Chapter 11 Self-Perception and Self-Concept Copyright © 2012, 2008 by Mosby, Inc., an affiliate of...

Chapter 11

Self-Perceptionand Self-Concept

Copyright © 2012, 2008 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 1

Lesson 11.1


Objectives

Discuss the concepts of self-perception and self-concept.

Describe how self-perception and self-concept change with aging.

Describe methods of assessing changes in self-perception and self-concept.

Identify older adults who are most at risk for experiencing problems related to self-perception and self-concept.


Normal Self-Perception and Self-Concept


Self-Identity

The attitudes and perceptions people have about themselves, their abilities, and their self-worth

People form their self-identities from their values, life experiences, and interactions with others


Self-Identity (cont.)

People with good self-worth and high self-esteem Have strong personal values and believe that they

have the ability to control their lives Have had positive life experiences and have

received positive feedback from others


Self-Identity (cont.)

People with poor self-worth and low self-esteem Tend to have weak personal values and think that

they have little control over their lives Have had primarily negative life experiences and

have received negative feedback from others


Self-Perception

Feedback from others affects our perception of ourselves

People who feel capable of controlling what happens perceive things far differently from those who perceive no control over their lives

Choices regarding activities of daily living are determined by and are reflections of an adult’s self-perception and level of self-esteem


Self-Perception (cont.)

Problems related to self-perception and self-esteem are not as obvious as are physical problems


Audience Response SystemQuestion 1

In today’s society, people usually have more negative experiences than positive ones. A.TrueB.False


Self-Perception, Self-Concept,and Aging


Attitudes Toward Aging

Aging individuals develop their own perceptions of aging

Many older adults express dismay with the realization and can even identify a particular moment when they perceived themselves as old

Successful aging is not so much a matter of years lived or health status, but rather a matter of perception and attitude


Level of Self-Esteem Throughout Life

Older adults who have had a poor self-concept throughout their lives are not likely to gain self-esteem with aging

Older adults who had a healthy level of self-esteem during their younger days may experience some problems during aging, but these are most often a result of societal attitudes



Successful aging has sometimes been described as:A.ageism.B.mind over matter.C.great body image.D.being over the hill.


Lesson 11.2


Objectives

Discuss the effects of disease processes on self-perception and self-concept.

Identify selected nursing diagnoses related to self-perception or self-concept.

Describe nursing interventions appropriate for older adults experiencing problems related to self-perception and self-concept.



Objectives (cont.)

Identify selected nursing diagnoses related to self-perception or self-concept problems.



Extent of Physical Change

Many people do all within their power to avoid the physical signs of aging

In an attempt to maintain their sense of self-worth, aging persons with adequate financial resources may try cosmetic surgery, hair dye, and hair transplants

The greater the amount of change, the more likely the person is to experience problems related to self-concept


Emotional Support Systems

Although losses of physical and functional abilities are damaging to self-worth, loss of the emotional support of loved ones is even more devastating

The friends and loved ones who made life worthwhile slip away, one by one

The positive messages that a person is worthwhile, lovable, and loved become less frequent, and the reasons for living disappear


Emotional Support Systems (cont.)

Older adults who are separated from their families and significant others are at increased risk for experiencing diminished self-worth


Lesson 11.3


Objectives


Identify selected nursing diagnoses related to self-perception or self-concept problems.



Depression and Aging

Difficult to recognize because typical indicators may be similar to those seen with a variety of medical disorders

May be related to a wide range of factors, including loss of independence or loved ones, increased medical problems, or use of medications to treat disease


Changes That Warrant Further Investigation

Stopping normal routines Neglected self-care Unwillingness to talk Agitation and irritability Suspiciousness or unjustified fears Mood swings


Changes That Warrant Further Investigation (cont.)

