RN Yogendra Mehta, profile picture
Uploaded byRN Yogendra Mehta
PPTX, PDF216 views

Psychosocial Problems in Elderly People.pptx

usefulr for nursing students

Embed presentation

Download to read offline
Psychosocial Problems in Elderly People Mr Yogendra Mehta Lecturer, HOD (Adult health Nursing) TU IOM BRNC, Biratnagar
Objectives • Explain the psychological problems in elderly people  Senile dementia  Sleep disturbance  Empty nest syndrome  Sun down syndrome  Depression  Anxiety  paranoia • Explain the social problem in elderly people. Social Isolation Change in societal role
Introduction Successful psychological aging is reflected in the older person's abil-ity to adapt to:  physical  social emotional losses and to achieve:  Contentment: state of being happy and satisfied  Serenity: peace of mind, patience  life satisfactions
Social problem in elderly people  Social Isolation  Change in societal role Social Isolation:  Individual lacks a sense of belonging socially, lack of engagement with others, minimal number of social contacts and deficit in fulfilling quality relationship.  It can exacerbate person’s feeling of a. Low self worth b. Shame c. Loneliness d. depression
Social problem in elderly people contd...... Social Isolation management: a. Increase awareness b. Address depression c. Increase opportunities for the elderly to contribute their wisedom to the society. d. Geriatric club e. promote living with family
Social problem in elderly people contd...... Change in societal Role: Retirement a. Often the first major transition faced by elderly. b. Reduced income and altered social role. Retirement management: c. Preretirement counselling d. Involving in social activities Widowhood e. Usually less financially secure and enter into poverty status. f. Lack of independency g. Abuse  Transition from parents to grand parents  Loss of identity in society.
Senile Dementia in elderly people a. Senile Dementia  Senile dementia is the mental deterioration in memory, thinking, behavior and the ability to perform every days activities.  difficulty learning or remembering recent events. Normal Aging a. Rarely Forgetting names of people b. Slightly forgetting the part of an experiences. c. Mood change in response to an appropriate causes. d. Change in their interest
Senile Dementia Contd.... Early Signs of dementia a. Forgetting the names of people close to them b. Forgetting the things more than they used too. c. Unpredictable mood change. d. Decreased interest in activities. Causes e. Alzheimer’s disease f. Major depression g. Trauma or infection h. Parkinson’s disease
Senile Dementia Contd.... e. Pick’s Disease: frontotemporal dementia, a neurodegenerative disease f. Creutzfeldt-Jakob disease: Change in brain tissues and affects muscle coordination thinking, and memory. g. Lewy body dementia:  Disease associated with abnormal deposits of a protein called alpha-synuclein in the brain.  lead to problems with thinking, movement, behavior, and mood.
Clinical Features of Senile dementia a. Physical Changes • Stooped posture • Wrinkled skin • Decrease in muscle strength • Changes in the lens and muscles of the eye • Brittleness of bone and stiffness of the joints • Hardening of the arteries
Clinical Features of Senile dementia Contd..... a. Mental Changes • Impaired judgment • Loss of memory • Sometimes childish behavior
Management of Senile dementia Contd..... a. No medicine have been shown to correct the dementia. It can be controlled the symptoms. Goal of treatment b. Maximize the functional abilities c. Improve quality of life d. provision for support for the family. e. Help their memory, thinking skills, mood, and behavior
Management of Senile dementia Contd..... Cholinesterase inhibitors  Donepezil, rivastigmine and galantamine are used to treat the symptoms of mild to moderate Alzheimer's disease.  slow the breakdown of a brain chemical involved in memory and judgment. Memantine: helps control a different brain chemical needed for learning and memory. Antidepressants: especially selective serotonin reuptake inhibitors (SSRIs), can improve low mood and irritability. Anxiolytics: such as lorazepam or oxazepam can ease anxiety or restlessness. Antipsychotic: Aripiprazole, Haloperidol, Olanazapine can help control feelings and behaviors such as aggression, Hallucination.
Management of Senile dementia Contd..... Therapies • Reminiscence therapy  might include things like talking with your loved one about their hometown, school days, work life, or favorite hobbies.  It can be done one-on-one or in groups as part of an organized therapy.  The person leading the session might use music from your loved one’s past, or things like photos or treasured items, to help. • Cognitive stimulation therapy (CST) : is a structured program for groups of people with mild to moderate dementia.  At meetings, the group does mentally engaging activities, like talking about current events, singing, playing word games, or cooking from a recipe.
Management of Senile dementia Contd..... • Reality orientation training : goes over basic things like the person’s name, and the date and time. They might have signs with that information placed around their home. • Lifestyle Changes  Stay active o it’s a fitness class for seniors or other physical activity such as walking, dancing, and gardening. o exercise may slow down dementia symptoms such as thinking problems, and ease anxiety or depression.  Prioritize good sleep avoid caffeinated tea and coffee especially in the evening, and to limit daytime naps.
Management of Senile dementia Contd..... • Focus on foods MIND Diet: Researchers say the MIND diet includes: • Vegetables, especially leafy greens like; spinach • Nuts, Berries , Beans , Whole grains • Fish • Olive oil • Wine • limits red meat, butter and stick margarine, cheese, sweets, and fried foods. • If your loved one is able to cook, let them join in and make sure they are involved in what they eat.
Management of Senile dementia Contd..... • Stay organized: Keep a calendar and other easy-to-see reminders around their home to help remember upcoming events and plans. • Rethink the home. remove items that create clutter and noise and hide things that can be dangerous, such as knives or car keys. • Check Hearing and Vision • Counseling and Support
PARANOIA • A mental disorder in which a person has an extreme fear and distrust of others. A paranoid person may have delusions that people are trying to harm him or her. • Extreme and unreasonable feeling that other people do not like you or are going to harm or criticize you. • Often linked to memory loss, paranoia can occur in the elderly if they misplace things, forget instructions, or no longer recognize people. • In fact, 70% of older adult patients with Alzheimer’s experience paranoid delusions.
Causes of PARANOIA • Dementia, including Alzheimer's disease • Brain tumors • Brain damage caused by stroke or injury • Medication side effects • Psychiatric conditions • Dehydration or heat-related illness • Untreated urinary tract infections • Social isolation
Features of PARANOIA • believing that someone is out to get you • is taking your stuff • is in the house at night • Delusions, which means believing things that aren’t true or real. • Hallucinations, which means seeing or hearing things that aren’t there. • Disorganized thoughts or speech, meaning saying or thinking things that seem illogical or bizarre to others.
Management of Paranoia As a geriatrician, assess an older person in the following five domains: a. Ability to manage key life tasks  include the ability to manage ,key tasks we usually learn as young children, such as walking, dressing, feeding ourselves, and toileting.  Instrumental Activities of Daily Living (key tasks we learn as teenagers, such as managing finances, transportation, meal preparation, home maintenance, etc). b. Physical health red flags  These include weight loss, declines in strength or physical abilities, falls, frequent ER visits, and complaints of pain.
Management of Paranoia c. Mood and brain health red flags  These include common signs of depression (especially sadness and/or loss of interest in activities), signs of loneliness or isolation, new or excessive worrying. d. Medication management red flags  These include signs of difficulty taking prescriptions as directed, checking on possible medication side-effects, and medications that older people should avoid or use with caution.
Management of Paranoia Aside from medications, prevention plans that include the following can be of great help: • Walking as a physical exercise for the patient. • Patient awareness of the location and time they’re in • Letting the patient rest and sleep adequately • Older adults need fluids, their glasses, and hearing aids
Management of Paranoia Steps that should follow for treatment:  Visit to the family doctor  Non-Drug Interventions and Therapy • doing art and being involved in music. • Walking, running • Adequate rest and sleep to make the body and mind function well. Medication • Antipsychotic medications: risperidone , olanzapine
Nursing Care of Paranoia Elderly People • Be understanding to patient. • Keep their surroundings calm and quiet. • Avoid arguing about anything that is making them paranoid. • Assess the client’s neurological status. • Talk openly with the client about their beliefs and thoughts, showing empathy and support. • Explain all procedures clearly and carefully, and their purpose, before starting them. • Avoid startling the client, sudden movements or touching the client unnecessarily. • Discuss feelings and help the client identify behaviors that cause conflict or alienate.
Nursing Care of Paranoia Elderly People • Encourage socialization with others, but do not force participation in activities. • Administer medications appropriately and monitor for reactions to medications. • Provide education, resources, and support for client’s family and loved ones. • Involve patients’ family or loved ones in care as appropriate in treatment plan .
Sleep Disturbance(Insomnia) • Sleep can e defined as a normal state of altered consciousness during which the body rests; it is characterized by decreased responsiveness to the environment, and a person can be aroused from it by external stimuli. • Sleep disorders in older adults involve any disrupted sleep pattern. • This can include problems falling or staying asleep, too much sleep, or abnormal behaviors with sleep. • Sleep patterns change with age, anxiety levels and many other factors. • In elderly individuals, sleep maintenance insomnia and early ‐ awakening are more common complaints.
Factors leading to Sleep Disturbance • Physical illness (eg. Nausea, mood disorders, breathing difficulty, pain) • Drugs and substances (eg. Tryptophan) • Lifestyle (eg. Daily routines, exercises) • Usual sleep patterns and excessive daytime sleepiness • Emotional stress • Environment ( ventilation) • Sound • Exercise and fatigue • Food and caloric intake
Symptoms of Insomnia • difficulty falling asleep at the start of the sleep period • waking up during the night and having difficulty falling back asleep • waking up early and being unable to get back to sleep.
Effects of Insomnia • increase confusion, • memory loss • depression • Stress • Physical Effect • Social Isolation
Treatment of Insomnia Cognitive-behavioral therapy (CBT)  can improve your sleep by changing your behavior before bedtime as well as changing the ways of thinking that keep you from falling asleep.  It also focuses on improving relaxation skills and changing lifestyle habits that impact your sleeping patterns.
