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KNPE 335 > Week 4 > Flashcards

Week 4 Flashcards

1
Q

cognitive function

A

changes in memory, attention and processing speed

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2
Q

mental disorders

A

depression, anxiety, cognitive impairments, etc.

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3
Q

well-being

A

general sense of feeling good and being able to adapt to various life events

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4
Q

coping mechanisms

A

strategies used to manage stress and life changes

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5
Q

resilience

A

ability to adapt positively to adversity or significant life events

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6
Q

life satisfaction

A

overall contentment and fulfillment with life experiences

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7
Q

purpose and meaning

A

a sense of contribution and meaningful engagement in daily activities and relationships

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8
Q

social support

A

relationships with family, friends and communities

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9
Q

social isolation

A

the degree to which an individual lacks a sense of engagement with others

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10
Q

cultural identity

A

the preservation and influence of one’s cultural background

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11
Q

cultural competence

A

the ability to interact effectively with people from diverse cultural backgrounds

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12
Q

retirement (life transitions)

A

adjusting to a new phase of life with changes to ones routine, responsibilities, and identity

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13
Q

bereavement (life transitions)

A

coping with loss and the associated grief processes

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14
Q

largest life transitions in adults older than 65

A
  1. retirement
  2. bereavement
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15
Q

self-esteem

A

maintaining a positive self-image and self-worth

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16
Q

autonomy

A

maintaining independence and control over one’s life decisions
- decreases with age which effects mental health and well-being

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17
Q

mental illness

A

alteration in thinking, mood or behaviour, associated with distress and impaired functioning

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18
Q

examples of the many forms of mental illness

A
  1. mood disorders
  2. schizophrenia
  3. anxiety disorders
  4. personality disorders
  5. eating disorders
  6. addiction (substance/gambling)
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19
Q

mental illness vs. mental health

A

mental illness: specific diagnosed disorders
mental health: quality of life and well-being
***distinct but interconnected

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20
Q

prevalence of mental health problems in adults over age of 65

A

20-30%
- increased more for hospital or LTC

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21
Q

what is the most common mental health condition among older adults?

A

depression

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22
Q

percentage of suicides in older adults

A

25% are aged 60 or older
- highest for older males (highlights gap in discussion and treatment)

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23
Q

what effects mental health?

A
  1. physical factors (exercise, nutrition, sleep, etc.)
  2. social factors (relationships, activites)
  3. emotional factors (self-esteem, knowledge, etc.)
  4. spiritual factors (meaning of life)
  5. services (health, dental, vision, etc.)
  6. income
  7. housing
  8. transportation and mobility
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24
Q

what is missing from what effects mental health?

A

organizational and policy effects

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25
Q

why are mental illnesses missed?

A
  1. signs an symptoms are different in older adults in comparison to younger adults (don’t have “usual” symptoms)
  2. older adults are les likely to self-identify
  3. can accompany or stem from serious physical illnesses and disorders
  4. environmental, social and cultural factors can affects signs and symptoms and willingness to seek treatment
  5. caregiver stress and burnout - less likely to notice changes in their loved one
  6. depression can be an early sign on dementia - dementia can mask depression too
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26
Q

proportion of Canadian adults that did not get mental health services when needed

A

15% = below average

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27
Q

things that contribute to compromised dignity

A
  1. lack of policy
  2. increased frailty and dependence
  3. less focus on functional recovery
  4. neurocognitive disorders
  5. institutionalization
  6. healthcare inequalities
  7. social stigma and discrimination
  8. ageism and elder abuse
  9. loneliness
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28
Q

what does compromised dignity cause

A
  1. stops them from getting care/help
  2. violates the right to have dignity and care
  3. affects mental health
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29
Q

dopamine

A
  1. reward-motivation system
  2. motor control, decision making, teaching, motivation, pleasure
    - declines with age causing motor performance and cognition to decline
    - also causes emotional problems with age
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30
Q

serotonin

A
  1. boost when you feel significant and important
  2. mood, memory, sleep, cognition
    - declines with age causing the things above to decline as well
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31
Q

norepinephrine

A
  1. regulates blood pressure
  2. memory formation and retrieval
  3. stress and sleep regulation
    - declines with age causing the things above to decline and cause anxiety
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32
Q

what happens when the neurotransmitters decline?

