Stress Vulnerability Model
Introduction Australia is ageing and nurses will be confronted with more and more age related diseases in the coming years than ever before. It is estimated that by 2050, 730,000 people will be living with some form of dementia compared with 269,000 that are currently living with the disease today (Help with health, 2011). This assignment will look at a case study in which a nurse is visiting a client, Mrs Jones who is suffering from Alzheimer’s disease and is currently being cared for by her husband. It will identify the bio-medical and psychosocial issues for Mrs Jones while relating it to Stress-Vulnerability Model, a theoretical model of health and include appropriate nursing interventions.
Analysis
Case study two is concerned …show more content…
with Mrs Jones. Mrs Jones is 76 years old lady and is in the early stages of Alzheimer’s disease. She currently lives with her husband of 56 years and at this stage of her illness he is her sole carer. They have no family help around as their only son lives interstate. Mr Jones is continuing to go about his normal hobbies such as playing bowls three times a week leaving his wife alone for 4-5 hours at a time. At this stage he is refusing any home assistance stating he is managing ok. Mrs Jones is visited by a practice nurse who has noticed that she has lost a marked amount of weight, appears dishevelled in her appearance and is demonstrating a number of non-verbal behaviours such as poor eye contact and avoiding physical contact. The nurse examines Mrs Jones and notes there is bruising to a number of areas to her body and questions Mr Jones who states she is refusing to eat and is becoming difficult to manage. The World Health Organisation (1948) defines health as “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” For this reason it is important to identify both the bio-medical and psychosocial issues for Mrs Jones. The bio-medical issues pertaining to Mrs Jones are her Alzheimer’s disease, marked weight loss and bruising. The psychosocial issues are her non-verbal behaviours which are avoiding eye and physical contact. To be able to assess and plan treatment for Mrs Jones, it is best if a model of health is applied. In this case the Stress Vulnerability Model will be used. In 1977, Zubin and Spring first proposed this Stress Vulnerability Model as a framework model for understanding psychosis but is now used in many aspects of health (The Stress Vulnerability Model, nd). It is a simplistic model looking at the individuals biological, psychological and social elements and how they affect their ability to cope with stressors in their life (Zubin & Spring, 1977). Stress and health go hand in hand. How people cope with stressors of everyday life and more complex issues such as chronic health problems with have an effect on their overall physical and mental health. Stressors also have a major influence on people’s behaviour, mood and sense of wellbeing (Schneiderman, Ironson & Seigel, 2005). The Stress Vulnerability Model looks at how vulnerable these people are to stressors such as age, family dynamics and culture and applies a Bio-Psycho-Social approach focusing on the patient who is considered best practice (Schneiderman, Ironson & Seigel, 2005). The most prominent stressor affecting both Mr and Mrs Jones is Mrs Jones’ chronic illness, Alzheimer’s disease. To be able to understand how this would be a stressor, it is important to understand the biology of the disease and how it affects the patient. Alzheimer’s disease is the most common type of dementia and is responsible for 50-70% of all cases of dementia (About Dementia, 2012). It is a form of dementia that attacks the brain, killing brain cells leading to shrinkage of the brain. It affects all areas of the brain and causes impaired memory, thinking and behaviour. In the early stages of Alzheimer’s the changes can be very subtle with the symptoms being lapses in memory and difficulty in finding the right words for everyday objects. It is quite a hard illness to diagnose in the early stages as these subtle changes can be labelled as “old age” so family can quite often miss these early warning signs. Alzheimer’s is a progressive disease and has no cure. There are seven stages to the disease with stage one being no-impairment and stage seven being considered very severe. In stage seven the patient will be unable to carry a conversation, unable to manage any ADL’s independently, will have trouble swallowing and unable to sit without support. The rate of progression varies from person to person but generally the average time a person lives with the disease is 7-10 years (Alzheimer’s Association, 2013). Mrs Jones is considered to be in the early stages so stage three and her symptoms at this stage of the disease would include; having trouble finding words for everyday objects, trouble remembering names for familiar people, losing or misplacing objects, increasing trouble with planning or organizing, having trouble performing tasks in a social setting (Alzheimer’s Association, 2013).
