Older adults have much to tell and active listening is validating. Free radical theory: Free radicals damage cell membranes, causing physical damage and decline. Sociocultural theories of aging address the interplay of the individual and the environment: Activity theory: Activity produces the most positive psychological climate for older adults, and the aged should remain active as long as possible. • Tendency to dismiss elders as complainers or demanding Delirium is common with significant morbidity and mortality among older adults (Botts, 2010). Caregiver response to behavior also must be assessed because it may reinforce or increase challenging behaviors. Wear-and-tear theory: Cells wear out from internal and external causes. 1981 Oct;7(10):607-9. This may be because its presentation differs from that in younger populations (e.g., physical complaints), it may be assumed to be part of the normal aging process, or the diagnosis may be complicated by co-morbidity issues (Naegle, 2011). Affective status is an essential part of geropsychiatric assessment. Historically, minority groups have had lower socioeconomic status and less access to health care. Physical, emotional, and social symptoms are believed to reflect problems in negotiating the transitions of the family life cycle. Although the prevalence of schizophrenia is estimated to be only 0.6% among older adults, with about one fourth of those having late-onset (after age 40 years) disorders, the prevalence of psychotic symptoms increases with age. Radical changes in personality in old age may indicate brain disease. However, some older people are preoccupied with the physical decline that occurs with age. Many nurses who work with these patients welcome the opportunity to integrate nurse practitioner and psychiatric nursing skills. Behavioral assessment involves defining the behavior, its frequency, duration, and precipitating factors or triggers, including the environment. How do you feel about the idea of a biological clock determining life span? Mental health in late life depends on a number of factors, including physiological and psychological status, personality, social support system, economic resources, and usual lifestyle. New evidence of the impact of healthy living on aging well is challenging the basis of some of these theories. Patients should be cautioned about side effects of medications and should be encouraged to take time when ambulating and moving from one position to another. Critical Reasoning By the year 2050, the oldest old (85 years or older) group will increase to between 24% and 30% of the total population. Critical Reasoning For example, a man is irritable because he is becoming forgetful. Demographic shifts and the shortage of nurses have increased the demand for nurses who work with older adults with mental disorders (Institute of Medicine, 2008; Loge and Sorrell, 2010). This may be because its presentation differs from that in younger populations (e.g., physical complaints), it may be assumed to be part of the normal aging process, or the diagnosis may be complicated by co-morbidity issues (Naegle, 2011). Mental Status Examination Historically, minority groups have had lower socioeconomic status and less access to health care. Contrary to popular myths, most older people do not dwell unrealistically on their health. Other symptoms in the elderly include sleep changes, weight loss, cognitive complaints, irritability/hostility, gastrointestinal distress, and refusal to eat or drink, with potentially life-threatening consequences. These projections, coupled with a reduction in stigma, will increase the need and demand for specialty mental health services. Discuss the elements of a comprehensive geropsychiatric nursing assessment. • Perseveration CardiovascularOrthopedicNeuromuscularPerceptualCognitiveAffectiveAltered nutritional statusFatigue and weaknessUnsteady gait/mobility problems There may be multiple somatic complaints with no diagnosable organic cause. 6. Examine the dimensions of mental illness in the elderly population and the role of the geropsychiatric nurse. The opportunity to share the wisdom and resilience of an older adult can make this specialty area especially rewarding (Cangelosi, 2007; Reichstadt et al, 2010). 2. Depression may begin with decreased interest in usual activities and lack of energy. These effects are particularly caused by sedative-hypnotic, antianxiety, cardiovascular, and hypertensive drugs. By the year 2050, the oldest old (85 years or older) group will increase to between 24% and 30% of the total population. It is better to overstate than to increase the patient’s anxiety and stress by omitting information. Behavioral responses Demographic shifts and the shortage of nurses have increased the demand for nurses who work with older adults with mental disorders (Institute of Medicine, 2008; Loge and Sorrell, 2010). For example, delusions can be part of psychotic depression in elders, and those with dementia may seem delusional because of the trouble they have in interpreting the environment. Free radical theory: Free radicals damage cell membranes, causing physical damage and decline. 6. The demographics of aging and mental health make geropsychiatric nursing the specialty of the future. A complete physical examination is needed after any abrupt behavioral change to rule out delirium (Botts, 2010). Providing nursing care to these patients can be complex because they are often involved with a number of agencies requiring coordination of services. Nurses are in an ideal position to lead efforts in delirium evaluation, prevention, and treatment. Maintaining contact with others Information about ombudsman or other advocacy programs for the elderly may be obtained by contacting any local office on aging. Factors that influence ambulation include restriction of joints caused by degenerative diseases, orthostatic hypotension, and the type and fit of footwear. ASSESSMENT FACTORS Untreated or inappropriately treated anxiety among older people can contribute to sleep problems, cognitive impairments, and other significant medical problems (Lenze and Wetherell, 2011). When a behavioral change occurs, it is important to analyze the underlying cause and meaning. The incidence of depression among people of all ages who have disabilities is higher. This theory is the basis of many myths and stereotypes (“What can you expect from someone his age?”). • Resistiveness Falls result in physical injuries, such as hip fractures, and in psychological effects, such as fearfulness (Van Leuven, 2010). Physical or mental disorders Analyze evidence-based nursing interventions for geropsychiatric patients. The Interview Setting It is anticipated that aging baby boomers (those born between 1946 and 1964), who number 75 million in the United States, will be at greater risk for substance abuse, anxiety disorders, and depression than the current group of elders. Sociocultural Theories Age is like a rainbow that follows the storms of life. Anxiety disorders decrease function and quality of life for many elderly people and increase the burden on family, care providers, and health services. Mini-Mental State ExaminationMental status examinationDepressionAnxietyPsychosis

role of geropsychiatric nurse

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