A

poor mental health

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33
Q

common mental health disorders in older adults

A
  1. depression
  2. suicide
  3. anxiety disorders
  4. dementia
  5. loneliness and isolation
  6. delusion
  7. delirium
  8. paraphrenia (paranoid delusions with no hallucinations)
  9. concurrent disorders (disorders that work together against eachother)
    - mental illness + substance abuse problem
34
Q

depression and aging

A
  • NOT a normal part of aging
  • depressive symptoms are very similar to dementia, so the person is often labelled as having dementia
35
Q

symptoms of depression

A

S: sleep
I: interest
G: guilt
E: energy
C: concentration
A: appetite
P: psychomotor
S: suicide

36
Q

SIGECAPS

A

mneumonic for the symptoms you should be looking for if you are a caregiver/family member to diagnose depression

37
Q

sleep symptom of depression

A

change in sleep patterns
- daytime napping
- unable to fall sleep
- fatigued even with sleep though

38
Q

interest symptom of depression

A

lack of interest or pleasure in life daily activities, anhedonia, physical limitations

39
Q

guilt symptom of depression

A

feeling like a burden, worthlessness, grief, loss, feeling sad without reason

40
Q

concentration symptom of depression

A

directly linked to fears
- fears about cognitive decline and memory loss and acute stress = concentration problems

41
Q

energy symptom of depression

A

changes in energy (lethargy and fatigue)
- increase in angry, aggressive, agitated, or irritable energy

42
Q

appetite symptom of energy

A

changes to appetite
- unintended weight loss of gain
- increased or decreased sense of hunger and satiety
- digestive problems

43
Q

psychomotor symptom of depression

A

reduced activity, like energy, feeling they have slowed down, or sense of restlessness

44
Q

suicide symptom of depression

A

feelings of hopelessness, helplessness, and sadness
- thoughts of death or better off dead

45
Q

late-life depression

A

depressive disorder developed at beginning of old age
- serious and life-threatening disorder
- underdiagnosed and inadequately treated
- challenging to distinguish from dementia

46
Q

prevalence of late-life depression

A

1 in 5 seniors

47
Q

what is late life depression characterized by

A

atypical cluster of symptoms
- somatic, anxiety, and psychotic symptoms
- less likely characterized by sadness

48
Q

why is late-life depression difficult to distinguish from dementia?

A

due to overlapping symptom profiles
- especially when depression affects the cognition and is presented as “pseudodementia”

49
Q

causes of late life depression

A
  1. medical illness
  2. executive dysfunction
  3. vulnerable personality
  4. stressful life events
  5. poor social networks
50
Q

treatment for major depression in older adults - prevention

A
  1. reduce isolation
  2. PA
  3. eat well
  4. social activities
  5. mindfulness, etc.
51
Q

treatment for major depression in older adults - assessment

A
  1. prolonged bereavement
  2. social isolation
  3. chronic illness
  4. memory difficulties
  5. recent onset anxiety, etc.
52
Q

screening for depression

A
  1. geriatric depression scale
  2. the hamilton rating scale for depression
53
Q

delirium

A

acute change in mental status causing shift in cognitive functioning, reduced environmental awareness, altered attention, and behaviour changes