Issues
The nurse visiting Mrs Jones has noticed her marked weight loss. Weight loss in patients with Alzheimer’s is common and often a clinical manifestation of the disease (Tamura, Masaki & Blanchette, 2008). Research has suggested that olfactory changes that occur in the disease can make food less appealing and combined with memory loss, confusion, trouble planning and organizing meals caused by the disease, can make routines such as meal times difficult for the person suffering. As Mr Jones is his wife’s sole carer, he has a responsability to ensure that she has an adequate daily intake and failure to do this can be deemed as neglect on his part (Miller, 2009). Weight loss also leads to more health problems both physically and mentally. The loss of weight will reduce muscle mass which puts Mrs Jones at a higher risk of falls and systematic infections. It will also lead to a reduction of energy and loss of autonomy (Tamura, Masaki & Blanchette, 2008). Mrs Jones dishevelled appearance is also of concern. At the stage of the disease Mrs Jones is currently at, being disorganised and unable to independently go about “normal” daily routines such as washing, showering and toileting can be expected (About Dementia, 2012). However it is Mr Jones responsibly to assist his wife in doing these tasks as her sole carer. Again not fulfilling her basic care such as hygiene is considered a form of neglect and elder abuse (Miller, 2009). On assessing Mrs Jones, the nurse noticed that Mrs Jones was avoiding physical contact and not making eye contact. These symptoms can raise red flags as a sign of elder abuse and it is crucial the nurse takes these signs seriously (Abramson, nd). On the other hand Alzheimer’s is a devastating disease and can make the person suffering from it feel useless and worthless resulting in a low self-esteem. Low self-esteem in Alzheimer’s is a common problem and can make suffers feel very withdrawn which presents behaviours such as poor eye contact and avoidance of physical contact (Dementia Guide, 2013). Mrs Jones’ bruising over her body could be caused by something as simple a medical condition that causes her body to bruise easily or she may be on medications that thin the blood which as a side effect cause the patient to easily bruise. However bruising can be a sign of physical abuse and the patient will need a full assessment by a medical officer to determine whether the bruising is sinister. Mrs Jones’ physical deterioration and behaviours have caused concern for the nurse visiting.
Individually the presenting issues can be seen as non-sinister and part of the disease process but collectively it appears more apparent the Mrs Jones is suffering from elder abuse at the hands of her own husband (Miller, 2009). It appears the type of abuse that Mrs Jones is suffering is neglect and physical abuse a form of domestic violence experienced by older people (Domestic Violence Resource Centre Victoria, nd.). Recognizing the signs of elder abuse is an essential part to the role of a practice nurse as they play a big part in advocating for the victim especially when it is done by their primary carer and family member. The nurse is then able to initiate necessary changes to reduce the impact of the abuse on the older person’s psychological and physical well-being (Abramson, …show more content…
nd). But does Mr Jones think he is abusing his wife or trying to help her? Sometimes incidents can be dismissed as care-giver stress with the abuser thinking they are simply trying to help their loved one (Domestic Violence Resource Centre Victoria, nd.). Being her sole carer would be an extremely stressful job which does put him at risk of becoming resentful and frustrated with his wife. Mr Jones has stated he is finding his wife increasingly difficult to manage but is refusing home help. At this stage Mr Jones is getting some respite from his wife by going to bowels three times a week, leaving his wife alone for four-five hours at a time. This is an excellent opportunity for Mr Jones to have some respite and prior to his wife having Alzheimer’s would have been ok, but due to Mrs Jones’ cognitive decline, he is putting his wife at risk of injury, wondering off from the house and becoming lost (Gainey & Payne, 2006).