Treatment of Insomnia • A study at Northwestern University found that aerobic exercise resulted in the most dramatic improvement in quality of sleep, including sleep duration, for middle-aged and older adults with a diagnosis of insomnia. • Melatonin is often prescribed to treat insomnia in older patients. • Suvorexant or low-dose doxepin can improve sleep maintenance. • Eszopiclone or zolpidem extended release can be utilized for both sleep onset and sleep maintenance. • Low-dose zolpidem sublingual tablets or zaleplon can alleviate middle-of-the-night awakenings. • Benzodiazepines should not be used routinely.
Nursing Care in Insomnia • offer meals at regular times, corresponding to client’s previous pattern. • provide active meaningful activities during daytime hours, including exposure to natural light, and an outdoor environment when possible. • monitor frequency and duration of naps. • create an individualized bedtime ritual that includes a quieting activity, a light carbohydrate snack, going to the bathroom and settling a routine. • Do not waken even if incontinent. Change and assist the client to the bathroom when he or she spontaneously awakens. • if turning or other care is necessary, try to provide for periods up to 2 hours of undisturbed sleep time whenever possible.
Empty Nest Syndrome • Sadness or emotional distress affecting parents whose children have grown up and left home. • This condition is typically more common in women, who are more likely to have had the role of primary carer. Loss of Motherhood  Once the last child moves out, the mother may feel that her most important job is finished.  the mother may feel worthless, disoriented and unsure of what meaning her future may hold.  However, most mothers adapt in time.  It may take between 18 months and two years to make the successful transition from ‘mum’ to independent woman.
Empty Nest Syndrome • Some parents are more susceptible than others People who suffer the most from empty nest syndrome tend to have things in common, including:  Change is considered stressful.  They found moving out of home a difficult and emotional experience.  Their marriage is unstable or unsatisfactory.  Parents who worry that their children aren’t ready to take on adult responsibilities tend to experience more grief.
Empty Nest Syndrome New challenges The challenges faced by parents experiencing empty nest syndrome includes: • Establishing a new kind of relationship with their adult children. • Filling the void in the daily routine created by absent children. • Lack of sympathy or understanding from others, who consider children moving out to be a normal, healthy event.
Symptoms of Empty Nest Syndrome • feelings of loss • Sadness • Anxiety • Grief • Irritability • fear
Stages of Empty Nest Syndrome Social psychologist Carin Rubenstein said three distinct stages: • Grief • Relief • joy
Deal with an empty nest syndrome parent • Accept that their feelings are normal. • Acknowledge that their parenting role has changed, not ended. • Keep in touch with their children (calls, emails, video chats, etc.) • Find a new hobby or take a class. • Volunteer for a meaningful cause. • Re establish old friendships.
Sun Down Syndrome • Sundowning is the name for a group of behaviors, feelings and thoughts people who have Alzheimer's or dementia can experience as the sun sets. • The behaviors start or get worse around sunset or sundown. However, this delirium can potentially occur at any time, not just at sunset.
Sun Down Syndrome Sundowning is most often experienced by people with dementia, a group of symptoms that can affect: • Memory • Thinking • Personality • Reasoning • Behavior • Mood Around 20% of people diagnosed with Alzheimer’s disease experience sundowning.
Features of Sun Down Syndrome Behavioral features • Pacing • Rocking in a chair • Wandering • Violence • Shadowing. This is when the individual follows their caregiver very closely, everywhere they go. • Crying • Insomnia • Yelling
Features of Sun Down Syndrome Emotional features • Sadness • Anxiety • Fear • Agitation • Restlessness • Irritability Mental States(Thoughts) • Confusion • Paranoia • Delusions and hallucinations
Factors that make worse Sun Down Syndrome • Disrupted circadian rhythms (sleep-wake cycles). • Insomnia • Infection • Dehydration • Problems with seeing the difference between reality and dreams. • Physical illnesses • Pain • Fatigue • Overstimulation from a busy day • Low lighting
Treatment of Sun Down Syndrome Nonmedication treatments include: • Light therapy • Music therapy • Environmental changes  Keep familiar objects (such as family photos) nearby.  Ensure the adequate lighting in their environment during the day and darkness at bedtime.  Availability of eyeglasses or hearing aids if patient needed.
Treatment of Sun Down Syndrome Pharmacological treatments include: • Antidepressant medications • Antianxiety medications • Antipsychotics • Melatonin to help with sleep
Nursing Care of Sun Down Syndrome Nurses must take the following steps to help them settle in at bedtime: • Make their bedroom room quiet. • Turn down all noises such as televisions and other electronic devices. • Play quiet music that’s soothing and gentle. • Ask to do a simple activity — enjoy a snack together, work on an easy puzzle or watch a favorite show. • Practice sleep hygiene by having your loved one go to bed at the same time, in the same place every night.
Prevention of Sun Down Syndrome • Make sure patient one gets enough rest at night. • Avoid caffeinated drinks after the morning. • Avoid drinking too much alcohol. • Try to help to get plenty of sunlight during the day by sitting by a window or going out for walks. • Encourage for Exercise every day. • If a nap is necessary, make it short and early in the day. • Plan some activities throughout the day but not too many.
Depression in Elderly People • Feeling down every once in a while is a normal part of life, but if these feelings last a few weeks or months, you may have depression. • It can affect the way you feel, act, and think. • Depression is a common problem among older adults, but clinical depression is not a normal part of aging.
Types of Depression in Elderly People • Major Depressive Disorder – includes symptoms lasting at least two weeks that interfere with a person’s ability to perform daily tasks. • Persistent Depressive Disorder (Dysthymia) – a depressed mood that lasts more than two years, but the person may still be able to perform daily tasks. • Substance/Medication-Induced Depressive Disorder – depression related to the use of substances, like alcohol or pain medication. • Depressive Disorder Due to A Medical Condition – depression related to a separate illness, like heart disease or multiple sclerosis.
Risk Factors of Depression 3 main causes of depression in older people are : • Poor physical health  Medical conditions, such as stroke or cancer  Stress  Sleep Disturbance  Genes – people who have a family history of depression may be at higher risk. • Social Isolation & Loneliness • Loss • Medication: Blood pressure medication (e.g. clonidine), Beta- blockers (e.g. Lopressor, Inderal), Tranquilizers (e.g. Valium), Calcium- channel blockers, Sleeping pills, Steroids, Anticholinergic drugs used to treat GI disorders.
Features of Depression • more of a numbness or a lack of interest in activities. • may not be as willing to talk about their feelings. • Persistent sad • Feelings of hopelessness, guilt, worthlessness, or helplessness • Irritability, restlessness • Loss of interest in once pleasurable activities. • fatigue • Moving or talking more slowly • Difficulty concentrating, remembering, or making decisions. • Difficulty sleeping, waking up too early in the morning, oversleeping. • Eating more or less than usual. • Thoughts of death or suicide, or suicide attempts
Treatment of Depression in Elderly People • Selective serotonin reuptake inhibitors (SSRIs) : escitalopram and sertraline are considered to have minimal drug interactions. • Volunteer your time • Take care of a pet • Join a Club • Create a opportunity to laugh • Music therapy • Cognitive Behavioural therapy(CBT)
Anxiety in Elderly People • Feeling anxious or nervous is a common emotion for people of all ages and a normal reaction to stress. • Feeling anxious can help us handle problems and strange situations, and even avoid danger. • when one feels anxious often and the anxiety is overwhelming and affects daily tasks, social life, and relationships, it may be an illness. • An anxiety disorder causes feelings of fear, worry. • Anxiety is a common illness among older adults, affecting as many as 10-20 percent of the older population.
Types of Anxiety • Specific phobias:is an intense, irrational fear of a place, thing or event that actually poses little or no threat. • Agoraphobia is a fear of public places, leaving one’s home, or being alone. • Phobias more common to older adults include fear of death, disaster to family, and dental procedures. • Social Phobias: An older adult might feel intense, persistent, and chronic fear of being judged by others and of doing things that will cause embarrassment. Physical symptoms can include blushing, heavy sweating, trembling, nausea, and difficulty talking.
Types of Anxiety • Generalized Anxiety disorder  constant worries, and there may be nothing or little to cause these worries.  Those with GAD are overly concerned about health issues, money, family problems, or possible disaster.  Older adults with GAD have difficulty relaxing, sleeping and concentrating, and startle easily. Symptoms  fatigue, chest pains, headaches  muscle tension, muscle aches, difficulty swallowing  trembling, twitching, irritability  sweating, nausea, lightheadedness  having to go to the bathroom frequently
Types of Anxiety • PTSD: PTSD develops after a traumatic event that involved physical harm or the threat of physical harm to the individual. • OCD: some older people do suffer from persistent, upsetting thoughts that they control by performing certain rituals, such as repeatedly checking things, touching things in a particular order, or counting things.
Causes of Anxiety in Elderly People • Stressful life events (e.g., death of a loved one) • Limited physical mobility. • Loss of independence. • Financial insecurity. • Sleep disturbances (e.g., insomnia) • Chronic health conditions (e.g., diabetes, obesity) • Side effects of medications (e.g., steroids, stimulants)
Features of Anxiety in Elderly People • irrational and excessive worry or fear. • checking and rechecking for safety. • avoiding routine activities. • avoiding social situations. • racing heart. • shallow breathing, trembling, nausea, sweating.
Management of Anxiety in Elderly People • Breathing Exercises. Deep breathing is a great way to manage the physiological symptoms of anxiety • Physical Activity • Diet Changes • Social Interaction • Routine work • Sleep Hygiene • Relaxing Hobbies Antidepressants are the first-line medications in the treatment of anxiety disorders. Anxiolytics drugs
Nursing Care of Elderly People with Anxiety • Acknowledge the feelings the patient is experiencing. • Administer medication as appropriate and as ordered. • Provide active-listening to patient • Instruct patient through guided imagery or other relaxation techniques/methods. • Encourage the patient to engage in regular daily exercise and activity programs.
THANK YOU

