ASPEK FUNGSI PSIKOSOSIAL PADA USIA LANJUT

LUTFI N.A

PERUBAHAN FUNGSI PSIKOSOSIAL

Proses menua (aging) adalah proses alami yang disertai adanya penurunan kondisi fisik, psikologis maupun sosial yang saling berinteraksi satu sama lain. Keadaan itu cenderung berpotensi menimbulkan masalah kesehatan secara umum maupun kesehatan jiwa secara khusus pada lansia

 Fisik
Kemampuan fungsional Psikologis

Sering mjd paling menentang

Menghabiskan energi koping

Masalah fisik

Perubahan peran, hubungan, lingkungan kahidupan

Risk factor that affect Psychosocial function

Poor physical health Impaired functional abilities Poor social support Lack of economic resources The occurrence of of unanticipated events The occurrence of several daily hassles at the same time The occurrence of several major life events in a short period of time High social status and high feelings of self efficacy in situations that cannot be changed

 Stres dan Koping pada Usia lanjut Stokes/Gordon Stress Scale (SGSS) :

Death of son or daughter (unexpected) Decreasing eyesight Death of Grandchild Death of spouse (unexpected) Loss ability to get around Death of son or daughter (anticipated, expected) Constant or recurring pain or discomfort

 Karakteristik mental usia lanjut yang vital dan meningkatkan kesehatan : Perasaan bahagia Manikmati hidup Memiliki tujuan hidup Menjadi ekstrovert Penuh harapan tentang masa depan Memiliki hubungan yang baik dengan orang lain Memiliki perasaan menerima diri sendiri Memiliki rasa religiusitas dan spiritualitas tinggi .. (Koenig, 2000; Ostir et all, 2000 cit. Miller, 2005)

EXAMPLES OF PSYCHOSOCIAL PROBLEMS Poor adjusment to role changes Poor adjusment to lifestyle changes Family relationship problems Coping with grief Low self esteem Anxiety and Depression Aggressive behavior Problem with sexuality Elder abuse

PERUBAHAN FUNGSI KOGNITIF PADA USIA LANJUT

Bervariasi scr individu : rentang n onset

60/70 th

Perubahan Fungsi Kognitif

Sehat, aktif dan stimulasi mental

Faktor Resiko Penurunan meningkat, mempengaruhi fungsi keseharian

Defisit diminimalkan, tdk mengganggu fungsi keseharian

Healthy older adult show no decline And perhaps improve, in some cognitive skills Most O.A show a slight and gradual Decline in some cognitive skills
Age related cognitive declines are thought to begin at about 60 years of age

Intellectual Ability

Functional Consequences Effecting Cognition in O.A

Memory

Short term memory, remote memory Faktor-faktor pendukung, Faktor resiko

Learning Abilities Of Older Adult

Capable of learningnew thingsas younger people, but the speed. More cautious in their responses n make more errors of omission Potential barriers to learning in OA

Pengkajian Psikososial

Mental/Cognitif Ability Social Support

Financial Resources

Affective Functioning/ Emotional Status

Assesment

Family Patern n Structure

Current Role n Role Changes

Usual Coping Mechanisms

Resources used in the environment or Community

 Is it grief or depression?
Although a grieving person may experience a number of depressive symptoms such as frequent crying and profound sadness, grief is a natural and healthy response to bereavement and other major losses. There is a difference between a normal grief reaction and one that is disabling or unrelenting. While theres no set timetable for grieving, if it doesnt let up over time or extinguishes all signs of joylaughing at a good joke, brightening in response to a hug, appreciating a beautiful sunsetit may be

Causes of depression in the elderly

Causes and risk factors that contribute to depression in the elderly include: Loneliness and isolation Living alone; a dwindling social
circle due to deaths or relocation; decreased mobility due to illness or loss of driving privileges. loss of identity due to retirement or physical limitations on activities.

Reduced sense of purpose - Feelings of purposelessness or Health problems Illness and disability; chronic or severe

pain; cognitive decline; damage to body image due to surgery or disease.

exacerbate depression. or health issues.

Medications Many prescription medications can trigger or

Fears Fear of death or dying; anxiety over financial problems

Recent bereavement - The death of friends, family
members, and pets; the loss of a spouse or partner.