Recommendations
It is apparent the Mr and Mrs Jones need help. The daily stress for Mr Jones caring for his deteriorating wife is taking its toll. Mrs Jones battling a frustrating and debilitating disease which is having a negative effect on both her physical and mental health. Being elderly with no family support makes them even more vulnerable to dealing with these daily stressors. Due to Mrs Jones’ physical decline and suspicious behaviours of elder abuse, the nurse has a legal and ethical requirement to report this case of possible elder abuse to the correct authorities which are state based (Ziminski & Phillips, 2011). It is not the nurse’s obligation to investigate intent, motivation or sequence of events but will need to look at whether Mrs Jones is in any immediate danger at home with her husband or can interdisciplinary teams be involved to help with the issues of possible abuse (Ziminski & Phillips, 2011). The first thing to be done is a full health assessment of Mrs Jones by the nurse, assessing her ability to perform her activities of daily living (ADL’s) (Crisp and Taylor, 2009). The nurse took into account all biological, medical and psychological issues affecting Mr and Mrs’s Jones and nursing interventions will be put in place in order to help them. Using the Bio-Psycho-Social approach the nurse seeks intervention for Mr and Mrs Jones to aim for Mrs Jones to have the best recovery possible (Schneiderman, Ironson & Seigel, 2005). Mrs Jones needs a full medical assessment from a doctor. The doctor will be able to see if Mrs Jones’ Alzheimer’s has become more severe and whether she is on the right medications. The doctor will be able to investigate whether Mrs Jones’s weight loss is due to an acute illness or part of the disease process and whether she needs a dietian review to possibly assist with caloric intake. The doctor will also be able to do a full physical examination of Mrs Jones and see if her bruising is likely to be caused by physical abuse or falls/bumps. Counselling for Mr and Mrs Jones will be organised due to the fact Mr Jones is refusing any home help. Although Mrs Jones health and independence is declining, Mr Jones’s health is not and he may see home help as a loss of his independence. He is also watching his life partner of 56 years decline. Due to the deterioration of Mrs Jones health, home help will be required to ensure that she is able to maintain her daily needs and live in a safe environment (Miller, 2009). Educating and engaging Mr Jones of what sort of help can be offered will be the best practice, allowing him to have some input into who comes into the home to support both him and his wife (Miller, 2009). A social worker will also be assigned to Mr and Mrs Jones who will be able to organise practical help through many disciplines and community care packages. The type of community care packages that will be most of help to Mr and Mrs Jones are things like meals on wheels who can assist by delivering meals to the house which will take away some of the stress of meal times. A carer in the mornings would be of help to Mrs Jones as there are obvious issues with her dishevelled appearance. This would ensure Mrs Jones is getting the appropriate help with showering and dressing while taking away this stress of this routine from Mr Jones. Respite care can also be organised to give Mr Jones a break such as when he plays bowels (Home Help, 2013). This will mean Mrs Jones will be in a safe environment and not left alone. The social worker can also organise the more legal needs of Mrs Jones such as financial management and guardianship due to Mrs Jones cognitive decline (Australian Society for Geriatric Medicine, 2003). If it is found that Mr Jones is abusing his wife, the safest option may be to have Mrs Jones put into a nursing home. She would then be looked after by trained medical staff offering a high level of assistance with ADL’s (Russell, de Benedictis & Saisan, 2013). If Mrs Jones is still lucid enough she will be able to make this decision for herself (Russell, de Benedictis & Saisan, 2013). If this was to occur it could trigger more stress to Mrs Jones as she may feel a complete loss of independence and grief of being separated from her husband. She would need to be monitored for those mental stressors.
Conclusion
This assignment has found that Alzheimer’s disease is not only a stressor for the person suffering from the disease but the carer involved. The age of these patients makes them more vulnerable to daily stressors which in the case of Mrs Jones has made her a possible victim of elder abuse. The nurse involved in the case referred to the Stress-Vulnerability-Model to assist in making decision around interventions required for both Mr and Mrs Jones and put them into place. Using a Bio-Psychosocial approach, interdisciplinary teams were engaged to assist Mr and Mrs Jones to assist them with daily life while maintaining a safe environment for Mrs Jones. This will give Mrs Jones the best chance at recovery.
References
About Dementia. (2012) Alzheimer’s disease. [Fact sheet]. Retrieved from http://www.fightdementia.org.au/understanding-dementia/alzheimers-disease.aspx
Abramson, T. (n.d.). Regognizing the Behavioural Signs of Elder Abuse. Retrieved from http://www.asaging.org/blog/recognizing-behavioral-signs-elder-abuse
Alzheimers Assocation. (2013). Seven Stages of Alzheimer’s. Retrieved from http://www.alz.org/alzheimers_disease_stages_of_alzheimers.asp
Australian Society for Geriatric Medicine. (2003). Position statement no.1: Elder abuse. Retrieved from http://www.anzsgm.org/documents/Revision-Elder Abuse-5-9-03.pdf
Behavioral Health Evolution.
