NATCEP Day Thirty Three
Objectives
Define depression
 Identify signs and symptoms
 Describe possible causes
 Identifies the nurse aide’s role a...
Definition
An emotional disorder that involves
the body, mood, and thoughts. The
person loses interest in daily
activities...
Signs & Symptoms
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Sadness
Inactivity
Difficulty thinking
Problems concentrating
Feelings of d...
Causes
Death of family or friends
 Loss of health
 Loss of body functions
 Loss of independence
 Loneliness/boredom
 ...
Nurse Aide
Roles/Responsibilities
Recognize signs & symptoms
 Report observations to nurse
 Maintain safety
 Follow car...
Nurse Aide
Roles/Responsibilities


Don’t make light of or ignore resident
comments or behaviors
 Suicidal?

 Suicide P...
Possible Interventions
One on One interaction
 Activities
 Learn the resident’s preferences and habits

NATCEP Day Thirty Three
Objectives
Identify possible causes of confusion
 Identify symptoms that indicate a resident
may be confused
 Discuss im...
Possible Causes of
Confusion
 Medical issues
 Chronic illnesses
 Surgery & injury
 Degenerative brain diseases – Alzhe...
Symptoms of Confusion
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Does not know self or others
Talks incoherently
Forgetful
Does not pay attention...
Implications
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The resident may be
 Frightened, unhappy, bewildered or angry
 Unaware of environment – doesn’t
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...
Ways to reduce confusion
Treat medical condition
 Improve nutrition & hydration
 Change prescribed medications
 Encoura...
Behaviors
Combative
 Withdrawn
 Socially inappropriate
 Verbal or physical aggression
 Wandering
 Abnormal sexual beh...
Therapeutic Interventions
Reality orientation to maintain reality contact
 Reminiscing = life review
 Validation therapy...
Therapeutic Interventions
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Begin conversation by identifying yourself
 Do not ask if they remember you

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Therapeutic Interventions


Dementia: eventually unable to understand verbal
communication
 Use pictures and point, touc...
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Natcep day 33

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Natcep day 33

  1. 1. NATCEP Day Thirty Three
  2. 2. Objectives Define depression  Identify signs and symptoms  Describe possible causes  Identifies the nurse aide’s role and responsibility in caring for the resident with depression  Possible interventions 
  3. 3. Definition An emotional disorder that involves the body, mood, and thoughts. The person loses interest in daily activities.  Most commonly overlooked disorder in the elderly   Misdiagnosised as a cognitive disorder  Can mimic physical illness
  4. 4. Signs & Symptoms              Sadness Inactivity Difficulty thinking Problems concentrating Feelings of despair Problems sleeping Changes in appetite Fatigue Agitation Withdrawn Thoughts of death or suicide Pain Irritability
  5. 5. Causes Death of family or friends  Loss of health  Loss of body functions  Loss of independence  Loneliness/boredom  Medications – side effect  Lose of purpose 
  6. 6. Nurse Aide Roles/Responsibilities Recognize signs & symptoms  Report observations to nurse  Maintain safety  Follow care plan 
  7. 7. Nurse Aide Roles/Responsibilities  Don’t make light of or ignore resident comments or behaviors  Suicidal?  Suicide Precautions according to policy  Observant for clues of attempts ○ High risk categories include  75 years of age and older  Recent diagnosis of terminal illness  Unrelieved chronic pain  Sudden loss of spouse  Elderly with recent multiple losses
  8. 8. Possible Interventions One on One interaction  Activities  Learn the resident’s preferences and habits 
  9. 9. NATCEP Day Thirty Three
  10. 10. Objectives Identify possible causes of confusion  Identify symptoms that indicate a resident may be confused  Discuss implications of confusion for the resident  Identify ways in which some of the causes of confusion may be minimized  Identify behaviors hat may be seen  Describe appropriate therapeutic interventions 
  11. 11. Possible Causes of Confusion  Medical issues  Chronic illnesses  Surgery & injury  Degenerative brain diseases – Alzheimers, dementia, arteriosclerosis    Poor nutrition Poor fluid intake Medication  Reaction  Combo of meds    Social Isolation Hearing & Vision Loss Changes in the usual environment
  12. 12. Symptoms of Confusion          Does not know self or others Talks incoherently Forgetful Does not pay attention Does not understand when someone else is speaking Sleep disorders Hallucinates – visual or auditory Hostile/combative SUNDOWNING
  13. 13. Implications  The resident may be  Frightened, unhappy, bewildered or angry  Unaware of environment – doesn’t       recognize danger Reduced contact with others Less self expression Less independence Insecure Verbal or physical aggression Socially inappropriate behavior
  14. 14. Ways to reduce confusion Treat medical condition  Improve nutrition & hydration  Change prescribed medications  Encouraging socialization  Avoid overstimulation  Calm, relaxed and peaceful setting  Hearing aids and glasses 
  15. 15. Behaviors Combative  Withdrawn  Socially inappropriate  Verbal or physical aggression  Wandering  Abnormal sexual behavior  Repetitive behaviors  Catastrophic reactions 
  16. 16. Therapeutic Interventions Reality orientation to maintain reality contact  Reminiscing = life review  Validation therapy   Focuses on responding to the affect or emotion expressed by the patient rather than the actual content, which may be distorted. Rather than correct and attempt to reorient a disoriented person, positive reinforcement is continually given.  Helps them feel more secure and oriented within their own reality
  17. 17. Therapeutic Interventions  Begin conversation by identifying yourself  Do not ask if they remember you          Eye level with eye contact Pleasant facial expression Place hand on resident’s arm or hand unless it causes agitation Control background noise – be sure they can hear you Lower tone of voice Short, common words; short, simple sentences Give resident time to respond One question at a time – if need to repeat, say same way Ask resident to do only one task at a time
  18. 18. Therapeutic Interventions  Dementia: eventually unable to understand verbal communication  Use pictures and point, touch, or hand the resident items  Demonstrate an action when you want resident to complete a task  Resident may use word substitutes  Consistent – find out what they mean & use yourself  Avoid abstract, common expressions  “You can hop into bed now”    Repeat resident’s last words to help stay on track during conversation Do not try to “make” resident understand = agitation Use nonverbal praise freely and always respect resident’s feelings

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