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Gerontology Exam 2 > Lecture 9 Mental health and the older adult > Flashcards

Lecture 9 Mental health and the older adult Flashcards

1
Q

_ are standard treatment for mild-to-moderate Alzheimer disease.

A

Cholinesterase inhibitors.

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2
Q

The most important goal regarding dementia is _, as this will allow for appropriate management strategies to be implemented.

A

Early recognition.

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3
Q

Dementia affects about _ of individuals 65 and older.

A

5%

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4
Q

High-level wellness (Dunn, 1961)

A

An integrated method of functioning that is oriented toward maximizing each person’s potential, while maintaining a continuum of balance and purposeful direction within the person’s environment.

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5
Q

Addressing _ is most appropriate in wellness-oriented nursing care.

A

Functional age.

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6
Q

“Mental health” is defined as _

A

Successful performance of mental functions, resulting in the ability to engage in productive activities, enjoy fulfilling relationships, and change or cope with adversity.

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7
Q

Psychosocial assessment requires that the nurse be _ to be comfortable in working with older adults.

A

Self-aware.

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8
Q

Goals of psychosocial assessment

A
  1. Early detection of asymptomatic or unacknowledged health problems.
  2. Identify signs/symptoms of psychological dysfunction (e.g., anxiety, depression, memory problems, change in mental status).
  3. Identify stressors and other risk factors that affect cognitive, emotional, or social function.
  4. Obtain information about the person’s usual personality, coping mechanisms, and cognitive abilities.
  5. Identify social supports and other coping resources that could be supported or strengthened.
  6. Assess cognitive functioning.
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9
Q

The most common impairment of psychosocial function in older adults is _

A

Depression.

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10
Q

The psychosocial theory of depression focuses on _

A

The impact of loss (losing independence, friends, etc.) and learned helplessness.

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11
Q

According to the cognitive triad theory, depression occurs when the older adult examines _

A
  1. Their self-image.
  2. Their environment/experiences.
  3. Their future.
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12
Q

The biologic theory of depression addresses the role of the neurotransmitters _ as causative factors.

A
  1. Serotonin.
  2. Dopamine.
  3. Acetylcholine.
  4. Norepinephrine.
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13
Q

Depression vs. dementia - onset/course of illness

A

Depression produces a rapid mental decline; dementia produces a slow, gradual decline.

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14
Q

Depression vs. dementia - level of consciousness

A

Depressed people remain oriented; dementia causes a person to become confused, disoriented, and/or lost in familiar locations.

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15
Q

Depression vs. dementia - attention span

A

Depressed people have difficulty concentrating; dementia causes problems with short-term memory.

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16
Q

Depression-related behaviors and symptoms in older adults

A 
D= Dysphoria
E= Emotional lability
P= Physical complaints
R= Rumination
E= Energy loss
S= Suicidal thoughts and plan
S= Sudden mood change
I= Insomnia
O= Omission of pleasure
N= Negativity with regard to self, world, and future
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17
Q

Of the 31 million adults age 65 and older in the U.S., about _ are affected by depression.

A

5 million.

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18
Q

Older adult males are _ times as likely to commit suicide compared with females.

A

Four.

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19
Q

The cohort that has the highest rate of suicide is _

A

White males over the age of 75.

20
Q

Adjustment disorder with depressed mood

A
  1. “Situational depression” - a reaction to a major change in a person’s life.
  2. It is usually of short duration - 6 months or less.
21
Q

Anxiety

A
  1. A feeling of distress, subjectively experienced as fear or worry and objectively expressed through autonomic and central nervous system responses.
  2. Older adults may characterize as “worries,” “concerns,” “trouble with my nerves.”
22
Q

It may be difficult to distinguish _ from dementia upon initial presentation.

A

Schizophrenia (usually not a new diagnosis in older adults because the age of onset for this disorder is 18-25; late age of onset is 25-35).

23
Q

_ is the drug that is most commonly used by older adults for its central nervous system effects of sedation and reducing anxiety.

A

Alcohol.

24
Q

Dementia

A
  1. A group of brain disorders characterized by a gradual decline in cognitive abilities; the term that most accurately describes progressive declines in cognitive function.
  2. A syndrome of impaired cognition caused by brain dysfunction and characterized by multiple cognitive deficits, such as memory impairment, aphasia, apraxia, agnosia, or impaired executive function.
25
Q

The Mini-Mental State Examination (MMSE) screens for _

A

Cognitive impairment, influenced by education, culture, and social class.

26
Q

The Mini-Cog

A

A three-item recall and clock-drawing test considered the best tool to quickly identify dementia; appropriate for all clinical settings.

27
Q

The Mini-Cog - word recall scoring

A

0 words= Probable dementia.
1-2 words= Proceed to clock-drawing test.
All 3 words= Non-demented, but the clock-drawing test is still administered.

28
Q

The Mini-Cog - clock-drawing scoring

A

Clock abnormal= Probable dementia.

Clock normal= Non-demented.

29
Q

An older adult exhibiting mild cognitive impairment should first be ruled out for a diagnosis of _

A

Delirium.

30
Q

The clock-drawing test included in the Mini-Cog is used to evaluate _

A

Executive function - patients must plan how to space out the numbers on the clock, decide how to arrange the hands on the clock to the specified time.

31
Q

Persons with dementia communicate unmet needs through _

A

Behavior.

32
Q

Primary dementia

A

Forms of dementia, such as Alzheimer’s disease, in which the dementia itself is a major sign of some organic brain disease not directly related to another organic illness.

33
Q

Types of primary dementia

A
  1. Alzheimer’s disease (60-80%).
  2. Vascular dementia (11-18%).
  3. Dementia with Lewy bodies (15-20%).
  4. Frontotemporal dementia.
34
Q

Secondary dementia

A

Dementia that is caused by or related to another disease or condition, such as HIV disease or a cerebral trauma.

35
Q

_ is usually the first symptom of dementia.

A

Short term memory loss.

36
Q

Clinical diagnosis of dementia requires _

A
  1. Loss of intellectual ability with impairment severe enough to interfere with social or occupational functioning, and
  2. Ruling out delirium.
37
Q

The ultimate functional consequence of dementia is _

A

Death.

38
Q

The stage of Alzheimer’s disease in which symptoms usually become noticeable to others is _

A

Stage 3.

39
Q

Confabulation

A

Creating imaginary events to fill in memory gaps.

40
Q

The stage of Alzheimer’s disease in which a person loses the ability to independently perform certain ADLs is _

A

Stage 5.

41
Q

Irreversible causes of dementia

A
  1. Stroke.
  2. Parkinson’s disease.
  3. Chronic alcohol abuse.
  4. Huntington’s disease.
  5. Creutzfeldt-Jakob disease.
42
Q

Treatable causes of dementia

A
  1. Infectious disease.
  2. Thyroid disease.
  3. Depression.
43
Q

Tools used in the assessment of Alzheimer’s disease include _

A
  1. The Global Deterioration Scale (GDS).

2. Functional Assessment Staging Test (FAST).

44
Q

Cholinesterase inhibitors include _

A
  1. Donepezil (Aricept).
  2. Rivastigmine (Exelon).
  3. Galantamine (Razadyne).
45
Q

The medication _ is usually prescribed for the moderate to later stages of dementia.

A

Memantine (Namenda).

46
Q

The two most important responsibilities of caregivers are to _, which becomes the primary mode of communication during later stages of dementia.

A

Encourage and interpret nonverbal communication.

47
Q

_ are the cognitive deficits most frequently associated with depressive disorders in older adults.

A

Memory impairments.

Gerontology Exam 2 (5 decks)

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