(2013). The Stress-Vulnerability Model of Co-occurring disorders. Retrieved from http://www.bhevolution.org/public/stress-vulnerability.page
Crisp, J. & Taylor, C. (2009). Potter and Perry’s fundamentals of nursing. Marrickville NSW: Harcourt Australia.
Dementia Guide. (2013). What to look for? Retrieved from http://www.dementiaguide.com/symptomlibrary/personalitychanges/low_self_esteem/
Domestic Violence Resource Centre Victoria. (n.d.). Elder abuse and family violence. Retrieved from http://www.dvrcv.org.au/help-advice/elder-abuse-and-family-violence/
Gainey, R.R. & Payne, B. K. (2006). Caregiver burden, elder abuse and Alzheimer’s disease: Testing the relationship. Journal of Health and Human Services Administration. 29 (1/2): 245-259.
Help with health. (2011). What is dementia? Retrieved from http://www.agedcareaustralia.gov.au/internet/agedcare/publishing.nsf/Content/what+is+dementia
Home Help. (2013). Retrieved from http://www.seniors.gov.au/internet/seniors/publishing.nsf/Content/Home+help
Miller, C. A. (2009). Nursing for wellness in older adults. (5th ed.) Philadelphia, PA: Lipincott, Williams &
Wilkins
Russel, D., de Benedictis, t., & Saisan, J. (2013). Dementia and Alzheimer’s Care. Planning and preparing for the road ahead. Retrieved from http://www.helpguide.org/elder/alzheimers_disease_dementias_caring_caregivers.htm
Tamura, B. K., Masaki, K. H., & Blanchette, P. L. (2008). "Weight Loss in Patients with Alzheimer 's Disease". Journal of nutrition for the elderly (0163-9366), 26 (3-4), p.21.
The Stress Vulnerability Model (n.d.). Retrieved from http://sydney.edu.au/bmri/docs/stress_vulnerability_model.pdf
WHO (1948). Retreived from http://www.who.int/about/definition/en/print.html
Ziminski, C. E., & Phillips, L. R. (2011). The nursing role in reporting elder abuse: Specific examples and interventions. Journal of Gerontological Nursing, 37(11), 19-23. doi:http://dx.doi.org/10.3928/00989134-20111010-01
Zubin, J. & Spring, B. (1977). Vulnerability: A new view on Schizophrenia. Journal of Abnormal Psychology, 86: 103-126.
Analysis
Case study two is concerned …show more content…
with Mrs Jones. Mrs Jones is 76 years old lady and is in the early stages of Alzheimer’s disease. She currently lives with her husband of 56 years and at this stage of her illness he is her sole carer. They have no family help around as their only son lives interstate. Mr Jones is continuing to go about his normal hobbies such as playing bowls three times a week leaving his wife alone for 4-5 hours at a time. At this stage he is refusing any home assistance stating he is managing ok. Mrs Jones is visited by a practice nurse who has noticed that she has lost a marked amount of weight, appears dishevelled in her appearance and is demonstrating a number of non-verbal behaviours such as poor eye contact and avoiding physical contact. The nurse examines Mrs Jones and notes there is bruising to a number of areas to her body and questions Mr Jones who states she is refusing to eat and is becoming difficult to manage. The World Health Organisation (1948) defines health as “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” For this reason it is important to identify both the bio-medical and psychosocial issues for Mrs Jones. The bio-medical issues pertaining to Mrs Jones are her Alzheimer’s disease, marked weight loss and bruising. The psychosocial issues are her non-verbal behaviours which are avoiding eye and physical contact. To be able to assess and plan treatment for Mrs Jones, it is best if a model of health is applied. In this case the Stress Vulnerability Model will be used. In 1977, Zubin and Spring first proposed this Stress Vulnerability Model as a framework model for understanding psychosis but is now used in many aspects of health (The Stress Vulnerability Model, nd). It is a simplistic model looking at the individuals biological, psychological and social elements and how they affect their ability to cope with stressors in their life (Zubin & Spring, 1977). Stress and health go hand in hand. How people cope with stressors of everyday life and more complex issues such as chronic health problems with have an effect on their overall physical and mental health. Stressors also have a major influence on people’s behaviour, mood and sense of wellbeing (Schneiderman, Ironson & Seigel, 2005). The Stress Vulnerability Model looks at how vulnerable these people are to stressors such as age, family dynamics and culture and applies