene when they defect isolation and loneliness in an older person. *encourage them to have pet

● Nurses should also understand that being alone is not synonymous with being lonely

Hearing and speech deficits and language differences

can also foster loneliness.

loneliness

= social isolation

Awareness of Mortality

● widowhood

● The thought of impending death may be more tolerable if people understand that their life has had depth and meaning.

1. Interest in fulfilling dreams.

2. Deepening religious convictions.

3. Strengthening family ties.

4. Providing for the ongoing welfare of the family.

5. Leaving a legacy.

Signs that elderly accept the reality of death:

● Facilitating life review and eliciting a life story

● Prompting self-reflection

● Strengthening older adults inner resources

Responding To Life Transitions - Nursing Responsibilities

Life Review and Life Story

Is the process of intentionally reflecting on past experiences

● Discussing the past is therapeutic

● Life review can be a painful experience

● Older adults can benefit by discussing them openly

● The young can give a new perspective on life.

Nurses’ Role:

1. Facilitate life review by eliciting the older adults’ life story

2. Older adults who may require some facilitation of creative activities may help the process

Self Reflection

● One of the hallmarks of successful aging is knowledge of self.

● Explaining and learning about one’s true self is significant to holistic health in late life.

● Does not come easily or naturally for some individuals.

Journaling

Writing Letters and Emails

Reflecting Through Art

Strengthening Inner Resources

Activities that Facilitates Self- Reflection

Journaling

- known as diary

● Pen and paper or word

● Nurses can assist individual

● Novices to journaling *can be short summary of the past

Writing Letters and Emails

● Thoughts and feelings that individual may not feel comfortable verbalizing can be expressed in writing

● Share relevant family history

● Older adults may enjoy communicating by email

Reflecting Through Art

● Many people find that painting, sculpting, weaving and other forms of creative expression

Strengthening Inner Resources

- spiritual and emotional aspect

● Comprehensive and regular assessment of health status and interventions

● Nurses can support older adults' inner strengths

1. Including and encouraging the active participation

2. Avoiding ageist attitude

3. Providing a variety of options

4. Equipping older adults

5. Advocating for older adults

6. Offering feedback

Nurses can facilitate empowerment by:

Avoiding ageist attitude

- do not shout to elderly

Providing a variety of options

- autonomy, respect their decision

Equipping older adults

- education on self-care

Offering feedback

- acknowledge that they have done

A sense of hope

fosters empowerment