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PPT Chapter37

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Chapter 37:
Mental Health Assessment of
Older Adults
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Normal Aging
 Life span has increased from 47 years (1900) to 78.8
years (2016)
 Normally, some physical decline
o Decreased sensory abilities
o Decreased pulmonary and immune functions
 No change in important functions
o Intellectual function
o Capacity for change
o Productive engagement with life
Copyright © 2018 Wolters Kluwer · All Rights Reserved
Older Adults: Mental Health Problems
Depression, anxiety disorders, dementia most
common
Complex because of comorbid medical problems and
treatment
Symptoms of somatic disorders imitating or masking
psychiatric disorders
Older adults are more likely to report somatic
symptoms than psychological ones
Copyright © 2018 Wolters Kluwer · All Rights Reserved
Question #1
Is the following statement true or false?
The average life expectancy has reached a plateau
since the beginning of the 21st century.
Copyright © 2018 Wolters Kluwer · All Rights Reserved
Answer to Question #1
False.
Based on current statistics, as of 2016, the average
life expectancy is now 78.8 years compared with the
average life expectancy of 47 years in 1900.
Copyright © 2018 Wolters Kluwer · All Rights Reserved
Techniques of Data Collection
Interviews
Self-report standardized tests
Laboratory test results
Medical records
Family members
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Biopsychosocial Geropsychiatric Nursing
Assessment
 Comprehensive, deliberate, systematic collection and
interpretation of biopsychosocial data (refer to Box 37.2)
 Purpose: determination of:
o Current and past health
o Functional status
o Human responses to mental health problems
 Atmosphere of respect, nondistracting environment,
pacing interview to mirror the patient’s ability to move
through the assessment
Copyright © 2018 Wolters Kluwer · All Rights Reserved
Question #2
Is the following statement true or false?
When collecting data for a geropsychiatric nursing
assessment, the patient’s family is a valuable source
of information.
Copyright © 2018 Wolters Kluwer · All Rights Reserved
Answer to Question #2
True.
Family members often notice changes that the
patient overlooks or fails to recognize. Therefore,
they are an important source of data.
Copyright © 2018 Wolters Kluwer · All Rights Reserved
Assessment for the Biologic Domain
 Past and present health
status
 Physical examination
results
 Physical functioning
o Elimination
o Sleep
 Insomnia; other
sleep problems
 Physical functioning
o Nutrition and eating
 Weight loss;
dysphagia or
xerostomia
 Pain
 Pharmacologic
assessment
o Polypharmacy
Copyright © 2018 Wolters Kluwer · All Rights Reserved
Assessment for the Psychological Domain
 Responses to mental health problems
o Denial
o Fear to admit any symptoms
 Mental status examination
o Mood and affect
o Thought processes
o Cognition and intellectual performance
 Behavior changes
 Stress and coping patterns
Copyright © 2018 Wolters Kluwer · All Rights Reserved
Assessment for the Psychological Domain:
Risk Assessment
Depression
Past suicide attempt
Family history of suicide
Firearms in home
Alcohol or substance
abuse
Unusual stress
Burden to family
Chronic medical
condition
Social isolation
Copyright © 2018 Wolters Kluwer · All Rights Reserved
Question #3
Which of the following would the nurse least likely
consider as a risk factor for suicide?
A. Firearms in the home
B. History of schizophrenia
C. Feeling of being a burden
D. Debilitating arthritis
Copyright © 2018 Wolters Kluwer · All Rights Reserved
Answer to Question #3
B.
Risk factors associated with older adults and suicide
include firearms in the house, history of previous
suicide attempt or a family history of suicide,
feelings of being a burden, and chronic medical
conditions such as debilitating arthritis. A history of
schizophrenia is not associated with an increased
risk for suicide.
Copyright © 2018 Wolters Kluwer · All Rights Reserved
Assessment for the Social Domain
Social support
Functional status: ADLs and IADLs
Social systems (community resources)
Spiritual assessment
Legal status
Quality of life
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