a Bio-Psycho-Social approach focusing on the patient who is considered best practice (Schneiderman, Ironson & Seigel, 2005). The most prominent stressor affecting both Mr and Mrs Jones is Mrs Jones’ chronic illness, Alzheimer’s disease. To be able to understand how this would be a stressor, it is important to understand the biology of the disease and how it affects the patient. Alzheimer’s disease is the most common type of dementia and is responsible for 50-70% of all cases of dementia (About Dementia, 2012). It is a form of dementia that attacks the brain, killing brain cells leading to shrinkage of the brain. It affects all areas of the brain and causes impaired memory, thinking and behaviour. In the early stages of Alzheimer’s the changes can be very subtle with the symptoms being lapses in memory and difficulty in finding the right words for everyday objects. It is quite a hard illness to diagnose in the early stages as these subtle changes can be labelled as “old age” so family can quite often miss these early warning signs. Alzheimer’s is a progressive disease and has no cure. There are seven stages to the disease with stage one being no-impairment and stage seven being considered very severe. In stage seven the patient will be unable to carry a conversation, unable to manage any ADL’s independently, will have trouble swallowing and unable to sit without support. The rate of progression varies from person to person but generally the average time a person lives with the disease is 7-10 years (Alzheimer’s Association, 2013). Mrs Jones is considered to be in the early stages so stage three and her symptoms at this stage of the disease would include; having trouble finding words for everyday objects, trouble remembering names for familiar people, losing or misplacing objects, increasing trouble with planning or organizing, having trouble performing tasks in a social setting (Alzheimer’s Association, 2013).
Issues
The nurse visiting Mrs Jones has noticed her marked weight loss. Weight loss in patients with Alzheimer’s is common and often a clinical manifestation of the disease (Tamura, Masaki & Blanchette, 2008). Research has suggested that olfactory changes that occur in the disease can make food less appealing and combined with memory loss, confusion, trouble planning and organizing meals caused by the disease, can make routines such as meal times difficult for the person suffering. As Mr Jones is his wife’s sole carer, he has a responsability to ensure that she has an adequate daily intake and failure to do this can be deemed as neglect on his part (Miller, 2009). Weight loss also leads to more health problems both physically and mentally. The loss of weight will reduce muscle mass which puts Mrs Jones at a higher risk of falls and systematic infections. It will also lead to a reduction of energy and loss of autonomy (Tamura, Masaki & Blanchette, 2008). Mrs Jones dishevelled appearance is also of concern. At the stage of the disease Mrs Jones is currently at, being disorganised and unable to independently go about “normal” daily routines such as washing, showering and toileting can be expected (About Dementia, 2012). However it is Mr Jones responsibly to assist his wife in doing these tasks as her sole carer. Again not fulfilling her basic care such as hygiene is considered a form of neglect and elder abuse (Miller, 2009). On assessing Mrs Jones, the nurse noticed that Mrs Jones was avoiding physical contact and not making eye contact. These symptoms can raise red flags as a sign of elder abuse and it is crucial the nurse takes these signs seriously (Abramson, nd). On the other hand Alzheimer’s is a devastating disease and can make the person suffering from it feel useless and worthless resulting in a low self-esteem. Low self-esteem in Alzheimer’s is a common problem and can make suffers feel very withdrawn which presents behaviours such as poor eye contact and avoidance of physical contact (Dementia Guide, 2013). Mrs Jones’ bruising over her body could be caused by something as simple a medical condition that causes her body to bruise easily or she may be on medications that thin the blood which as a side effect cause the patient to easily bruise. However bruising can be a sign of physical abuse and the patient will need a full assessment by a medical officer to determine whether the bruising is sinister. Mrs Jones’ physical deterioration and behaviours have caused concern for the nurse visiting.
