What we ll talk about today. Elder Abuse. Categories of Elder Abuse. Signs of Abuse in the Elderly 5/14/2014

Transcription

1 What we ll talk about today Katherine Wainwright, BA, Cyndy Soto, BA & Jane Fisher, Ph.D. Department of Psychology Nevada Caregiver Support Center University of Nevada, Reno Sponsored by the Nevada Aging and Disability Services Division Organized by the Nevada Geriatric Education Center, a program of the University of Nevada School of Medicine Elder abuse and why it occurs Common stressors within caregiving relationships Effective strategies for safe and healthy caregiving The importance of self care Elder Abuse Any knowing, intentional, or negligent act by a caregiver or any other person that causes harm or a serious risk of harm to a vulnerable adult (NCEA, 2007) Elder Abuse Elder abuse is the infliction of Pain Injury or Deprivation of Food Mental anguish on an older person Shelter Clothing or services necessary to maintain physical or mental health Categories of Elder Abuse Physical Abuse Psychological Abuse Neglect of basic needs Self Neglect Exploitation Isolation Signs of Abuse in the Elderly Inadequately explained bruises, cuts or injuries Dehydration or malnutrition Overly medicated or extremely sedated Unusual confinement (Closed off in a room, tied to furniture) Lack of cleanliness, grooming 1

2 Signs of Abuse in the Elderly Fear of speaking for oneself in the presences of the family or caretaker; anxious to please Anxiety, confusion, withdrawal, depression Shame, fear, embarrassment Sudden change in financial activity Prevalence Adult Protective Services (APS) 2004 received 565,747 reports National Center on Elder Abuse, in 4 vulnerable older adults are at risk of some type of abuse Most commonly reported: neglect (60%), physical abuse (16%), and financial or material exploitation (12%) Report What can be done? Understand specific reason problem is occurring Are demands exceeding caregiver s emotional and/or instrumental problem solving skills? Is the family underestimating the needs of the elderly person? Are there tangible or financial gains? What can be done Increase caregiver s personal resources by building: Healthy coping behaviors Effective responding in high stress situations Healthy self care Perspective taking Knowledge of elderly person s needs What can be done Increase instrumental resources by connecting family with needed services Caregivers and Stress If necessary: separate vulnerable person from unsafe environment Resources * Stressors *Stressors cause stress 2

3 Caregivers and Stress What is stress? When the demands of a situation exceed a person s ability to cope effectively Common Sources of Stress Unexpected, seemingly uncontrollable events Not knowing what future holds Day to day hassles Lack of respite Why is Stress Management Important? How Does Stress Impact Caregivers? Physical health Behavior changes Emotions Thoughts What is Burnout? Burnout is a condition of sheer physical, emotional, and mental exhaustion, often experienced by individuals taking on high stress roles Symptoms of Burnout Emotional Physical Behavioral 3

4 Ways of Thinking That Get in the Way Catastrophizing Telling yourself I can t stand it What if ing Overgeneralizing and black and white thinking Ways of Thinking That Get in the Way Mind Reading and jumping to conclusions Ways of Thinking That Get in the Way Having unrealistic expectations or thinking I should Self rating and labeling Personalizing He is doing this intentionally to bother me What Can You Do Instead? Notice Label Change Behavioral Activation Behavior, thoughts, and emotions are intertwined Making purposeful changes in our behavior can lead to powerful changes in our thinking and emotions 4

5 Behavioral Activation Values: Decide what you want to work toward Discover (or rediscover) productive and rewarding behavior and interactions Break tasks into doable steps Monitor the impact of what you do on what you feel Behavior Mood If Relaxation Stresses You Out About 4% of individuals experience negative side effects of relaxation Diaphragmatic Breathing Signs: restlessness, trembling, pounding heart, shivering, sweating, intrusive thoughts, and fear of losing control Solution: Try a different technique Rate Your Level of Tension I am feeling 1. Deeply and completely relaxed throughout my entire body 2. Very relaxed and calm 3. More relaxed than usual 4. Relaxed as in my normal resting state 5. Tension in some parts of my body 6. Generally tense throughout my body 7. Extremely tense and upset throughout my body Diaphragmatic Breathing Get comfortable lying on firm surface or seated with lower back supported Place left hand on your chest Place right hand just below your rib cage Take a deep breath Notice the movement of your right hand it should move outward your left should lie fairly still Exhale through your nose and mouth completely Inhale for 2 seconds hold for 2 exhale for 2 5

6 Rate Your Level of Tension I am feeling 1. Deeply and completely relaxed throughout my entire body 2. Very relaxed and calm 3. More relaxed than usual 4. Relaxed as in my normal resting state 5. Tension in some parts of my body 6. Generally tense throughout my body 7. Extremely tense and upset throughout my body What is Mindfulness? Mindfulness means paying attention in a particular way; on purpose, in the present moment, and nonjudgmentally. Jon Kabat Zinn Mindfulness Based Stress Reduction Stress job, family or financial Chronic pain and illness Anxiety and panic GI distress Sleep disturbances Fatigue High blood pressure Headaches Leaves on a stream exercise When to Practice Mindfulness? Daily! When feeling overwhelmed and stressed Observe non judgmentally and notice what flows through your senses when you: Drink a cup of tea Rub lotion into your hands Take a walk Wash the dishes Breathe 6

7 Benefits Lasting decreases in physical symptoms An increased ability to relax Reductions in pain levels An enhanced ability to cope with pain Greater energy and enthusiasm for life Improved self esteem An ability to cope more effectively with stressful situations Relationship Skills Don t let hurts and problems build up Resolve conflicts before they get overwhelming Ask others for help Say no when necessary If overwhelmed, reduce or put off lowpriority demands Linehan, 1993 Guidelines for Effectiveness Keeping a good relationship Be courteous in your approach Listen to the other person and acknowledge his or her point of view Use a little humor Keeping self respect Be truthful and fair Don t be overly apologetic Consume Less: Eat Well Simple carbohydrates (sweetened, sugary foods) Caffeine (coffee, soda, etc.) Eat breakfast and lunch Spread out your eating Drink plenty of water 7

8 Sleep Hygiene Dos: Most adults require 7 8 hrs Go to bed at the same time each day Get up at the same time Get regular exercise (preferably in the AM) Sleep Hygiene Don ts: Oversleep Exercise just before bed Have caffeine in the evening Command yourself to go to sleep Exercise Find a physical activity that you enjoy Find an exercise buddy Set aside time for exercise Start slow and work up Other healthy behaviors Do one thing at a time Become more time efficient Check in on yourself several times daily Set realistic goals and ask for help Incorporate relaxation into your daily life Getting Yourself to Do Any of This Start slowly, don t do too much all at once Give strategies a try (even if they seem weird) Pay attention the results (even if they're small) Use the strategies that work for you Stick with it Getting Yourself to Do Any of This Start slowly, don t do too much all at once Give strategies a try (even if they seem weird) Pay attention the results (even if they're small) Use the strategies that work for you Stick with it 8

9 Where to Report Elder Abuse Nevada Aging & Disability Services Division offices in: Las Vegas area: Reno area: Carson area: Elko area: Toll free: Crisis Call Center (after hours, weekends) * Any Police department or Sheriff s office Especially if there is imminent danger. Call 911. Other Resources Nevada Caregiver Support Center University of Nevada, Reno 775/ Alzheimer s Association 775/