305 Nursing Care of the Postmenopausal Woman, 3rd Edition
care Questionnaire, or PHQ-9. A copy of this questionnaire can be found here: https://www.apa.org/depression-guide- line/patient- health-questionnaire.pdf Implicit Bias Ageism is a social construct of old age that produces an alteration in feeling, belief, or behavior in response to an individual’s perceived chronological age. Nurses are not immune to having unrecognized biases toward patients. Unfortunately, bias can influence diagnosis and treatment decisions. For example, the notion that older women may naturally be expected to be depressed because of their age may lead to lower levels of care for depression and suicidality (Stubbe, 2021). Older women are unlikely to say that they are “sad.” Instead, they may say that they do not have much motivation, they have a lack of energy, or they are having physical problems. Physical complaints of arthritis pain or headaches are frequent- ly signs of depression in older women (NIA, 2021). Older women are unlikely to commit suicide, but the possibility is there. If the nurse recognizes symptoms of depression, they should ask the aging woman if she has contemplated suicide (NIA, 2021). Nurses should not shy away from further conversation with the woman about thoughts of self-harm or suicide. Asking the question is not going to make her more likely to commit suicide, and after developing rapport and trust, the woman might reveal information, for instance, that she has been hoarding pills. Older adults do contemplate, attempt, and commit suicide. According
to the Centers for Disease Control and Prevention, in 2020, there were 12.2 million adults who seriously thought about suicide, 3.2 million adults who made a plan, and 1.2 million adults who attempted suicide. The suicide death rates per 100,000 in 2020 for older adults were: ● 85+ years: 20.9. Nurses should not let anyone—the woman, her family, or her friends—tell them that their loved one would never think of suicide. Because it does happen (CDC, 2021c). | NURSING CONSIDERATION Nurses should be on alert and ready to discuss mental health and suicide with the patient and other healthcare providers involved with the woman’s care (NIA, 2021). ● 75–84 years: 18.4. ● 65–74 years: 14.5. ● 55–64 years: 16.9. ● 45–54 years: 18. SOCIAL SUPPORT A woman going through the meno- pausal transition may be taking care of one or both elderly parents, and many women at this stage will start to won- der who will care for them when they themselves enter that phase. Women in the U.S. can expect to live nearly half of their adult lives after their children leave home (Low & Roosevelt, 2022). Decades ago, adult children would typically live near their parents. Now, it is more com- mon for adult children to live farther away from their parents. Thus, day-to- day so- cial support from adult children may be unavailable. Furthermore, older women frequently outlive their spouses, leaving
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