More Related Content

PPTX
Recreational therapy
bySusmita Halder
 
PPTX
ppt on Alzheimer’s disease
byDr Ashok dhaka Bishnoi
 
PPTX
Complementary and alternative medicine
byShweta Sharma
 
PPT
Terminologies of psychiatry
byBonsy Scaria
 
PPTX
Delirium and dementia
byKarishma Rajput
 
PPTX
Psychopharmacology
byVipin Chandran
 
PPT
Breast cancer
byPallavi Lokhande
 
PPTX
Principles of Mental Health (Psychiatric) Nursing
byAjeshkumar Tk
 
Recreational therapy
bySusmita Halder
 
ppt on Alzheimer’s disease
byDr Ashok dhaka Bishnoi
 
Complementary and alternative medicine
byShweta Sharma
 
Terminologies of psychiatry
byBonsy Scaria
 
Delirium and dementia
byKarishma Rajput
 
Psychopharmacology
byVipin Chandran
 
Breast cancer
byPallavi Lokhande
 
Principles of Mental Health (Psychiatric) Nursing
byAjeshkumar Tk
 

What's hot

PPTX
Alzheimer’s disease
byBobby Abraham
 
PPTX
Nursing management of the- medical surgical nursing-1 UNIT 14.pptx
byJyotiBhagat31
 