Illness and depression

Medical conditions that commonly trigger depression include: Heart attack or disease Parkinsons disease Stroke Alzheimers Multiple sclerosis Cancer Diabetes

Medication-induced depression
Medications that can induce depression include: Steroids Painkillers Hormones Arthritis medication High blood pressure drugs Heart disease medication Tranquilizers Cancer drugs

Signs and symptoms of depression in the elderly

Sadness Fatigue Abandoning or losing interest in hobbies or other pleasurable pastimes Social withdrawal and isolation (reluctance to be with friends, engage in activities, or leave home) Weight loss; loss of appetite Sleep disturbances (difficulty falling asleep or staying asleep, oversleeping, or daytime sleepiness) Loss of self-worth (worries about being a burden, feelings of worthlessness, self-loathing) Increased use of alcohol or other drugs Fixation on death; suicidal thoughts or attempts

Counseling and therapy

Supportive counseling includes religious and peer counseling. It can help ease loneliness and the hopelessness of depression. Psychotherapy helps people work through stressful life changes, heal from losses, and process difficult emotions. Cognitive behavioral therapy (CBT) helps people change negative thinking patterns, deal with problems in healthy ways, and develop better coping skills. Support groups for depression, illness, or bereavement connect people with others who are going through the same challenges. They are a safe place to share experiences, advice, and encouragement.

What Is Elder Abuse?

Elder abuse is the infliction of physical, emotional, or psychological harm on an older adult. Elder abuse also can take the form of financial exploitation or intentional or unintentional neglect of an older adult by the caregiver.

PHISICAL ABUSE Physical abuse Can range from slapping

or shoving to severe beatings and restraining with ropes or chains. When a caregiver or other person uses enough force to cause unnecessary pain or injury

Emotional or psychological abuse

Emotional or psychological abuse can range from name-calling or giving the "silent treatment" to intimidating and threatening the individual. When a family member, a caregiver, or other person behaves in a way that causes fear and emotional pain or distress, the behavior can be regarded as abusive.

Caregiver neglect
Caregiver neglect can range from caregiving strategies that withhold appropriate attention from the individual to intentionally failing to meet the physical, social, or emotional needs of the older person. Neglect can include failure to provide food, water, clothing, medications, and assistance with the activities of daily living or help with personal hygiene, failure to manage the elder persons money responsibly

Sexual abuse

Sexual abuse can range from sexual exhibition to rape. Sexual abuse is not often reported as a type of elder abuse.

FINANCIAL EXPLOITATION
Financial exploitation can range from misuse of an elders funds to embezzlement.

Purchasing expensive items with the older persons money without the older persons knowledge or permission, or denying the older person access to his or her own funds or home. etc

The Symptoms
Bruises or grip marks around the arms or neck Rope marks or welts on the wrists and/or ankles Repeated unexplained injuries Dismissive attitude or statements about injuries Refusal to go to same emergency department for repeated injuries

Physical Abuse

Emotional/Psychological Abuse

Uncommunicative and unresponsive Unreasonably fearful Lack of interest in social contacts Chronic physical or psychiatric health problems

Sexual Abuse
Unexplained vaginal or anal bleeding Torn or bloody underwear Etc.

Financial Abuse or Exploitation

Life circumstances dont match with the size of the estate Unusual ATM activity Signatures on checks dont match elders signature Etc.

Neglect
Sunken eyes or loss of weight Extreme thirst Etc.

Family Situations and Elder Abuse

Family situations that can contribute to elder abuse include :

a history and pattern of violent interactions within the family social isolation or the stresses on one or more family members who care for the older adult and lack of knowledge or caregiving skills.

Caregiver Issues and Elder Abuse

Personal problems of the caregiver that can lead to abusing a frail older person

caregiver stress, mental or emotional illness, addiction to alcohol or other drugs, job loss or other personal crises, financial dependency on the older person, a tendency to use violence to solve problems.

penurunan fungsional yang disebabkan oleh kelainan yang terjadi pada otak

Pikun merupakan gejala umum demensia

Orang-orang yang menderita demensia sering tidak dapat berpikir dengan baik dan berakibat tidak dapat beraktivitas dengan baik

Mereka lambat laun kehilangan kemampuan untuk menyelesaikan permasalahan dan perlahan menjadi emosional, sering hal tersebut menjadi tidak terkendali.

 Wassalamualaikum Wr.Wb..