Isolation and withdrawal Increased use of alcohol or mood-altering

drugs Unexplained injuries Verbalization of worthlessness Verbalization of suicidal thoughts


Suicide and Aging

Older adults at risk for suicide because of depression, severe emotional/physical pain, a recent loss, stressful event, or terminal illness

A large percentage of those who attempt to take their own lives have often presented to health care providers with various physical complaints

Older adults have a higher rate of successful suicides than other age groups



Older adults have a higher rate of __________ suicides than do other age groups.A.successfulB.unintentionalC.accidentalD.unsuccessful


Nursing Process for Disturbed Self-Perception and Self-Concept When an older adult has a poor self-concept,

fears and anxieties increase As control over one’s life decreases, self-

esteem plummets even lower, and older adults fall victim to feelings of hopelessness and powerlessness, which lead to depression

Depression leads to isolation from others, further decreasing the sense of self-worth


Nursing Process for Disturbed Body Image

People experiencing body image disturbance are likely to refuse to look at or touch the affected body parts

In severe disturbances, the individual may deny that the change has occurred and act as though nothing has happened

Likely to verbalize feelings of worthlessness and powerlessness


Nursing Interventions for Disturbed Body Image

Assess the older individual’s perceptions of self, including strengths and support systems

Establish a trusting relationship Provide care in a nonjudgmental manner Encourage the person to look at and touch

affected body areas Focus on abilities, not disabilities


Nursing Interventions for Disturbed Body Image (cont.)

Assist in selecting clothing and/or dressing older adults in a manner that deemphasizes body changes

Ensure that the person is carefully groomed Coordinate rehabilitative care with other

departments


Nursing Interventions for Situational Low Self-Esteem

Explore feelings and concerns Demonstrate acceptance of older adults as people

with value and self-worth Encourage participation in self-care activities Provide opportunities for reminiscence Encourage the family to participate in

reminiscence by providing pictures or items that bring back memories of happy times

Encourage families to communicate positive feelings to the older person


Active Participation in Care


Reminiscing


Self-Esteem in Aging


Nursing Process for Fear

Fear is a feeling of dread or apprehension regarding an identified source

Most common fears identified in older adults Fear of disruption in lives or routines Crime and victimization Loss of loved ones Disease, injury, pain and suffering Loss of independence Financial destitution Loneliness


Nursing Interventions for Fear

Provide opportunities for expression of fears Remove or reduce the most common sources

of fear Provide explanations for all care procedures Encourage older adults to verbalize their

thoughts and feelings Provide a quiet environment and reduce

excessive stimulation Provide distraction or diversion


Crafts


Hopelessness

Hopelessness is a subjective state in which people feel unable to solve problems or establish goals

They feel that they have no alternatives or choices, even when they actually can control what occurs

Hopeless persons express feelings of complete apathy in response to problems


Nursing Interventions for Hopelessness

Visit older adults frequently and spend time exploring the factors that contribute to feelings of hopelessness

Assess the potential for self-destructive behaviors or suicide

Allow older adults to make choices whenever possible


Nursing Interventions for Hopelessness (cont.)

Encourage older adults to do as much as possible for themselves

Adapt the environment to encourage independent activity

Explain the reasons for any changes in the plan of care

Avoid being overprotective or directive Respect older adults’ right to refuse


Nursing Process for Powerlessness

Powerlessness occurs when older adults feel they have lost control of what happens to them

May result from the loss of control of physical functions or body parts or from loss of a body part

Powerlessness is common with hospitalization or placement in an extended-care facility


Assertiveness


Nursing Interventions for Powerlessness

Allow older adults to make choices when possible

Encourage older adults to do as much as possible for themselves

Adapt the environment to encourage independent activity

Explain the reasons for any changes in the plan of care

Avoid being overprotective or directive Respect older adults’ right to refuse



One of the most common fears of older adults is death.A.TrueB.False


Chapter 11 Self-Perception and Self-Concept Copyright © 2012, 2008 by Mosby, Inc., an affiliate of...

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