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Anxiety in Seniors

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Milar Moore, Psychiatric Mental Health Nurse Practitioner, with At Home Psychiatry LLC, presents at OSRAA Conference 2018. Learn how to prevent, identify, and determine severity of anxiety in an older adult. Know how to manage at home or when to call a professional for help.

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Anxiety in Seniors

  1. 1. Anxiety in Seniors M. Milar Moore Psychiatric Mental Health Nurse Practitioner At Home Psychiatry LLC
  2. 2. Talk Outline • Getting our Bearings (3 minutes) • Prevention (5 min) • Identifying Anxiety in Seniors (7 min) • Determining Severity (5 min) • Home Management (12 min) • Professional Treatment – Counseling (5 min) – Medical (8 min) • Questions?
  3. 3. A Starting Place • Scratching the surface • Reducing judgment and stigma • Maintaining compassion and respect • Importance of empowerment and autonomy 10:43
  4. 4. Preventing Anxiety: Life in Balance • Realistic expectations • Social support (people, pets) • Pleasure/fun/laughter • Meaning/mindfulness/faith/grief • Sleep • Physical activity • Nutrition • Sunlight • Being able to express our concerns • Good primary care (heart, lung, thyroid, adrenal, etc.) • Affirmation, esteem • Self-efficacy, agency 10:48
  5. 5. Recognizing Anxiety in Seniors • Worry • Restlessness • Withdrawal/avoidance • Pessimism • Irritability • Lack of pleasure/satisfaction • Sensitivity • Increased medical problems • Disrupted sleep • Obsessive or repetitive behaviors • Appetite changes 10:55
  6. 6. Assessing Anxiety Severity • Subjective /objective • Self-harm risk • Effect on daily function • Quality of life • Simple instruments – GAS – Hamilton – Beck – Include with referral! 11:00
  7. 7. Managing Anxiety: The 3 A’s • Alter the situation • Adapt to the stressor • Accept the unchangeable 11:03
  8. 8. ALTER • Change the stressor • Express your concerns • Be willing to compromise • Balance your schedule • Ask for what you need 11:06
  9. 9. ADAPT • Change your response to the stressor • Reframe problems • Take a longer view • Adjust your standards • Practice gratitude 11:09
  10. 10. ACCEPT • Don’t try to control the uncontrollable • Look for opportunities • Forgive and seek forgiveness • Embrace grief • Be open and share 11:12
  11. 11. When Anxiety Self-Care Isn’t Enough • Unable to function • Causing damage, self-harm, threat to health, financial peril • History of acute trauma • Possible underlying medical cause • Consider counseling or behavior therapy • If anxiety precludes counseling, start with medical intervention to control symptoms enough to allow therapy. 11:17
  12. 12. Common Anxiety Medications • Benzodiazepines • Serotonin agents • Special concerns in aging – Slowed clearance – Polypharmacy – Falls – Sensitivity to side effects 11:25
  13. 13. Questions? 11:30
  14. 14. Thank you!

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