Download Chapter 38 Geropsychiatric Nursing

Copyright © 2005 Mosby, Inc. All rights reserved.
Slide 0
Chapter 38
Geropsychiatric Nursing
Copyright © 2005 Mosby, Inc. All rights reserved.
Slide 1
Components of Geropsychiatric Nursing
Assessment
• Interviewing—Therapeutic communication skills;
comfortable, quiet setting
• Mental status examination—Mini-Mental State
Examination; evaluation for depression, anxiety, and
psychosis
• Behavioral responses—Description of behavior and
triggers; assessment of behavioral change; frequently
observed challenging behaviors
• Functional abilities—Mobility; activities of daily living;
risk for falls
• Physiological functioning—General health; nutrition;
substance abuse
• Social support—Social support systems past and
current; family-patient interaction; caregiver concerns
Copyright © 2005 Mosby, Inc. All rights reserved.
Slide 2
Diagnosis of the Geriatric Patient
• Disturbed thought processes—Impaired memory;
confusion; paranoia
• Affective responses—Dysfunctional grieving and
hopelessness; risk for self-directed violence; situational
low self-esteem
• Somatic responses—Disturbed sleep pattern;
imbalanced nutrition: less than body requirements
• Stress responses—Progressively lowered stress
threshold (PLST); relocation stress syndrome; risk for
caregiver role strain
• Behavioral responses—Social isolation; self-care
deficit/behavioral deficit; challenging
behaviors/behavioral excess
Copyright © 2005 Mosby, Inc. All rights reserved.
Slide 3
Evidence-Based Treatments for Depression
and Anxiety in the Aged
Disorder: Depression and anxiety in the aged
Treatment:
• The primary classes of antidepressant medications
(SSRIs and TCAs) were effective in both the acute and
maintenance phases of late-life depression, although
the latter has a heightened risk of adverse side effects.
• Electroconvulsive therapy (ECT) has shown its
effectiveness and safety in the short-term management
of late-life, severe psychotic depression and mania.
• Psychosocial interventions were efficacious, especially
cognitive, behavioral, and cognitive-behavioral therapy,
in treating major depressive disorders in the aged.
Copyright © 2005 Mosby, Inc. All rights reserved.
Slide 4