Nursing Care of the Postmenopausal Woman, 3rd Edition
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Americans with Disabilities Act, which be- came law in 1990, many Americans with disabilities face a range of barriers when they attempt to access healthcare and live their daily lives. They can face attitu- dinal barriers such as prejudice, stigma, and discrimination from providers and staff. They may also experience physical barriers in locations that are difficult to ac - cess, such as restroom doors that aren’t wide enough to pass through with assis- tive devices or examination furniture that is difficult to utilize. Women with hearing disabilities may have limited access to written material or sign language interpreters, unless they bring their own. Health information is rarely written in Braille or large print for women with vision impairments. There may also be limited access to written or pictorial material with a lower reading lev- el for women with cognitive impairments, making information about their health dif- ficult to understand. A holistic approach to assessing and educating persons with disabilities in- cludes resources to address social sup- port, attitudinal barriers, finances, the environment, and education. The nurse should work to assist with the removal of barriers in the work environment. Nurses should be familiar with types of supports available, such as assistive technology and personal assistive devices. It’s also important for nurses to know the types of interventions available to assist women with disabilities (WHO, 2021). DEPRESSION AND SUICIDE RISK Sometimes aging itself can cause a woman to feel depressed over losses and missed opportunities. The nurse should be alert for any signs of depression in the aging woman. Depression, which is common in older adults, can be associ-
ated with chronic diseases, the loss of a spouse, “empty nest syndrome,” chang- ing appearance, and loss of physical vig- or. Depression impairs quality of life and can exacerbate illness, causes somatic symptoms, and contributes to fatigue. Depression can worsen overall health. In older adults, depression may be mistaken for dementia (NIA, 2021). Illnesses such as Parkinson’s disease, stroke, heart disease, cancer, diabetes, thyroid disorders, vitamin B12 deficiency, dementia, lupus, and multiple sclerosis can lead to depression—though in actu- ality, any chronic condition that is painful or threatens disability or death can be a factor in depression. Medications that can contribute to depression include blood pressure medications, beta-block- ers, sleeping pills or tranquilizers, calcium channel blockers, ulcer medications, ste- roids, hyperlipidemia medications, pain- killers, arthritis medications, and estro- gens (NIA, 2021). The nurse needs to be alert for the signs and symptoms of depression, which include: ● Sadness. ● Fatigue. ● Aggravated aches and pains. ● Feelings of hopelessness. ● Slowed movements or speech. ● Increased use of alcohol or drugs. ● Fixation on death. ● Loss of interest in friends and activities. ● Neglecting personal care or meals. If a woman presents with any of these symptoms, the nurse or healthcare pro- vider can quickly assess her using a de- pression tool called the Patient Health- ● Memory problems. ● Lack of motivation. ● Sleep disturbances.
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