Ch. 32&33: Mental Health Promotion/Assessment with Older Persons

Question 1

What is immunosenescence?

Answer 1

Immune system’s effectiveness in its function to defend the body from pathogens decreases over time, leaving the body more vulnerable.

Question 2

What are some risk factors for Geriatric Psychopathology?

Answer 2

1. Polypharmacy - check beer’s criteria
2. Bereavement & loss - (high risk for depression)
3. Poverty - inadequate retirement income, illness
4. Suicide and lack of social support (linked)

Question 3

Older adults who have been exposed to conventional antipsychotics may have what long-term symptoms?

Answer 3

Tardive Dyskinesia - (extrapyramidal side effect) abnormal involuntary movements of the mouth, tongue and jaw such as lip smacking, sucking, puckering, tongue protrusion (Older adults may have dysphagia)

Question 4

What is a popular pain assessment instrument? (especially for those who may be cognitively impaired)

Answer 4

Wong-Baker FACES Pain Rating Scale (initially developed for children, but now used on all ages)
*Scale of 0 - 5 (0 is happy, 5 is almost crying)

Question 5

Why should you ask about an older adult’s grapefruit juice consumption?

Answer 5

Grapefruit juice contains naringin - compound that inhibits CYP3A4 enzyme involved in metabolism of many medications

Question 6

What are special areas of interest in the mental status examination of an Older Adult?

Answer 6

1. Mood & affect
2. Thought processes
3. Cognitive Functioning

Question 7

What is the most common mental disorder in older adults?

What are the risk factors for it?

Answer 7

Depression
Risk factors: 
-loss of spouse
-physical illness
-education below high school
-impaired functional status
-heavy alcohol consumption

Question 8

Screening tool for depression in older adults?

Answer 8

Geriatric Depression Scale (GDS) - yes/no format

Question 9

Scale to assess anxiety in clients with Dementia?

Answer 9

RAID - Rating Anxiety in Dementia
*domains the RAID scale assesses include worry, apprehension & vigilance, motor tension, autonomic hyperactivity, phobias & panic attacks

Question 10

Tool used to assess thought & behavioural disturbances? (like wandering and aggressive behaviours)

Answer 10

Suspicious & delusional thoughts that characterize dementia:
1. people are stealing my things
2. my spouse is having an affair
3. My relative is an imposter
Complete further assessment by using Behavioural Pathology in Alzheimer’s Disease rating scale (BEHAVE-AD)
*Based on care-giver reports within the past 2 weeks.
Comparable to MMSE!

Question 11

Tool used to assess cognitive status in older adults? (More specific than MMSE)

Answer 11

Cognitive Abilities Screening Instrument (CASI)

Question 12

What is the major mental health risk for older adults?

And what is the greatest risk factor?

Answer 12

Suicide**

Depression is the greatest risk factor for suicide.