PPTX
Psychopharmacology
bySweet Lyn Balleza
 
PDF
Psychosocial aspects (Cancer patients has to cope with a variety of stressors)
bykalyan kumar
 
PPT
History Psychiatry .ppt
byMaheshWangi2
 
PDF
challenges in Psychiatric nursing
byMental Health Center
 
PPTX
Organic Amnesia
byRooban Thavarajah
 
PPTX
Multidisciplinary mental health team
byNursing Path
 
PPTX
Electro convulsive therapy
byHindusthan College of Nursing
 
PPTX
Psychopharmacology
byAashish Parihar
 
PPTX
Therapeutic attitude.pptx
byMANUSHARMA741469
 
PPTX
Milieu therapy or therapeutic community
byDeblina Roy
 
PPTX
Pituitary tumors
byRatheesh R
 
PPTX
nursing assessment of cancer.pptx
byGarimaSrivastava93
 
PPTX
BPAD
byFlemin Thomas
 
PDF
ECT
byRichard Asare
 
PPTX
Review structure and function of brain, limbic system, ubnormal neurotransmis...
byJinto Philip
 
PPTX
Cancer of the oral cavity
byANILKUMAR BR
 
PDF
Management of cancer
bymeducationdotnet
 
PPTX
Transitional care
byvinoli_sg
 
Alzheimer’s disease
byBobby Abraham
 
Nursing management of the- medical surgical nursing-1 UNIT 14.pptx
byJyotiBhagat31
 
Psychopharmacology
bySweet Lyn Balleza
 
Psychosocial aspects (Cancer patients has to cope with a variety of stressors)
bykalyan kumar
 
History Psychiatry .ppt
byMaheshWangi2
 
challenges in Psychiatric nursing
byMental Health Center
 
Organic Amnesia
byRooban Thavarajah
 
Multidisciplinary mental health team
byNursing Path
 
Electro convulsive therapy
byHindusthan College of Nursing
 
Psychopharmacology
byAashish Parihar
 
Therapeutic attitude.pptx
byMANUSHARMA741469
 
Milieu therapy or therapeutic community
byDeblina Roy
 
Pituitary tumors
byRatheesh R
 
nursing assessment of cancer.pptx
byGarimaSrivastava93
 
BPAD
byFlemin Thomas
 
ECT
byRichard Asare
 
Review structure and function of brain, limbic system, ubnormal neurotransmis...
byJinto Philip
 
Cancer of the oral cavity
byANILKUMAR BR
 
Management of cancer
bymeducationdotnet
 
Transitional care
byvinoli_sg
 

Similar to Psychosocial Problems in Elderly People.pptx

PPTX
Depression, schizophrenia, ALZHEIMER'S DISEASE
bySanskar College of Pharmacy & Research
 
PPTX
Education and Awareness in the Workplace: A Key to a Dementia Friendly Community
byTheChamber
 
PPTX
Psychiatric problems among elderly
bySabitha Jain
 
PPT
10-neurocognitive disorders.ppt. which is scribe.
byseidshumye143
 
PPT
10-neurocognitive disorders.ppt
byILIKAGUHAMAJUMDARDep
 
PPTX
Geriatric related Mental Health problems
byIslamabad Nursing College
 
PPTX
Dementia
bydivya2709
 
PPTX
Seniors Mental Health How we can help and protect our seniors
byDrSmitaMahajan
 
PPTX
Section 6 caring for persons with confusion and dementia-1
bybaxtermom
 
PPTX
HEALTH CARE ASSISTANTS dementia PATIENTS notes
byNaomikibithe
 
PPTX
Geriatric psychiatric mental health problems..pptx
bysaminaroohiN
 
PPTX
Mental health in
byrdhdgrandma
 
PPTX
Cognitive Impairments and Dementia
byMMIStudios
 
PPT
Delirium, dementia, depression
byImtitsal Aulia
 
PPT
10 HUS 133 Mental Disorders
byDon Thompson
 
PPTX
A c hall
byRajesh Konnur
 
PPTX
Dementia .pptx !!!!!!!!!!!!!!!!!!!!!!!!!
bypoornima884404
 
PPT
Neurocognitive disorders corcoran 2013
byJacqueline Corcoran
 
PPT
Abnormal Psychology 8_Lecture_18 Presentation .ppt
byrajapakserakhitha
 
PPT
Family presentation
byHeather597
 
Depression, schizophrenia, ALZHEIMER'S DISEASE
bySanskar College of Pharmacy & Research
 
Education and Awareness in the Workplace: A Key to a Dementia Friendly Community
byTheChamber
 
Psychiatric problems among elderly
bySabitha Jain
 
10-neurocognitive disorders.ppt. which is scribe.
byseidshumye143
 
10-neurocognitive disorders.ppt
byILIKAGUHAMAJUMDARDep
 
Geriatric related Mental Health problems
byIslamabad Nursing College
 
Dementia
bydivya2709
 
Seniors Mental Health How we can help and protect our seniors
byDrSmitaMahajan
 
Section 6 caring for persons with confusion and dementia-1
bybaxtermom
 
HEALTH CARE ASSISTANTS dementia PATIENTS notes
byNaomikibithe
 
Geriatric psychiatric mental health problems..pptx
bysaminaroohiN
 
Mental health in
byrdhdgrandma
 
Cognitive Impairments and Dementia
byMMIStudios
 
Delirium, dementia, depression
byImtitsal Aulia
 
10 HUS 133 Mental Disorders
byDon Thompson
 
A c hall
byRajesh Konnur
 
Dementia .pptx !!!!!!!!!!!!!!!!!!!!!!!!!
bypoornima884404
 
Neurocognitive disorders corcoran 2013
byJacqueline Corcoran
 
Abnormal Psychology 8_Lecture_18 Presentation .ppt
byrajapakserakhitha
 
Family presentation
byHeather597
 

More from RN Yogendra Mehta

PPTX
Nursing Care of Client with Corticosteroid Therapy.pptx
byRN Yogendra Mehta
 
PPTX
Osteoporosis.pptx lecture slide for Bsc Nursing 2nd Year
byRN Yogendra Mehta
 
PPTX
Ethics & Ethical Issues in Nursing.pptx for nurses
byRN Yogendra Mehta
 
PPTX
Guillain – Barre syndrome.pptxfor nursing students
byRN Yogendra Mehta
 
PPTX
PAGET'S DISEASE (2).pptx lecture slide for Bachelor of Nursing
byRN Yogendra Mehta
 
PPTX
Guillain – Barre syndrome for nursing students
byRN Yogendra Mehta
 
PPTX
Unit 5.8SupervisionLeadership & Management
byRN Yogendra Mehta
 
PPTX
Unit -5 L&M BNS3rd Yr.pptx for undergraduate nurse
byRN Yogendra Mehta
 
PPTX
Parathyroid Disorder.pptx for bachelor of nursing
byRN Yogendra Mehta
 
PPTX
Cushing Syndrome.pptx lecture slide for nursing students
byRN Yogendra Mehta
 
