Nursing Care of the Postmenopausal Woman, 3rd Edition
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them with little social support within the family (Low & Roosevelt, 2022). The nurse should ask an aging woman about her social situation to assess her needs and to assist in recommending ways to enhance her support networks, such as continuing to work part-time, vol- unteering, or joining activity groups for older adults. | NURSING CONSIDERATION The nurse can advise or assist the woman in making the plans she may need when it comes to care as she ages, including power of attorney, healthcare proxies, living wills, medical orders for life-sustaining treatment (MOLST) forms, and wills. The more plans the woman can have in place before needing them, the less likely she is to have difficulty receiving care when the need arises. Elder mistreatment As a woman enters the transition to menopause, she may start to be con- cerned about who will care for her as she ages, or she may develop concerns about the nature of that care and how she might be treated. Every year, there are numer- ous reports of older adults being abused and neglected. Studies have found that anywhere from one in six to one in ten community-dwelling older adults have experienced some form of abuse in the prior year. For those residing in institu- tions, prevalence estimates have been reported: Psychological abuse, 33.4%; physical abuse, 14.1%; financial abuse, 13.8%; neglect, 11.6%; and sexual abuse, 1.9% (National Center on Elder Abuse [NCEA], n.d.). The definition of elder abuse is the “intentional act or failure to
act that causes or creates a risk of harm to an old adult. The abuse occurs at the hands of a caregiver or a person the elder trusts” (CDC, 2021a). As many as 10% of women may be abused or neglected in a year’s time (CDC, 2021a). The nurse must be alert to the possibility of elder abuse. The nurse should ask questions such as: Who helps you with your meals? Does anyone refuse to give you food when you are hungry? Do you feel safe at home? Does anyone shout at you, hit you, or touch you? (CDC, 2021a). The nurse should also observe for frequent tension or arguing between the caregiver and the older adult woman or a change in the woman’s personality. Other signs and symptoms may include the following (CDC, 2021a): ● Bruises or scars that go unexplained, especially if they appear symmetrically on both sides of the body. ● Broken bones, sprains, or dislocated joints. ● Apparent failure to take a prescribed medication or taking an overdose of the medication. ● Broken glasses or dentures. ● What appear to be rope or restraint marks on the wrists or ankles. ● Caregiver refusal to allow the nurse or provider to see the woman unattended. ● Caregiver behavior that is belittling, threatening, or controlling. ● Changes in the woman’s behavior, such as clinging to a doll or rocking back and forth. ● Bruising around the genitals or breasts, unusual vaginal bleeding, or signs of sexually transmitted infections.
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