6. Older person's mental health

Question 1

What is the situation with older people’s MH?

Answer 1

- commonly presented among people with:
> chronic illnesses
> living in residential aged care facilities (RACF)
> people with CALD backgrounds
> people with dementia

• The presentation of MH problems in older age can be atypical, and often co-occur with other physical health conditions.

Question 2

What are the common types of older person’s MH problems?

Answer 2

• anxiety, depression
• substance abuse
• psychotic disorders, ie schizophrenia
• neurodegenerative induced brain disorders, ie dementia, Parkinson’s disease

Question 3

What are the risk factors?

Answer 3

loneliness, loss of autonomy → depression

financial insecurity, stressful life events [chronic conditions] → anxiety

poor social network, limited family connection → psychotic disorders

Question 4

What are the protective factors?

Answer 4

Resilience

• cultivated earlier in the lifespan
• associated with higher self-esteem
• can be enhanced by several factors, ie personality traits/optimism, problem-solving abilities, social supports, family connections

Question 5

What is delirium?

Answer 5

Delirium can be the direct consequence of an underlying medical condition or toxic exposure.
> It is often overlooked as MH condition
> Medical causes: opiates, benzo, anticholinergics

• Screening:
  > infection in bowel, bladder, pressure sores
  > pain → a common indicator
  > recent change in medication
  > screening tests: urinalysis, full blood examination, CT brain

Question 6

What is elderly abuse?

Answer 6

WHO definition: aggressive acts, lack of appropriate reaction, betrayal of the trust

Abuse forms:
> physical abuse → push, kick
> psychological abuse → insult, threat
> sexual abuse → inappropriate sexual contact
> financial exploitation
> neglect → not providing food or care

Question 7

What is the role of nursing in older people’s MH?

Answer 7

Comprehensive assessment: think about Pt history, risk factors and psychological influences
> seek conversation opportunities to learn about the Pt

Engage the Pt in social networks, ie introduce them to others in their vicinity
> collaborate community ventures, ie day centres, clubs