PPTX
Unit-7.1 (Resource Management)leadership
byRN Yogendra Mehta
 
PPTX
DI1.pptx lecture slide for bachelor students
byRN Yogendra Mehta
 
PPTX
Abortion.pptx for nurses studying bachelor
byRN Yogendra Mehta
 
PPTX
Regulation of Thyroid Hormone.ppt for nursesx
byRN Yogendra Mehta
 
PPTX
Septic Arthritis.pptx for bachelor of nursing students
byRN Yogendra Mehta
 
PPT
Cushing Syndrome.PPT lecture slide for nursing
byRN Yogendra Mehta
 
PPTX
Unit III.pptx for Bachelor Nursing helpful
byRN Yogendra Mehta
 
PPTX
DI.pptxuseful for Bachelor of nursing students
byRN Yogendra Mehta
 
PPTX
Amputation.pptx slide for nursing students
byRN Yogendra Mehta
 
PPT
UTI.ppt Helpful for Bachelor Nursing Students
byRN Yogendra Mehta
 
Nursing Care of Client with Corticosteroid Therapy.pptx
byRN Yogendra Mehta
 
Osteoporosis.pptx lecture slide for Bsc Nursing 2nd Year
byRN Yogendra Mehta
 
Ethics & Ethical Issues in Nursing.pptx for nurses
byRN Yogendra Mehta
 
Guillain – Barre syndrome.pptxfor nursing students
byRN Yogendra Mehta
 
PAGET'S DISEASE (2).pptx lecture slide for Bachelor of Nursing
byRN Yogendra Mehta
 
Guillain – Barre syndrome for nursing students
byRN Yogendra Mehta
 
Unit 5.8SupervisionLeadership & Management
byRN Yogendra Mehta
 
Unit -5 L&M BNS3rd Yr.pptx for undergraduate nurse
byRN Yogendra Mehta
 
Parathyroid Disorder.pptx for bachelor of nursing
byRN Yogendra Mehta
 
Cushing Syndrome.pptx lecture slide for nursing students
byRN Yogendra Mehta
 
Unit-7.1 (Resource Management)leadership
byRN Yogendra Mehta
 
DI1.pptx lecture slide for bachelor students
byRN Yogendra Mehta
 
Abortion.pptx for nurses studying bachelor
byRN Yogendra Mehta
 
Regulation of Thyroid Hormone.ppt for nursesx
byRN Yogendra Mehta
 
Septic Arthritis.pptx for bachelor of nursing students
byRN Yogendra Mehta
 
Cushing Syndrome.PPT lecture slide for nursing
byRN Yogendra Mehta
 
Unit III.pptx for Bachelor Nursing helpful
byRN Yogendra Mehta
 
DI.pptxuseful for Bachelor of nursing students
byRN Yogendra Mehta
 
Amputation.pptx slide for nursing students
byRN Yogendra Mehta
 
UTI.ppt Helpful for Bachelor Nursing Students
byRN Yogendra Mehta
 

Recently uploaded

PPTX
COGNITION IN DEPRESSION
byDr Hari Ram Sedai
 
PPTX
Swallowing & Swallowing Disorders SLP_1 lecture 4.pptx
byDr Zonera Khalid PT
 
PPTX
Disease, Spectrum of disease, Iceberg phenomenon of disease
byBindu Nepal
 
PPTX
LEGISLATION IN NURSING ppt.pptx good ppt
byGaziaKhan
 
PPTX
Communication and utilization of research.pptx
byPreeti Kulshreshtha
 
PPTX
MICROSPORIDIAL KERATITIS , CLINICAL FEATURES , TREATMENT
byDr Aarushi Choudhary
 
PPTX
Concept of Shodhana in Rasashastra PPT.pptx
byDr. Vaishnavi B R
 
PPTX
Drug Distribution Explained | Pharmacokinetics, Barriers, Vd & Redistribution...
byRGUHS
 
PPTX
A critical review on Parpati kalpana .pptx
byDr. Vaishnavi B R
 
PPTX
Differential Diagnosis OF PERIAPICAL LESION.pptx
byvijit17
 
PPTX
Pharmacology and Toxicology Multiple Choice Questions (MCQs) Part 3
byVanarajRabari
 
PPTX
Basic overview and structural elucidation of Morphine
bySumitSharma743530
 
PPTX
Chronic Viral Hepatitis HEP B HEP C HEP D
byNAWEEN KUMAR
 
PPTX
Imaging of benign focal lesions of the Liver
byDr. Aryan (Anish Dhakal)
 
PDF
RETINAL VEIN OCCLUSION; CRVO & BRVO types, pathophysiology, diagnosis & manag...
bySamikshaRai22
 
PPTX
Review on Analytical tests on Bhasma.pptx
byDr. Vaishnavi B R
 
PDF
Femoral Triangle-Prof.Dr.N.Mugunthan KMMC Medical College, Muttom.pdf
byKanyakumari Medical Mission Research Center, Muttom
 
PPT
Forging New Paths With Earlier Use of ADCs in Breast Cancer: From Clinical Br...
byPVI, PeerView Institute for Medical Education
 
PPTX
Pressure ulcer Internal KPIs results for July,2024.pptx
byprofyasser95
 
PPTX
"SUPER FLU": TRUTH VS HYPE - WHAT CLINICIANS MUST KNOW
byArchitMehta11
 
COGNITION IN DEPRESSION
byDr Hari Ram Sedai
 
Swallowing & Swallowing Disorders SLP_1 lecture 4.pptx
byDr Zonera Khalid PT
 
Disease, Spectrum of disease, Iceberg phenomenon of disease
byBindu Nepal
 
LEGISLATION IN NURSING ppt.pptx good ppt
byGaziaKhan
 
Communication and utilization of research.pptx
byPreeti Kulshreshtha
 
MICROSPORIDIAL KERATITIS , CLINICAL FEATURES , TREATMENT
byDr Aarushi Choudhary
 
Concept of Shodhana in Rasashastra PPT.pptx
byDr. Vaishnavi B R
 
Drug Distribution Explained | Pharmacokinetics, Barriers, Vd & Redistribution...
byRGUHS
 
A critical review on Parpati kalpana .pptx
byDr. Vaishnavi B R
 
Differential Diagnosis OF PERIAPICAL LESION.pptx
byvijit17
 
Pharmacology and Toxicology Multiple Choice Questions (MCQs) Part 3
byVanarajRabari
 
Basic overview and structural elucidation of Morphine
bySumitSharma743530
 
Chronic Viral Hepatitis HEP B HEP C HEP D
byNAWEEN KUMAR
 
Imaging of benign focal lesions of the Liver
byDr. Aryan (Anish Dhakal)
 
RETINAL VEIN OCCLUSION; CRVO & BRVO types, pathophysiology, diagnosis & manag...
bySamikshaRai22
 
Review on Analytical tests on Bhasma.pptx
byDr. Vaishnavi B R
 
Femoral Triangle-Prof.Dr.N.Mugunthan KMMC Medical College, Muttom.pdf
byKanyakumari Medical Mission Research Center, Muttom
 