Individually the presenting issues can be seen as non-sinister and part of the disease process but collectively it appears more apparent the Mrs Jones is suffering from elder abuse at the hands of her own husband (Miller, 2009). It appears the type of abuse that Mrs Jones is suffering is neglect and physical abuse a form of domestic violence experienced by older people (Domestic Violence Resource Centre Victoria, nd.). Recognizing the signs of elder abuse is an essential part to the role of a practice nurse as they play a big part in advocating for the victim especially when it is done by their primary carer and family member. The nurse is then able to initiate necessary changes to reduce the impact of the abuse on the older person’s psychological and physical well-being (Abramson, …show more content…
nd). But does Mr Jones think he is abusing his wife or trying to help her? Sometimes incidents can be dismissed as care-giver stress with the abuser thinking they are simply trying to help their loved one (Domestic Violence Resource Centre Victoria, nd.). Being her sole carer would be an extremely stressful job which does put him at risk of becoming resentful and frustrated with his wife. Mr Jones has stated he is finding his wife increasingly difficult to manage but is refusing home help. At this stage Mr Jones is getting some respite from his wife by going to bowels three times a week, leaving his wife alone for four-five hours at a time. This is an excellent opportunity for Mr Jones to have some respite and prior to his wife having Alzheimer’s would have been ok, but due to Mrs Jones’ cognitive decline, he is putting his wife at risk of injury, wondering off from the house and becoming lost (Gainey & Payne, 2006).
Recommendations
It is apparent the Mr and Mrs Jones need help. The daily stress for Mr Jones caring for his deteriorating wife is taking its toll. Mrs Jones battling a frustrating and debilitating disease which is having a negative effect on both her physical and mental health. Being elderly with no family support makes them even more vulnerable to dealing with these daily stressors. Due to Mrs Jones’ physical decline and suspicious behaviours of elder abuse, the nurse has a legal and ethical requirement to report this case of possible elder abuse to the correct authorities which are state based (Ziminski & Phillips, 2011). It is not the nurse’s obligation to investigate intent, motivation or sequence of events but will need to look at whether Mrs Jones is in any immediate danger at home with her husband or can interdisciplinary teams be involved to help with the issues of possible abuse (Ziminski & Phillips, 2011). The first thing to be done is a full health assessment of Mrs Jones by the nurse, assessing her ability to perform her activities of daily living (ADL’s) (Crisp and Taylor, 2009). The nurse took into account all biological, medical and psychological issues affecting Mr and Mrs’s Jones and nursing interventions will be put in place in order to help them. Using the Bio-Psycho-Social approach the nurse seeks intervention for Mr and Mrs Jones to aim for Mrs Jones to have the best recovery possible (Schneiderman, Ironson & Seigel, 2005). Mrs Jones needs a full medical assessment from a doctor. The doctor will be able to see if Mrs Jones’ Alzheimer’s has become more severe and whether she is on the right medications. The doctor will be able to investigate whether Mrs Jones’s weight loss is due to an acute illness or part of the disease process and whether she needs a dietian review to possibly assist with caloric intake. The doctor will also be able to do a full physical examination of Mrs Jones and see if her bruising is likely to be caused by physical abuse or falls/bumps. Counselling for Mr and Mrs Jones will be organised due to the fact Mr Jones is refusing any home help. Although Mrs Jones health and independence is declining, Mr Jones’s health is not and he may see home help as a loss of his independence. He is also watching his life partner of 56 years decline. Due to the deterioration of Mrs Jones health, home help will be required to ensure that she is able to maintain her daily needs and live in a safe environment (Miller, 2009). Educating and engaging Mr Jones of what sort of help can be offered will be the best practice, allowing him to have some input into who comes into the home to support both him and his wife (Miller, 2009). A social worker will also be assigned to Mr and Mrs Jones who will be able to organise practical help through many disciplines and community care packages. The type of community care packages that will be most of help to Mr and Mrs Jones are things like meals on wheels who can assist by delivering meals to the house which will take away some of the stress of meal times. A carer in the mornings would be of help to Mrs Jones as there are obvious issues with her dishevelled appearance. This would ensure Mrs Jones is getting the appropriate help with showering and dressing while taking away this stress of this routine from Mr Jones. Respite care can also be organised to give Mr Jones a break such as when he plays bowels (Home Help, 2013). This will mean Mrs Jones will be in a safe environment and not left alone. The social worker can also organise the more legal needs of Mrs Jones such as financial management and guardianship due to Mrs Jones cognitive decline (Australian Society for Geriatric Medicine, 2003). If it is found that Mr Jones is abusing his wife, the safest option may be to have Mrs Jones put into a nursing home. She would then be looked after by trained medical staff offering a high level of assistance with ADL’s (Russell, de Benedictis & Saisan, 2013). If Mrs Jones is still lucid enough she will be able to make this decision for herself (Russell, de Benedictis & Saisan, 2013). If this was to occur it could trigger more stress to Mrs Jones as she may feel a complete loss of independence and grief of being separated from her husband. She would need to be monitored for those mental stressors.
