Psychological needs of the older adult Flashcards
what assessment steps do you take to distinguish between delirium, dementia and depression?
- onset of mental status change and course of illness
- level of consciousness
- attention span
what is the first line of treatment for depression?
SSRIs
what (psych) drug is prescribed often for chronic pain?
TCAs
what factors increase the risk of suicide in older adults?
- addictions
- personality factors
- medical illness
- negative life events
- difficult transitions
- lack of social support
- functional impairment
- anxiety
- hopelessness
- previous attempts
what is the most common mental illness in older adults?
anxiety
what is the issue with giving anti anxiety medications to older adults?
the side effects of confusion, over sedation and paradoxical aggitation
standards of practice for the geriatric populations
- physiological health
- optimizing functional health
- responsive care
- relationship care
- health system
- safety and security
when taking a history of an older adult what actions should you take to show respect and comfort?
- do interview in a private area
- introduce yourself and ask how they like to be called (last or first name)
- establish rapport
- correct lighting and not too much noise in the back ground
- use touch
- sum up interaction and ask for feedback and questions.
what are some psychological interventions?
- nursing counselling
- group therapy
- re-motivation therapy
- reminiscence therapy
what does remotivation therapy look like?
- climate of acceptance:
- introductions to group and a little about themselves
- creating a bridge to reality:
- ex. talking about oceans, used a world globe, shells, sun tan lotion, to cause thinking
- sharing the world we live in
- group discussion focused on jobs of the body of water.
- An appreciation of the world of work
- think and talk about work in relation to others. past work roles, hobbies and past times - climate of appreciation
- leader thanks the group individually and tells them the theme for the next time.
Other interventions
promotion of self care activities
milieu managment
What are the 3 main cognitive disorders?
Delirium
Dementia
Amnestic disorder
What is delirium?
Cognitive disturbance characterized by inattention, disorganized thinking, and fluctuation in mental status
Is acute but can have long term effects.
If they have a preexisting cognitive impaired in dementia, delirium can speed up cognitive decline
Always secondary to another condition
Onset difference between the 3 Ds
Delirium is sudden, over hours to days
Dementia is slowly over months
Depression can be gradual, with exacerbation during crisis or stree
What are causes or contributing factors of delirium
Hypoglycemia fever dehydration hypotension infection adverse drug reactions head injury Change in environment ie hospitalization
What are causes or contributing factors to dementia
Alzheimer's disease Vascular disease HIV Infection Neurological disease Chronic alcoholism Head trauma
what are the causes or contributing factors of depression
life long history losses loneliness crisis declining health medical conditions
out of the 3 Ds which one has altered level of consciousness?
delirium
which of the 3 Ds is not reversible?
Dementia
what is the emotional state of delirium?
rapid swings fearful anxious suspicious aggressive may have hallucinations or delusions or both
what is the emotional state of dementia?
flat and delusional
what is the speech like for delirium?
rapid, inappropriate, incoherent, rambling
what is the speech like for dementia?
incoherent, slow, inappropriate, rambling, repititious
Cognition in delirium
memory,
judgement,
calculations,
attention span (fluctuates in the day)
depression cognition?
difficulty concentrating, forgetful and lack of attention
cognition in dementia
memory, judgement, calculations, attention span. cannot abstract think agnosia (inability to process sensory info)
Interventions of Delirium
- prevent physical harm due to confusion or aggression
- perform nursing assessment
- assist in proper heath management
- supportive measures to relieve distress
- orientate them
- apply safety measures to prevent falls
what is dementia
progressive deterioration of cognitive functioning and global change in intellect with no change in LOC
what is the most common form of dementia?
Alzheimer
difference b/w primary and secondary dementia?
primary is irreversible, and progressive ie. Alzheimer
secondary is because of some pathological process ie metabolic or nutritional. ie. AIDs related dementia