Forging New Paths With Earlier Use of ADCs in Breast Cancer: From Clinical Br...
byPVI, PeerView Institute for Medical Education
 
Pressure ulcer Internal KPIs results for July,2024.pptx
byprofyasser95
 
"SUPER FLU": TRUTH VS HYPE - WHAT CLINICIANS MUST KNOW
byArchitMehta11
 

Psychosocial Problems in Elderly People.pptx

  • 1.
    Psychosocial Problems inElderly People Mr Yogendra Mehta Lecturer, HOD (Adult health Nursing) TU IOM BRNC, Biratnagar
  • 2.
    Objectives • Explain thepsychological problems in elderly people  Senile dementia  Sleep disturbance  Empty nest syndrome  Sun down syndrome  Depression  Anxiety  paranoia • Explain the social problem in elderly people. Social Isolation Change in societal role
  • 3.
    Introduction Successful psychological agingis reflected in the older person's abil-ity to adapt to:  physical  social emotional losses and to achieve:  Contentment: state of being happy and satisfied  Serenity: peace of mind, patience  life satisfactions
  • 4.
    Social problem inelderly people  Social Isolation  Change in societal role Social Isolation:  Individual lacks a sense of belonging socially, lack of engagement with others, minimal number of social contacts and deficit in fulfilling quality relationship.  It can exacerbate person’s feeling of a. Low self worth b. Shame c. Loneliness d. depression
  • 5.
    Social problem inelderly people contd...... Social Isolation management: a. Increase awareness b. Address depression c. Increase opportunities for the elderly to contribute their wisedom to the society. d. Geriatric club e. promote living with family
  • 6.
    Social problem inelderly people contd...... Change in societal Role: Retirement a. Often the first major transition faced by elderly. b. Reduced income and altered social role. Retirement management: c. Preretirement counselling d. Involving in social activities Widowhood e. Usually less financially secure and enter into poverty status. f. Lack of independency g. Abuse  Transition from parents to grand parents  Loss of identity in society.
  • 7.
    Senile Dementia inelderly people a. Senile Dementia  Senile dementia is the mental deterioration in memory, thinking, behavior and the ability to perform every days activities.  difficulty learning or remembering recent events. Normal Aging a. Rarely Forgetting names of people b. Slightly forgetting the part of an experiences. c. Mood change in response to an appropriate causes. d. Change in their interest
  • 8.
    Senile Dementia Contd.... EarlySigns of dementia a. Forgetting the names of people close to them b. Forgetting the things more than they used too. c. Unpredictable mood change. d. Decreased interest in activities. Causes e. Alzheimer’s disease f. Major depression g. Trauma or infection h. Parkinson’s disease
  • 9.
    Senile Dementia Contd.... e.Pick’s Disease: frontotemporal dementia, a neurodegenerative disease f. Creutzfeldt-Jakob disease: Change in brain tissues and affects muscle coordination thinking, and memory. g. Lewy body dementia:  Disease associated with abnormal deposits of a protein called alpha-synuclein in the brain.  lead to problems with thinking, movement, behavior, and mood.
  • 10.
    Clinical Features ofSenile dementia a. Physical Changes • Stooped posture • Wrinkled skin • Decrease in muscle strength • Changes in the lens and muscles of the eye • Brittleness of bone and stiffness of the joints • Hardening of the arteries
  • 11.
    Clinical Features ofSenile dementia Contd..... a. Mental Changes • Impaired judgment • Loss of memory • Sometimes childish behavior
  • 12.
    Management of Seniledementia Contd..... a. No medicine have been shown to correct the dementia. It can be controlled the symptoms. Goal of treatment b. Maximize the functional abilities c. Improve quality of life d. provision for support for the family. e. Help their memory, thinking skills, mood, and behavior
  • 13.
    Management of Seniledementia Contd..... Cholinesterase inhibitors  Donepezil, rivastigmine and galantamine are used to treat the symptoms of mild to moderate Alzheimer's disease.  slow the breakdown of a brain chemical involved in memory and judgment. Memantine: helps control a different brain chemical needed for learning and memory. Antidepressants: especially selective serotonin reuptake inhibitors (SSRIs), can improve low mood and irritability. Anxiolytics: such as lorazepam or oxazepam can ease anxiety or restlessness. Antipsychotic: Aripiprazole, Haloperidol, Olanazapine can help control feelings and behaviors such as aggression, Hallucination.
  • 14.
    Management of Seniledementia Contd..... Therapies • Reminiscence therapy  might include things like talking with your loved one about their hometown, school days, work life, or favorite hobbies.  It can be done one-on-one or in groups as part of an organized therapy.  The person leading the session might use music from your loved one’s past, or things like photos or treasured items, to help. • Cognitive stimulation therapy (CST) : is a structured program for groups of people with mild to moderate dementia.  At meetings, the group does mentally engaging activities, like talking about current events, singing, playing word games, or cooking from a recipe.
  • 15.
    Management of Seniledementia Contd..... • Reality orientation training : goes over basic things like the person’s name, and the date and time. They might have signs with that information placed around their home. • Lifestyle Changes  Stay active o it’s a fitness class for seniors or other physical activity such as walking, dancing, and gardening. o exercise may slow down dementia symptoms such as thinking problems, and ease anxiety or depression.  Prioritize good sleep avoid caffeinated tea and coffee especially in the evening, and to limit daytime naps.
  • 16.
    Management of Seniledementia Contd..... • Focus on foods MIND Diet: Researchers say the MIND diet includes: • Vegetables, especially leafy greens like; spinach • Nuts, Berries , Beans , Whole grains • Fish • Olive oil • Wine • limits red meat, butter and stick margarine, cheese, sweets, and fried foods. • If your loved one is able to cook, let them join in and make sure they are involved in what they eat.
  • 17.
    Management of Seniledementia Contd..... • Stay organized: Keep a calendar and other easy-to-see reminders around their home to help remember upcoming events and plans. • Rethink the home. remove items that create clutter and noise and hide things that can be dangerous, such as knives or car keys. • Check Hearing and Vision • Counseling and Support
  • 18.
    PARANOIA • A mentaldisorder in which a person has an extreme fear and distrust of others. A paranoid person may have delusions that people are trying to harm him or her. • Extreme and unreasonable feeling that other people do not like you or are going to harm or criticize you. • Often linked to memory loss, paranoia can occur in the elderly if they misplace things, forget instructions, or no longer recognize people. • In fact, 70% of older adult patients with Alzheimer’s experience paranoid delusions.
  • 19.
    Causes of PARANOIA •Dementia, including Alzheimer's disease • Brain tumors • Brain damage caused by stroke or injury • Medication side effects • Psychiatric conditions • Dehydration or heat-related illness • Untreated urinary tract infections • Social isolation
  • 20.
    Features of PARANOIA •believing that someone is out to get you • is taking your stuff • is in the house at night • Delusions, which means believing things that aren’t true or real. • Hallucinations, which means seeing or hearing things that aren’t there. • Disorganized thoughts or speech, meaning saying or thinking things that seem illogical or bizarre to others.
  • 21.
