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Caregiver neglect: Caregiver neglect involves the failure to meet an older adult’s basic needs, such as providing food, hygiene, or medical care. In this situation, the neighbor is not neglecting her care but rather manipulating her for personal financial gain, which is a different form of mistreatment.

Abandonment: Abandonment involves deserting an older adult who requires assistance, leaving them without necessary support or care. Although the woman depends on her neighbor for transportation, he is not abandoning her but instead exploiting her financially through manipulation.

Psychological abuse: Psychological abuse includes verbal threats, intimidation, or emotional manipulation that cause distress or fear. While the neighbor’s behavior exerts emotional pressure, the primary harm here is financial exploitation rather than emotional torment.

Ask, "Do you have trouble sleeping?": Difficulty sleeping may be related to anxiety, pain, or medical issues, but it does not directly assess spiritual distress. While poor sleep can be a symptom of emotional or existential concerns, this is too general to identify the source as spiritual in nature.

Ask, "Would you like to speak with a chaplain?": Offering to involve a chaplain may be appropriate once spiritual distress has been identified, but it is not an assessment question. This assumes distress is already present without exploring the patient’s personal beliefs or sources of meaning.

Ask, "Do you attend religious services?": Attendance at religious services reflects religious practice rather than spirituality itself. Many older adults may find spiritual fulfillment outside of organized religion, so this question may not reveal deeper concerns related to purpose or inner peace.

"She can't take a walk outdoors today; it's much too cold and snowy": Limiting outdoor activity in hazardous weather is an appropriate safety measure. Cold or icy conditions increase the risk of falls and hypothermia in older adults, so temporarily restricting outdoor walks protects the resident’s well-being.

"The grandchildren have colds so they should not visit this week.": Restricting visits from individuals who are ill helps prevent the spread of infections in a long-term care facility. Older adults are more susceptible to complications from respiratory infections, this precaution supports infection control and resident safety.

"I don't understand why, but she wants a different doctor to see her.": Residents have the right to choose or request a change in their healthcare provider. Expressing this preference does not require justification, and nursing staff should support the resident’s right to autonomy.

Withdrawing from friends and family: Social withdrawal can occur in both men and women after the loss of a spouse. It is a common grief response characterized by isolation, sadness, and emotional fatigue, but it is not specific to older adult males.

Focusing on "doing" rather than "feeling": Many men cope with grief through activity or problem-solving as a way to manage emotional pain. While this behavior is more common in males, it is not as distinctively representative of older male bereavement as the tendency to remarry soon after loss.

Experiencing moderate to severe depression: Depression is a frequent grief-related reaction across genders. Both men and women can experience significant depressive symptoms following spousal loss, it does not represent a uniquely male bereavement response.

Self-actualization – He is focused on achieving his personal potential: Self-actualization involves striving for personal growth, fulfillment, and the realization of one’s own capabilities. Mr. Jones has already achieved these goals in his career and has moved beyond personal development toward helping others achieve theirs.

Esteem – He wants to be respected and feel accomplished: The esteem stage centers on recognition, respect, and self-worth. Mr. Jones’s motivation is not driven by the need for acknowledgment or accomplishment but by a deeper desire to serve others and find meaning beyond self-interest.

Belongingness – He wants to feel accepted and connected to others: The belongingness stage involves forming relationships and maintaining social connections. Although Mr. Jones interacts with others, his motivation stems from a sense of universal purpose and contribution, rather than from a need for personal belonging.

The older adult’s desire for daily exercise: Physical activity generally promotes health and well-being and is not typically a source of family conflict. Unless it interferes with household routines or safety, exercise is usually encouraged and supported within multigenerational homes.

The adult child’s career satisfaction: While work-related stress can affect family dynamics, it is not the most common source of tension when an older parent moves in. Conflicts usually stem from daily living arrangements and household expectations rather than professional fulfillment.

Financial independence of the older adult: Financial issues may occasionally cause tension, but they are less frequent than interpersonal or lifestyle conflicts. Many families find ways to balance finances through planning or shared contributions.

Cover the resident’s lap with a blanket and leave him in the dayroom: Simply covering the resident does not address the underlying cause of the behavior and leaves him in a public setting where his dignity and the comfort of others may continue to be compromised.

Counsel the resident by telling him that his behavior is inappropriate: Attempting to reason or reprimand a person with dementia is ineffective due to cognitive impairment. Such an approach can increase agitation or shame without resolving the behavior or its underlying cause.

Distract the resident so that he will stop the behavior: Distraction may temporarily redirect attention, but it does not provide privacy or ensure that the resident’s needs are assessed. Without evaluation, the behavior may recur because the root cause remains unaddressed.