54
Q

types of delirium

A
  1. hypoactive
  2. hyperactivity
  3. mixed
55
Q

hypoactive delirium

A
  1. withdrawn
  2. reduced speech and activity
  3. apathy
  4. unawareness
56
Q

hyperactivity delirium

A
  1. increased activity
  2. irritability
  3. restlessness
  4. combativeness
57
Q

mixed delirium

A

fluctuations psychomotor activity

58
Q

short-term delirium outcomes

A
  1. falls
  2. pressure injuries
  3. aspiration pneumonia
  4. distress
  5. prolonged hospital stay
  6. long-term care admission
  7. increased risk mortality
59
Q

long-term delirium outcomes

A
  1. functional and cognitive impairment
  2. dementia
  3. PSTD symptoms
  4. sleep disturbances
  5. increased risk mortality
60
Q

factors reducing the risk of delirium

A
  1. cognitive reserve
  2. social support and interactions
  3. environmental influences
  4. pain management
61
Q

cognitive reserve and delirium

A

capacity of the mature adult brain can buffer the effects of neurological disease or injury

62
Q

social support and interactions with delirium

A

regular visits from care partners help to reduce burden of cognitive impairment and provide comfort with frequent reorientation

63
Q

environmental influences and delirium

A

exposure to natural daylight can support the promotion of regular circadian rhythms and healthy sleep cycles

64
Q

pain management and delirium

A

appropriate and consistent pain assessments should be conducted to ensure pain is adequately controlled and severity is monitored, especially is communication becomes difficult with delirium

65
Q

delirium distress symptoms

A
  1. anger
  2. fear
  3. frustration
  4. hopelessness
  5. loss of control
  6. embarrassment
  7. guilt
66
Q

delirium and mental health conditions

A

some of the populations most vulnerable to delirium are older adults who have dementia, depression and acute psychiatric syndrome

67
Q

delirium superimposed on dementia

A

when an individual with pre-existing dementia develops delirium

68
Q

loneliness

A

perception of being alone and isolated matters the most
- a state of mind
- subjective, negative feeling related to the deficient social relations
- more dangerous to health than smoking

69
Q

what does a high degree of loneliness cause

A
  1. suicidal ideation
  2. para-suicide
  3. alzheimers disease
  4. dementia
  5. negative effects of immune system
  6. negative effects of cardio-vascular system
  7. increased risk of hospitalization
  8. increased risk of LTC facility placement
70
Q

types of loneliness

A
  1. developmental
  2. internal
  3. situational
71
Q

developmental loneliness

A

lack of balance between individualism and innate desire to relate to others

72
Q

internal loneliness

A

perception of being along
- associated with low self-esteem and worth

73
Q

situational loneliness

A

socio-economic and cultural milieu
- effected by environment

74
Q

interventions for loneliness

A
  1. activity involvement
  2. volunteer roles
  3. developing and keeping quality relationships **most imp
  4. pharmacological management of
    physical ailments
  5. staying in contact with family and friends
75
Q

social isolation

A

a state in which the individual lacks a sense of belonging socially, lacks engagement with others, has a minimal number of social contacts and are deficient in fulfilling and quality relationships

76
Q

the prevalence of social isolation

A

43% in community dwelling older adults

77
Q

what health effects does social isolation lead to?

A
  1. increased risk for all-cause mortality
  2. dementia
  3. increased risk for rehospitalization
  4. increased number of the falls
    - can be avoided through prevention and mitigation efforts if detected early
78
Q

what three factors should patient care efforts be focused on assessing and improving?

A

physical, mental and social well-being

79
Q

impacts of social isolation

A
  1. health behavioural
  2. psychological
  3. physiological
  4. other outcomes
80
Q

interventions for social isolation

A
  1. no one-size fits all approach, tailor programs to individual needs
  2. group based social activities and support groups
  3. patient-centred approach is essential
81
Q

principals for a comprehensive approach to aging and mental health

A
  1. elderly must have access to mental health treatment
  2. they should receive the care and supports needed to live safely
  3. equity, safety and inclusion must be embedded
  4. policy, programs, and practices should support mentally healthy aging
  5. government must prioritize and invest

KNPE 335 (9 decks)

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