Conclusion
This assignment has found that Alzheimer’s disease is not only a stressor for the person suffering from the disease but the carer involved. The age of these patients makes them more vulnerable to daily stressors which in the case of Mrs Jones has made her a possible victim of elder abuse. The nurse involved in the case referred to the Stress-Vulnerability-Model to assist in making decision around interventions required for both Mr and Mrs Jones and put them into place. Using a Bio-Psychosocial approach, interdisciplinary teams were engaged to assist Mr and Mrs Jones to assist them with daily life while maintaining a safe environment for Mrs Jones. This will give Mrs Jones the best chance at recovery.
References
About Dementia. (2012) Alzheimer’s disease. [Fact sheet]. Retrieved from http://www.fightdementia.org.au/understanding-dementia/alzheimers-disease.aspx
Abramson, T. (n.d.). Regognizing the Behavioural Signs of Elder Abuse. Retrieved from http://www.asaging.org/blog/recognizing-behavioral-signs-elder-abuse
Alzheimers Assocation. (2013). Seven Stages of Alzheimer’s. Retrieved from http://www.alz.org/alzheimers_disease_stages_of_alzheimers.asp
Australian Society for Geriatric Medicine. (2003). Position statement no.1: Elder abuse. Retrieved from http://www.anzsgm.org/documents/Revision-Elder Abuse-5-9-03.pdf
Behavioral Health Evolution.
(2013). The Stress-Vulnerability Model of Co-occurring disorders. Retrieved from http://www.bhevolution.org/public/stress-vulnerability.page
Crisp, J. & Taylor, C. (2009). Potter and Perry’s fundamentals of nursing. Marrickville NSW: Harcourt Australia.
Dementia Guide. (2013). What to look for? Retrieved from http://www.dementiaguide.com/symptomlibrary/personalitychanges/low_self_esteem/
Domestic Violence Resource Centre Victoria. (n.d.). Elder abuse and family violence. Retrieved from http://www.dvrcv.org.au/help-advice/elder-abuse-and-family-violence/
Gainey, R.R. & Payne, B. K. (2006). Caregiver burden, elder abuse and Alzheimer’s disease: Testing the relationship. Journal of Health and Human Services Administration. 29 (1/2): 245-259.
Help with health. (2011). What is dementia? Retrieved from http://www.agedcareaustralia.gov.au/internet/agedcare/publishing.nsf/Content/what+is+dementia
Home Help. (2013). Retrieved from http://www.seniors.gov.au/internet/seniors/publishing.nsf/Content/Home+help
Miller, C. A. (2009). Nursing for wellness in older adults. (5th ed.) Philadelphia, PA: Lipincott, Williams &
Wilkins
Russel, D., de Benedictis, t., & Saisan, J. (2013). Dementia and Alzheimer’s Care. Planning and preparing for the road ahead. Retrieved from http://www.helpguide.org/elder/alzheimers_disease_dementias_caring_caregivers.htm
Tamura, B. K., Masaki, K. H., & Blanchette, P. L. (2008). "Weight Loss in Patients with Alzheimer 's Disease". Journal of nutrition for the elderly (0163-9366), 26 (3-4), p.21.
The Stress Vulnerability Model (n.d.). Retrieved from http://sydney.edu.au/bmri/docs/stress_vulnerability_model.pdf
WHO (1948). Retreived from http://www.who.int/about/definition/en/print.html
Ziminski, C. E., & Phillips, L. R. (2011). The nursing role in reporting elder abuse: Specific examples and interventions. Journal of Gerontological Nursing, 37(11), 19-23. doi:http://dx.doi.org/10.3928/00989134-20111010-01
Zubin, J. & Spring, B. (1977). Vulnerability: A new view on Schizophrenia. Journal of Abnormal Psychology, 86: 103-126.