Mental Health and Wellness in Later Life Flashcards
Delusion
A fixed, false belief
Dysthmia
2+ years of depressed mood for more days than not, with more depressive symptoms not aligning with a major depressive episode
Illusion
Misinterpretation of a real experience
Insight
Recognition one has a health problem or illness
Mood
A person’s internal, self-reported emotional state
Paranoia
An intense and strongly defended irrational suspicion
Mental Health
A state of wellbeing in which every individual realizes their own potential, can cope with the normal stresses of life, can work productively and fruitfully, able to contribute to community
Components of an MSE
Mental Status Examination
Appearance, behaviour, affect, mood, speech, language etc.
Most common anxiety disorders in older persons
Generalized anxiety disorder and specific phobias
Symptoms of GAD
Unwarranted worries, feelings of apprehension, restlessness, on edge, fatigue that develops readily, difficulty concentrating
Phobia
Unrealistic or irrational fear that interferes with a persons life
Anxiety - Non pharm interventions
Family support, community resources and therapists, support groups, provision of information
Obsessive-Compulsive disorder
Recurrent and persistent thoughts, impulses, or images that are repetitive and purposeful; and by intentional ritualistic behaviour
PTSD
Development of symptoms after a traumatic event
Psychosis
Syndrome or constellation of psychiatric symptoms that occurs in a number of physical and mental disorders
Schizophrenia
Severe mental disorder characterized by two or more of the following symptoms:
Delusions
Hallucinations
Disorganized thinking
Apathy
Bipolar Disorder and Mania
Periods of mania and depression, often level out later in life
Age related changes
Etiology
Decrease in neurons and neurotransmitters
Modifications in cerebral dendrites, glial support cells, synapses
Compromised thermoregulation
Age related changes
Implications
Impaired muscle strength, deep tendon reflexes
Slowed motor skills, balance and coordination
Decreased temp sensitivity
Slowed processing
What is cognition
Process of acquiring, storing, sharing and using information
Includes language, thought, memory, executive function, judgement, attention and perceptions
3 D’s
Delirium, dementia, depression
Which is the only irreversible D?
Dementia
Delirium is characterized by
- Sometimes they may altered LOC
- Sometimes they may have no interest in eating
- They have forms of delusions or they hallucinate
What causes delirium?
Any for of pathology Alcohol withdrawal Trauma Antibiotics Infection medication
How do nurses assess for delirium?
Urinary test
Patients who experience delirium are at greater risk for
Longer hospitalization
Further functional decline
Institutionalism
Interventions For delerium
Keep calm
Routine
Don’t feed into the delusion
Be conscious of body movement
Primary Dementia
Progressive disorders caused by pathological conditions of the brain
Secondary
Produce pathological conditions of the brain
Examples of Primary Progressive Dementias
Alzheimer's Fronto-temporal Lewy bodies Creutzfeldt-Jakob Huntington's
Common Secondary Dementias
Parkinsons Alcohol-associated HIV Post-stroke Post Anoxic Ecephalopathy
Medications should _____ be the first or even second line of response
NOt
Understand that behavioural expressions communicate
Distress
Wandering
can lead to falls. elopement, disturbances in care routines
Can be predicted through observation
Prevalence: Depression
In hospitals: 12-45%
In LTC: as high as 45%
Onset
Delirium: Acute, often at twilight
Dementia: Slow and gradual
Depression: Rapid, coincides with life changes
Progression
Delirium: Abrupt
Dementia: Slow but even
Depression: Variable & uneven
Duration
Delirium: Hours-days, seldom 1 month
Dementia: Months to years
Depression: At least 2wks, can be months to yrs
Speech
Delirium: Incoherent, disorganized
Dementia: Aphasic, words difficult to find
Depression: Normal
Attention
Delirium: Impaired, fluctuates
Dementia: Generally normal, present in late stages
Depression: Distractible
Orientation
delirium: Impaired, fluctuates
Dementia: Impaired
Depression: Selective
Thinking
Delirium: Disorganize, fragmented
Dementia: Memory impaired, no abstraction
Depression: Intact with themes of hopelessness
LOC
Delirium: Altered, fluctuates
Dementia: Not altered
Depression: Not altered
