Coping

Coping and Elderly: Study Notes

Key Concepts & Objectives

  • Describe the physiological process of stress and coping across the lifespan.
  • Identify types of physiological, psychological, and emotional stressors among various populations.
  • Discuss the impact of stress and coping in vulnerable populations.
  • Explore stress-reduction strategies and healthy coping mechanisms.
  • Identify tools used in assessment of stress and coping with patients across the lifespan.
  • Utilize coping strategies for healthcare professionals to reduce risk.

Stress and Adaptation

  • Definition of Stress:

    • Stress is identified as a nonspecific response of the body to any demand made on it.

  • Definition of Adaptation:

    • Adaptation is the ability to positively adjust to changes that occur in an individual’s environment.

  • Hans Selye’s Theory of Stress and Illness:

    • Phases of Stress Response:
    • Alarm Phase: Initial reaction to stress, characterized by a fight-or-flight response.
    • Resistance Phase: The body adapts to the stressor and attempts to maintain homeostasis.
    • Exhaustion Phase: Prolonged exposure to stressors can lead to depletion of body resources, resulting in illness or disease.

  • General Adaptation Syndrome (GAS):

    • A model describing the body’s response to stress in three phases: Alarm, Resistance, Exhaustion.

Responding to Stress

  • Factors Affecting Response to Stressors:
    • Individual perception of the stressor.
    • Current health status.
    • Availability of support systems.
    • Other contextual factors at play.
  • Outcome of Stress:
    • An individual either successfully adapts to stress, or may develop diseases or illnesses as a result.

Symptoms of Stress (Box 7-3)

  • Common Symptoms When Experiencing Stress:
    • Frequent feelings of anger, helplessness, or hopelessness.
    • Physical symptoms: headaches, back pain, and insomnia.
    • Social withdrawal: hiding true feelings from family and friends, isolation.
    • Negative behaviors: hurting loved ones verbally or physically, overuse of substances (alcohol, drugs, food).
    • Cognitive impairments: constant worry, memory loss, difficulty thinking clearly.
    • Panic attacks characterized by rapid heart rate, shortness of breath, dizziness, and inability to make decisions.

Tools to Assess Stress

NovoPsych Perceived Stress Scale (PSS-10)
  • Instructions:
    • Respond to the following questions based on feelings and thoughts from the past month on a scale of 0 (Never) to 4 (Very Often).
    • Example Questions:
    1. Been upset because of something that happened unexpectedly?
    2. Felt that you were unable to control the important things in your life?
    3. Felt nervous and "stressed"?
    4. Felt confident about your ability to handle personal problems?
    5. Felt that things were going your way?
    6. Found that you could not cope with all the things that you had to do?

Coping Strategies

  • Definition of Coping Strategies:
    • Actions taken by individuals to combat or manage stress.
  • Common Coping Strategies:
    • Eating regular meals with lower levels of fat and sugar.
    • Exercising regularly.
    • Getting adequate sleep each night.
    • Using deep breathing exercises for relaxation.
    • Listening to one’s body and addressing its needs.
Continued Coping Strategies
  • Additional Strategies:
    • Prevent taking on more responsibility than manageable.
    • Taking time to relax and socialize with family/friends.
    • Utilizing laughter as a coping mechanism.
    • Reducing excesses in life.
    • Expressing feelings through conversation.
More Coping Strategies
  • Further Strategies:
    • Asking for assistance when needed.
    • Taking mental breaks or vacations.
    • Maintaining a journal for self-reflection.

Alternative Therapies for Coping

  • Hypnotherapy:
    • Involves achieving an altered state of consciousness through relaxation and focused attention.
  • Meditation:
    • A technique training the mind to focus and redirect thoughts, typically towards the breath.
  • Massage Therapy:
    • Manipulation of soft tissues to alleviate pain.
  • Reflexology:
    • Massaging the feet and hands to influence bodily functions related to pain and stress.

Tools for Coping Assessment

  • Coping Scales:
    • Used to measure the type of coping mechanisms employed by individuals.
  • Commonly Used Scales:
    • COPE (Coping Orientation to Problems Experienced).
    • Ways of Coping Questionnaire.
    • Coping Strategies Questionnaire.
    • Coping Inventory for Stressful Situations.
    • Religious-COPE.
    • Coping Response Inventory.

The Aging Population and Nursing

  • Statistics:
    • Presently, 8.5% of worldwide population is aged 65 and over.
    • By 2050, this number is expected to rise to nearly 17%.
  • Healthcare Implications:
    • Increasing demand for nursing care due to aging population.
    • Health Resources and Services Administration projects a shortfall of over 1 million nurses in the U.S.
    • Urgent need for interventions to recruit and retain nursing professionals.

Aging: Myths and Reality

  • Age Myths:
    • It is essential to avoid stereotypes like “elderly,” which implies weakness or frailty.
    • Patients in later adulthood are unique individuals; a holistic assessment is essential.

Physiological Effects of Aging

  • Considerations for Older Adults:
    • Patients often have multiple chronic conditions.
    • Importance of holistic assessment; focus should not only be on primary complaints.

Psychosocial Problems of Aging

  • Concerns that may arise for older adults and their caregivers:
    • Fears regarding the dying process and spiritual struggles.
    • Loss and grief due to the passing of friends/family.
    • Safety concerns including scams and elder abuse.
    • Financial worries about retirement and living arrangements.
    • Increasing dependence on others for daily activities.

Nursing Considerations for the Elderly

  • Key Concerns:
    • Address safety issues and living alone.
    • Recognize signs of depression and isolation.
    • Monitor for caregiver burnout.
  • Resource Identification:
    • Help patients access community resources such as Meals on Wheels and socialization opportunities.
    • Address spiritual needs and support.

Assessment Considerations for the Elderly

  • Areas to assess:
    • General appearance and adaptive equipment.
    • Communication abilities and cognitive level.
    • Dietary habits and special nutritional needs.
    • Bowel and bladder status.
    • Mobility status and aids.
    • Sleep patterns and medical equipment usage.
    • Overall activities and engagement.

Signs of Elder Abuse

  • Physical Signs:
    • Excessive bruises in unexpected locations.
    • Bruises at various healing stages, bite marks, burns, lacerations, fractures/dislocations.
    • Signs of sedation, dehydration, malnutrition, poor hygiene.
  • Types of Abuse:
    • Neglect.
    • Psychological abuse.
    • Financial exploitation.
    • Sexual assault.