Respond to the following discussion with two  APA references. 

62-year-old Hispanic female with history of diabetes, hypertension, nicotine dependence. Patient is seen for depression and anxiety. She lives in the house of her son, with her nephew, and the nephew’s children. Her nephew is in his 40s and has a 20-year-old daughter. She does not live in the house but comes to visit. Patient states that when she goes outside to smoke, the 20-year-old nephew’s daughter locks her out and does not let patient back in. The young adult locked the patient out in the garage when the patient went to the garage. Patient states that the 10-year-old granddaughter let her in by opening the door for her. Patient is crying. Patient reports difficulties sleeping. She wakes up early mornings and is unable to fall back asleep. PHQ-9-19; GAD-7-10. Patient states that her son is “working a lot”. Patient spoke with her son about the incidents a day before her appointment.

Park (2019) discusses five types of elder abuse. He notes that between verbal, emotional, physical, financial, and neglect elderly abuse, emotional and verbal abuse are significantly corelated with elder depression (Park, 2019).

Prevention activities include Primary Prevention, Secondary Prevention, and Tertiary Prevention (www.cdc.gov). In our case, we are in the Tertiary Prevention stage when the signs and symptoms of the disease, such as depression and anxiety, are present already. The most important is Primary Prevention that includes interventions before the disease occurs. The Elder Justice Act (EJA) passed in 2010 as part of the Affordable Care Act that includes grants for research, for support of state adult protective services programs, grants for dissemination of state-level Adult Protective Services data. The law authorized spending of $777 million dollars. Congress did not fund the law (Greenlee, 2020). Therefore, the dissemination of data falls on the nurses and nurse practitioners’ laps. We must screen elderly patients for depression and anxiety during regular visits.

I choose for this family Orem’s Self-Care Model. Orem first proposed the idea of self-care in her 1956. The theory views a human being as its own caregiver that attends to self. The theory views the individual as both the agent of action and the object of action (Denyes, Orem, Bekel, 2001). The family is a unit. Applying Orem’s Self-Care Model to the family, the family as a unit needs to maintain self-care by preserving a healthy environment. The cause of the family disease is the 20-year-old. She should be removed, or her behavior must be corrected. These actions must be done by the family in order to maintain the unit/family healthy.