307 Nursing Care of the Postmenopausal Woman, 3rd Edition
● Unusual weight loss; signs of dehydration or malnutrition. ● Bedsores. ● Soiled clothing; inappropriate clothes for the weather or for going out. ● No signs of recent bathing. ● Significant amounts of money withdrawn from the woman’s accounts. ● Sudden changes in the woman’s financial situation. ● Changes in the woman’s will, power of attorney, or property titles, or changes in benefactors on insurance policies. The challenges of caring for someone with physical and mental impairments may frustrate and exhaust caregivers who may be coping with other problems as well. An abusive spouse who feels chal- lenged by retirement, sexual changes, developing disabilities, or substance use may become more abusive (NCEA], n.d.)). In addition to observing the woman’s condition, the nurse should watch the caregiver for signs of stress or burnout. Most caregivers, especially when they are family, have the best interests of the woman in mind when they choose to take on the caregiver role; however, caring for an older person can be taxing, especially if illness or dementia complicates matters. Warning signs of caregiver burnout include (CDC, 2021a): ● Caregiver’s inability to cope with stress. ● Depression (common). ● Lack of support from other family members. ● The caregiver speaking of their role as a burden. ● Suspected substance abuse in the caregiver.
Many older women are afraid to identify that they are being mistreated. They are afraid that they may be placed in a nurs- ing home, they will lose their autonomy, or the abusive caregiver will be removed and then no one will care for them. They are also fearful of getting the abusive caregiver into trouble, which could cause more abuse (Abujarad et al., 2021). Aside from abuse, they could also be a victim of neglect. Neglect can be either active or passive. A caregiver who actively ne- glects an older adult woman may mean to cause her harm or death. Passive neglect can result from the caregiver’s innate lim- itations or problems. The caregiver may simply be ignorant of the woman’s needs (CDC, 2021a; WHO, 2022). A nurse who suspects that there may be elder abuse, neglect or the potential for elder abuse or neglect should discuss this possibility with the healthcare provider. Referral to a geriatric physician or nurse practitioner is appropriate. If there is con- cern about a woman being in immediate danger, she can be admitted to the hos- pital for evaluation and her caregiver can be reported to Adult Protective Services. Most communities and states have elder abuse hotlines. The website sponsored by the National Council on Child Abuse & Family Violence (n.d.) lists elder abuse hotlines for each state (https://www.nc- cafv.org/adult-protective-services-num- bers). Older adults can be abused in their own homes or at facilities that are charged with caring for them. A woman who is unable to care for herself may be left alone where she is unable to care for herself or has to struggle with doing the best for herself that she can. She may be intimidated or threatened. She may be subject to phys- ical abuse that includes not just hitting
Powered by FlippingBook