Mental Health_Gerontology_CH24 Flashcards
“A state of well being in w/c every individual realizes his or her own potential, can cope w normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community”
Mental Health accdng to WHO
“One who accepts the aging self as an active being, engaging available strengths to compensate for weakness in order to create personal meaning, maintain maximum autonomy by mastering the environment, and sustain positive relationships w others”
Mental health in aging: a mentally healthy person
Autonomy, intimacy, integrity and generativity
All aspect of mentally healthy adult
Characterized by alterations in a variety of factors that include mood and affect, behaviour, and thinking and cognition. The disorder are associated w various degrees of distress and impaired functioning
Mental order or diagnosable mental illness
If a person lost a significant person and developed painful persistent health problems, the consequences may be quite different and could cause :
Stress overload
In older adult, stress may appear as cognitive impairment or behaviour change that will be alleviated as the stress is reduced to match the individual’s____
Adaptability
Older people maybe reluctant to seek help for stressors because of ___
- Pride of independence
- Stoic acceptance of difficulty
- Unawareness of resources
- Fear of being “put away”
The most prevalent mental disorders in late life are:
- Anxiety
- Dementia
- Mood disorder (depression)
- Addiction & substance abuse
________ about having mental illness discourages many people from seeking treatment
Stigma
______ and _____ in older adults are often not recognized or mistakenly viewed as normal part of aging.
Mental illness and addiction
Some obstacles to mental health care in these settings include:
- Shortage of trained personnel
- Limited availability of and access to psychiatric services
- Lack of staff training related to mental health and mental illness
Assessment of mental health includes:
- Observation of appearance
- Behaviour and examination of cognitive function
- Functional abilities
- Anxiety
- Adjustment reactions
- Depression
- Substance abuse
- Suicidal risk
____ is the most common anxiety disorder in older people. symptoms include:
- Unrealistic and excessive worries
- Restlessness or feeling keyed up or on edge
- Being easily fatigued
- Difficulty concentrating or mind going blank
- Irritability
- Muscle tension
- Sleep disturbance
Generalized Anxiety Disorder (GAD)
Factors that reduce the chances of recognizing anxiety:
- Stigma associated w/ mental illness
- Attributing psychological symptoms to physical causes
- Under reporting and denying problems
- Labels and words used for anxiety
- Ageist attitude and beliefs
- Diagnostic difficulties
- Setting-specific deficits, such as time constraints in primary care settings
- Somatic complaints
Scales to assess anxiety that are recommended in Best practice guidelines on detection and assessment of anxiety include:
- The Geriatric Anxiety Inventory
- The Short Anxiety Screening Test
- The Hospital Anxiety and Depression Scale
- Rating Anxiety in Dementia
Suggested questions to identify anxiety in older people:
- Can you say what triggers you feeling anxious?
- Have you been concerned about or fretted over a number of things?
- Is there anything going on in your life that is causing you concern?
- Do you find that you have a hard time putting things out of your mind?
Other questions useful in identifying how and when physical symptoms begin:
- What were you doing when you noticed the chest pain?
- What were you thinking about when you felt your heart start to race ?
- When you can’t sleep, what is usually going through your head?
Anxiety depression in older people can be treated effectively.
Treatment choices depend on the symptoms, the specific anxiety diagnosis, comorbid medical conditions and any current medication regimen
Older people often report somatic complaints such as:
Rather than the cognitive symptoms such as: excessive worrying
- Gastrointestinal symptoms
- Headache
- Dizziness
- Pain
- Dyspnea
- Palpitations
Psychotic manifestations may occur as a secondary syndrome in a variety of disorder, the most common being:
- Alzheimer’s disease
- Dementia
- Parkinson’s disease
Major treatment option for depression in older adults?
- Pharmacology
- Psychotherapy
- Psychosocial intervention
- Electroconvulsive therapy
The risk factors associated with suicide among older persons:
- Living alone
- Having a depressive disorder
- Medical illness
The most significant risk factor for suicide is having:
A depressive disorder
Risk factors for suicide among older persons include:
- Older age
- Previous suicidal behaviours
- Thoughts of suicide or wanting to die
- Mental illness
- Substance abuse
- Functional impairment
- Personality disorders
- Social, physical or financial loss
- Negative life events
- Being unmarried
- Living alone
Positive factors associated with suicide resiliency are:
- Positive health care practice and adaptive coping
- Contact with family and friends
- Moderate alcohol consumption
- Active interest
- Religious practice and spirituality
- Extroversion
- Openness to experience
- Perceived meaning in life
- Future orientation
Risk factors associated with substance use disorders are:
- Male gender
- Family history of dependence on alcohol, tobacco, or prescription medications
- Social isolation
- Recent and multiple losses
- Persistent pain
- Co-occurrence with depression
- Being unmarried or living alone or both
Non-pharmacological interventions recommended for anxiety disorder:
- Cognitive-behavioural therapy (CBT)
2. Exercise
Pharmacological treatment with GAD
- SSRI
2. Short-acting Benzoid
Possible signs of problem gambling include:
- Spending more money on gambling than intended
- Feeling bad, sad, or guilty about gambling
- Not having enough money for food, rent, or bills
- Being unable to account for blocks of time
- Experiencing social withdrawal
- Experiencing anxiety or depression
Following behaviour can indicate depression in older adult:
- Frequent use of call bell and numerous physical complaints
- Avoidance of social activities
- Complaints of poor care in the facility
Depression can also involves
- Decreased concentration
- Indecisiveness
______ maladaptive pattern of substance use evidenced by recurrent and significant adverse consequences related to the repeated use of substance.
Substance Abuse
A ______ is a health condition characterized by alterations in a variety of factors that include mood and affect, behaviour, and thinking and cognition.
Mental Disorder
Risk factors for suicide among older persons include:
- Older age
- Previous suicidal behaviours
- Thoughts of suicide or wanting to die
- Mental illness
- Substance abuse
- Functional impairment
- Personality disorder
- Social, physical, or financial loss
- Negative life events
- Being unmarried
- Living alone
Three stages of stress:
- Alarm
- Resistance
- Exhaustion
Most prevalent mental health problems:
- Anxiety
- Severe cognitive impairment
- Mood disorder
- Alcohol abuse and dependence
a state of being without, is usually accompanied by grief, which is an emotional state of intense sadness and a reaction to the disruption of attachment.
Loss
Worden’s Four Tasks of Mourning
- To accept the reality of loss
- To work through the physical and emotional pain of grief
- To adjust to an environment in which the deceased is missing
- To find an enduring connection with the deceased while embarking on a new life-emotionally relocate the loss
______ is a multifaceted response to loss that affects the entire person. It includes physical, emotional, intellectual, spiritual, social, and occupational elements
Grief
Six Dimensions of the normal grief response
- Physical
- Emotional
- Occupational
- Social
- Intellectual
- Spiritual