    Management of Paranoia Asa geriatrician, assess an older person in the following five domains: a. Ability to manage key life tasks  include the ability to manage ,key tasks we usually learn as young children, such as walking, dressing, feeding ourselves, and toileting.  Instrumental Activities of Daily Living (key tasks we learn as teenagers, such as managing finances, transportation, meal preparation, home maintenance, etc). b. Physical health red flags  These include weight loss, declines in strength or physical abilities, falls, frequent ER visits, and complaints of pain.
  • 22.
    Management of Paranoia c.Mood and brain health red flags  These include common signs of depression (especially sadness and/or loss of interest in activities), signs of loneliness or isolation, new or excessive worrying. d. Medication management red flags  These include signs of difficulty taking prescriptions as directed, checking on possible medication side-effects, and medications that older people should avoid or use with caution.
  • 23.
    Management of Paranoia Asidefrom medications, prevention plans that include the following can be of great help: • Walking as a physical exercise for the patient. • Patient awareness of the location and time they’re in • Letting the patient rest and sleep adequately • Older adults need fluids, their glasses, and hearing aids
  • 24.
    Management of Paranoia Stepsthat should follow for treatment:  Visit to the family doctor  Non-Drug Interventions and Therapy • doing art and being involved in music. • Walking, running • Adequate rest and sleep to make the body and mind function well. Medication • Antipsychotic medications: risperidone , olanzapine
  • 25.
    Nursing Care ofParanoia Elderly People • Be understanding to patient. • Keep their surroundings calm and quiet. • Avoid arguing about anything that is making them paranoid. • Assess the client’s neurological status. • Talk openly with the client about their beliefs and thoughts, showing empathy and support. • Explain all procedures clearly and carefully, and their purpose, before starting them. • Avoid startling the client, sudden movements or touching the client unnecessarily. • Discuss feelings and help the client identify behaviors that cause conflict or alienate.
  • 26.
    Nursing Care ofParanoia Elderly People • Encourage socialization with others, but do not force participation in activities. • Administer medications appropriately and monitor for reactions to medications. • Provide education, resources, and support for client’s family and loved ones. • Involve patients’ family or loved ones in care as appropriate in treatment plan .
  • 27.
    Sleep Disturbance(Insomnia) • Sleepcan e defined as a normal state of altered consciousness during which the body rests; it is characterized by decreased responsiveness to the environment, and a person can be aroused from it by external stimuli. • Sleep disorders in older adults involve any disrupted sleep pattern. • This can include problems falling or staying asleep, too much sleep, or abnormal behaviors with sleep. • Sleep patterns change with age, anxiety levels and many other factors. • In elderly individuals, sleep maintenance insomnia and early ‐ awakening are more common complaints.
  • 28.
    Factors leading toSleep Disturbance • Physical illness (eg. Nausea, mood disorders, breathing difficulty, pain) • Drugs and substances (eg. Tryptophan) • Lifestyle (eg. Daily routines, exercises) • Usual sleep patterns and excessive daytime sleepiness • Emotional stress • Environment ( ventilation) • Sound • Exercise and fatigue • Food and caloric intake
  • 29.
    Symptoms of Insomnia •difficulty falling asleep at the start of the sleep period • waking up during the night and having difficulty falling back asleep • waking up early and being unable to get back to sleep.
  • 30.
    Effects of Insomnia •increase confusion, • memory loss • depression • Stress • Physical Effect • Social Isolation
  • 31.
    Treatment of Insomnia Cognitive-behavioraltherapy (CBT)  can improve your sleep by changing your behavior before bedtime as well as changing the ways of thinking that keep you from falling asleep.  It also focuses on improving relaxation skills and changing lifestyle habits that impact your sleeping patterns.
  • 32.
    Treatment of Insomnia •A study at Northwestern University found that aerobic exercise resulted in the most dramatic improvement in quality of sleep, including sleep duration, for middle-aged and older adults with a diagnosis of insomnia. • Melatonin is often prescribed to treat insomnia in older patients. • Suvorexant or low-dose doxepin can improve sleep maintenance. • Eszopiclone or zolpidem extended release can be utilized for both sleep onset and sleep maintenance. • Low-dose zolpidem sublingual tablets or zaleplon can alleviate middle-of-the-night awakenings. • Benzodiazepines should not be used routinely.
  • 33.
    Nursing Care inInsomnia • offer meals at regular times, corresponding to client’s previous pattern. • provide active meaningful activities during daytime hours, including exposure to natural light, and an outdoor environment when possible. • monitor frequency and duration of naps. • create an individualized bedtime ritual that includes a quieting activity, a light carbohydrate snack, going to the bathroom and settling a routine. • Do not waken even if incontinent. Change and assist the client to the bathroom when he or she spontaneously awakens. • if turning or other care is necessary, try to provide for periods up to 2 hours of undisturbed sleep time whenever possible.
  • 34.
    Empty Nest Syndrome •Sadness or emotional distress affecting parents whose children have grown up and left home. • This condition is typically more common in women, who are more likely to have had the role of primary carer. Loss of Motherhood  Once the last child moves out, the mother may feel that her most important job is finished.  the mother may feel worthless, disoriented and unsure of what meaning her future may hold.  However, most mothers adapt in time.  It may take between 18 months and two years to make the successful transition from ‘mum’ to independent woman.
  • 35.
    Empty Nest Syndrome •Some parents are more susceptible than others People who suffer the most from empty nest syndrome tend to have things in common, including:  Change is considered stressful.  They found moving out of home a difficult and emotional experience.  Their marriage is unstable or unsatisfactory.  Parents who worry that their children aren’t ready to take on adult responsibilities tend to experience more grief.
  • 36.
    Empty Nest Syndrome Newchallenges The challenges faced by parents experiencing empty nest syndrome includes: • Establishing a new kind of relationship with their adult children. • Filling the void in the daily routine created by absent children. • Lack of sympathy or understanding from others, who consider children moving out to be a normal, healthy event.
  • 37.
    Symptoms of EmptyNest Syndrome • feelings of loss • Sadness • Anxiety • Grief • Irritability • fear
  • 38.
    Stages of EmptyNest Syndrome Social psychologist Carin Rubenstein said three distinct stages: • Grief • Relief • joy
  • 39.
    Deal with anempty nest syndrome parent • Accept that their feelings are normal. • Acknowledge that their parenting role has changed, not ended. • Keep in touch with their children (calls, emails, video chats, etc.) • Find a new hobby or take a class. • Volunteer for a meaningful cause. • Re establish old friendships.
  • 40.
    Sun Down Syndrome •Sundowning is the name for a group of behaviors, feelings and thoughts people who have Alzheimer's or dementia can experience as the sun sets. • The behaviors start or get worse around sunset or sundown. However, this delirium can potentially occur at any time, not just at sunset.
  • 41.
    Sun Down Syndrome Sundowningis most often experienced by people with dementia, a group of symptoms that can affect: • Memory • Thinking • Personality • Reasoning • Behavior • Mood Around 20% of people diagnosed with Alzheimer’s disease experience sundowning.
