Psychological needs of the older adult

Question 1

what assessment steps do you take to distinguish between delirium, dementia and depression?

Answer 1

1. onset of mental status change and course of illness
2. level of consciousness
3. attention span

Question 2

what is the first line of treatment for depression?

Answer 2

SSRIs

Question 3

what (psych) drug is prescribed often for chronic pain?

Answer 3

TCAs

Question 4

what factors increase the risk of suicide in older adults?

Answer 4

1. addictions
2. personality factors
3. medical illness
4. negative life events
5. difficult transitions
6. lack of social support
7. functional impairment
8. anxiety
9. hopelessness
10. previous attempts

Question 5

what is the most common mental illness in older adults?

Answer 5

anxiety

Question 6

what is the issue with giving anti anxiety medications to older adults?

Answer 6

the side effects of confusion, over sedation and paradoxical aggitation

Question 7

standards of practice for the geriatric populations

Answer 7

1. physiological health
2. optimizing functional health
3. responsive care
4. relationship care
5. health system
6. safety and security

Question 8

when taking a history of an older adult what actions should you take to show respect and comfort?

Answer 8

1. do interview in a private area
2. introduce yourself and ask how they like to be called (last or first name)
3. establish rapport
4. correct lighting and not too much noise in the back ground
5. use touch
6. sum up interaction and ask for feedback and questions.

Question 9

what are some psychological interventions?

Answer 9

1. nursing counselling
2. group therapy
3. re-motivation therapy
4. reminiscence therapy

Question 10

what does remotivation therapy look like?

Answer 10

1. climate of acceptance:
   
   • introductions to group and a little about themselves
2. creating a bridge to reality:
   
   • ex. talking about oceans, used a world globe, shells, sun tan lotion, to cause thinking
3. sharing the world we live in
   
   • group discussion focused on jobs of the body of water.
4. An appreciation of the world of work
   - think and talk about work in relation to others. past work roles, hobbies and past times
5. climate of appreciation
   
   • leader thanks the group individually and tells them the theme for the next time.

Question 11

Other interventions

Answer 11

promotion of self care activities

milieu managment

Question 12

What are the 3 main cognitive disorders?

Answer 12

Delirium
Dementia
Amnestic disorder

Question 13

What is delirium?

Answer 13

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

Question 14

Onset difference between the 3 Ds

Answer 14

Delirium is sudden, over hours to days

Dementia is slowly over months

Depression can be gradual, with exacerbation during crisis or stree

Question 15

What are causes or contributing factors of delirium

Answer 15

Hypoglycemia
fever
dehydration
hypotension
infection
adverse drug reactions
head injury
Change in environment ie hospitalization

Question 16

What are causes or contributing factors to dementia

Answer 16

Alzheimer's disease
Vascular disease
HIV
Infection
Neurological disease
Chronic alcoholism 
Head trauma

Question 17

what are the causes or contributing factors of depression

Answer 17

life long history
losses
loneliness
crisis
declining health
medical conditions

Question 18

out of the 3 Ds which one has altered level of consciousness?

Answer 18

delirium

Question 19

which of the 3 Ds is not reversible?

Answer 19

Dementia

Question 20

what is the emotional state of delirium?

Answer 20

rapid swings
fearful
anxious
suspicious
aggressive
may have hallucinations or delusions or both

Question 21

what is the emotional state of dementia?

Answer 21

flat and delusional

Question 22

what is the speech like for delirium?

Answer 22

rapid, inappropriate, incoherent, rambling

Question 23

what is the speech like for dementia?

Answer 23

incoherent, slow, inappropriate, rambling, repititious

Question 24

Cognition in delirium

Answer 24

memory,
judgement,
calculations,
attention span (fluctuates in the day)

Question 25

depression cognition?

Answer 25

difficulty concentrating, forgetful and lack of attention

Question 26

cognition in dementia

Answer 26

memory,
 judgement,
 calculations,
 attention span.
cannot abstract think 
 agnosia (inability to process sensory info)

Question 27

Interventions of Delirium

Answer 27

1. prevent physical harm due to confusion or aggression
2. perform nursing assessment
3. assist in proper heath management
4. supportive measures to relieve distress

• orientate them
• apply safety measures to prevent falls

Question 28

what is dementia

Answer 28

progressive deterioration of cognitive functioning and global change in intellect with no change in LOC

Question 29

what is the most common form of dementia?

Answer 29

Alzheimer

Question 30

difference b/w primary and secondary dementia?

Answer 30

primary is irreversible, and progressive ie. Alzheimer

secondary is because of some pathological process ie metabolic or nutritional. ie. AIDs related dementia