STRESS & COPING

STRESS & COPING

Stress & stressors Effects of stress
• The experience of stress is an internal state accompanying threats to • Adults show greater immunological impairments associated
self with distress or depression
• Stressors: • Older people often experience multiple simultaneous
o The narrowing range of bio-psychosocial homeostatic stressors (Box 28-2)
resilience and changing environmental needs as one ages may o Abrupt internal & external body changes & illnesses
produce stress overload o Loss of significant people
o Sensory, functional, memory impairment
o Acute discomfort & pain
o Loss of ability to drive
o Retirement
o Ageist attitudes
• Any stressors that occur in the lives of older people may
actually be experienced as a crisis if the event occurs
abruptly, is unanticipated, or requires skills or resources the
individual does not possess
Factors affecting stress
• Cognitive style, coping strategies, social resources, personal efficacy, • Resilience
and personality characteristics have all been found to be significant to • Resourcefulness
stress management • Coping
• Social relationships and social support are particularly salient to stress o Coping strategies of older adults (Box 28-4)
management and coping o Coping strategies and actions (Box 28-5)
• Factors influencing ability to manage stress (Box 28-3)
Coping strategies of older adults (Box 28-4)
 Use active strategies to avoid negative situations
o Older adults do not add to their stress by getting involved in other stressful situations
 Use cognitive strategies to manage negative emotions
o Use perspective & avoid overreacting
 Stay focused on the positive things/events happening
 Actively compare current stressors to things you have experienced & coped with in the past
o Understand you can get through stressful times
  Turn to meaningful people and activities in life during hard times
Coping strategies and actions (Box 28-5)
Strategy Types of action
Problem-focused  Consider alternatives
 Behaviors targeted toward solving or managing a problem  Draw on past experiences
 Involves formulating and implementing a plan  Step back & be more objective of situation
 Learn more about situation
 Make an action plan
Emotion-focused  Express emotions
 Efforts to manage one’s emotional reaction to the problem  Distraction, meditation, relaxation, exercise
 Take one day at a time
Social support  Ask for advice, help
 Efforts to seek help and guidance from friends, family,  Seek help from people with similar experiences
professionals  Provide support
Religious coping  Pray for strength & guidance
 Seek help from higher power  Attend services
Psychosocial assessment Interventions
• Psychosocial assessment: distinguishing among normal, idiosyncratic, • Nurses can design individualized interventions to enhance
and diverse characteristics of aging and pathological conditions coping ability such enhancing characteristics of resilience and
• Includes examination for cognitive function and conditions of anxiety resourcefulness
and adjustment reactions, depression, paranoia, substance use, and • Promote a sense of control, fostering social supports and
suicidal risk relationships, and connecting to resources
• Obtaining assessment data from elders is best done during short • Meditation, yoga, exercise, spirituality, and religiosity can
sessions after some rapport has been established enhance coping ability
• Mind-body therapies are most helpful
• Reminiscence is useful in understanding coping style