  • 42.
    Features of SunDown Syndrome Behavioral features • Pacing • Rocking in a chair • Wandering • Violence • Shadowing. This is when the individual follows their caregiver very closely, everywhere they go. • Crying • Insomnia • Yelling
  • 43.
    Features of SunDown Syndrome Emotional features • Sadness • Anxiety • Fear • Agitation • Restlessness • Irritability Mental States(Thoughts) • Confusion • Paranoia • Delusions and hallucinations
  • 44.
    Factors that makeworse Sun Down Syndrome • Disrupted circadian rhythms (sleep-wake cycles). • Insomnia • Infection • Dehydration • Problems with seeing the difference between reality and dreams. • Physical illnesses • Pain • Fatigue • Overstimulation from a busy day • Low lighting
  • 45.
    Treatment of SunDown Syndrome Nonmedication treatments include: • Light therapy • Music therapy • Environmental changes  Keep familiar objects (such as family photos) nearby.  Ensure the adequate lighting in their environment during the day and darkness at bedtime.  Availability of eyeglasses or hearing aids if patient needed.
  • 46.
    Treatment of SunDown Syndrome Pharmacological treatments include: • Antidepressant medications • Antianxiety medications • Antipsychotics • Melatonin to help with sleep
  • 47.
    Nursing Care ofSun Down Syndrome Nurses must take the following steps to help them settle in at bedtime: • Make their bedroom room quiet. • Turn down all noises such as televisions and other electronic devices. • Play quiet music that’s soothing and gentle. • Ask to do a simple activity — enjoy a snack together, work on an easy puzzle or watch a favorite show. • Practice sleep hygiene by having your loved one go to bed at the same time, in the same place every night.
  • 48.
    Prevention of SunDown Syndrome • Make sure patient one gets enough rest at night. • Avoid caffeinated drinks after the morning. • Avoid drinking too much alcohol. • Try to help to get plenty of sunlight during the day by sitting by a window or going out for walks. • Encourage for Exercise every day. • If a nap is necessary, make it short and early in the day. • Plan some activities throughout the day but not too many.
  • 49.
    Depression in ElderlyPeople • Feeling down every once in a while is a normal part of life, but if these feelings last a few weeks or months, you may have depression. • It can affect the way you feel, act, and think. • Depression is a common problem among older adults, but clinical depression is not a normal part of aging.
  • 50.
    Types of Depressionin Elderly People • Major Depressive Disorder – includes symptoms lasting at least two weeks that interfere with a person’s ability to perform daily tasks. • Persistent Depressive Disorder (Dysthymia) – a depressed mood that lasts more than two years, but the person may still be able to perform daily tasks. • Substance/Medication-Induced Depressive Disorder – depression related to the use of substances, like alcohol or pain medication. • Depressive Disorder Due to A Medical Condition – depression related to a separate illness, like heart disease or multiple sclerosis.
  • 51.
    Risk Factors ofDepression 3 main causes of depression in older people are : • Poor physical health  Medical conditions, such as stroke or cancer  Stress  Sleep Disturbance  Genes – people who have a family history of depression may be at higher risk. • Social Isolation & Loneliness • Loss • Medication: Blood pressure medication (e.g. clonidine), Beta- blockers (e.g. Lopressor, Inderal), Tranquilizers (e.g. Valium), Calcium- channel blockers, Sleeping pills, Steroids, Anticholinergic drugs used to treat GI disorders.
  • 52.
    Features of Depression •more of a numbness or a lack of interest in activities. • may not be as willing to talk about their feelings. • Persistent sad • Feelings of hopelessness, guilt, worthlessness, or helplessness • Irritability, restlessness • Loss of interest in once pleasurable activities. • fatigue • Moving or talking more slowly • Difficulty concentrating, remembering, or making decisions. • Difficulty sleeping, waking up too early in the morning, oversleeping. • Eating more or less than usual. • Thoughts of death or suicide, or suicide attempts
  • 53.
    Treatment of Depressionin Elderly People • Selective serotonin reuptake inhibitors (SSRIs) : escitalopram and sertraline are considered to have minimal drug interactions. • Volunteer your time • Take care of a pet • Join a Club • Create a opportunity to laugh • Music therapy • Cognitive Behavioural therapy(CBT)
  • 54.
    Anxiety in ElderlyPeople • Feeling anxious or nervous is a common emotion for people of all ages and a normal reaction to stress. • Feeling anxious can help us handle problems and strange situations, and even avoid danger. • when one feels anxious often and the anxiety is overwhelming and affects daily tasks, social life, and relationships, it may be an illness. • An anxiety disorder causes feelings of fear, worry. • Anxiety is a common illness among older adults, affecting as many as 10-20 percent of the older population.
  • 55.
    Types of Anxiety •Specific phobias:is an intense, irrational fear of a place, thing or event that actually poses little or no threat. • Agoraphobia is a fear of public places, leaving one’s home, or being alone. • Phobias more common to older adults include fear of death, disaster to family, and dental procedures. • Social Phobias: An older adult might feel intense, persistent, and chronic fear of being judged by others and of doing things that will cause embarrassment. Physical symptoms can include blushing, heavy sweating, trembling, nausea, and difficulty talking.
  • 56.
    Types of Anxiety •Generalized Anxiety disorder  constant worries, and there may be nothing or little to cause these worries.  Those with GAD are overly concerned about health issues, money, family problems, or possible disaster.  Older adults with GAD have difficulty relaxing, sleeping and concentrating, and startle easily. Symptoms  fatigue, chest pains, headaches  muscle tension, muscle aches, difficulty swallowing  trembling, twitching, irritability  sweating, nausea, lightheadedness  having to go to the bathroom frequently
  • 57.
    Types of Anxiety •PTSD: PTSD develops after a traumatic event that involved physical harm or the threat of physical harm to the individual. • OCD: some older people do suffer from persistent, upsetting thoughts that they control by performing certain rituals, such as repeatedly checking things, touching things in a particular order, or counting things.
  • 58.
    Causes of Anxietyin Elderly People • Stressful life events (e.g., death of a loved one) • Limited physical mobility. • Loss of independence. • Financial insecurity. • Sleep disturbances (e.g., insomnia) • Chronic health conditions (e.g., diabetes, obesity) • Side effects of medications (e.g., steroids, stimulants)
  • 59.
    Features of Anxietyin Elderly People • irrational and excessive worry or fear. • checking and rechecking for safety. • avoiding routine activities. • avoiding social situations. • racing heart. • shallow breathing, trembling, nausea, sweating.
  • 60.
    Management of Anxietyin Elderly People • Breathing Exercises. Deep breathing is a great way to manage the physiological symptoms of anxiety • Physical Activity • Diet Changes • Social Interaction • Routine work • Sleep Hygiene • Relaxing Hobbies Antidepressants are the first-line medications in the treatment of anxiety disorders. Anxiolytics drugs
  • 61.
    Nursing Care ofElderly People with Anxiety • Acknowledge the feelings the patient is experiencing. • Administer medication as appropriate and as ordered. • Provide active-listening to patient • Instruct patient through guided imagery or other relaxation techniques/methods. • Encourage the patient to engage in regular daily exercise and activity programs.
  • 62.