T3-Blueprint: Suicide-Care plan for elderly-Life review-Meds Flashcards
15% of all suicides are committed by persons ____
65 and older, especially white men
What are predisposing factors to suicide?
Loneliness Financial problems Physical illness Loss Depression
Who are especially vulnerable to suicide after losing a spouse: men or women?
Men
What is a significant predictor of suicide in older adults?
Major depression
Risk for trauma r/t confusion, disorientation, muscular weakness, spontaneous fractures, and falls.
What are some interventions to help ensure client safety in older adult?
- Arrange furniture to accommodate disabilities
- Put frequently used items in easy reach
- Bed in elevated position, pad side rails and headboard if client has seizures
- Bed rails up when client is in bed (per hospital policy)
- Room needs to be near nurse station
- Assist with ambulation
- Dim light on at night
- Cigs and lighters kept at nursing station and dispensed only when someone is able to be with client as they smoke
- Frequently orient client x3
- Soft restraints may be required if client is very disorientated and hyperactive
Self-care deficit r/t weakness, disorientation, confusion, memory deficit AEB inability to filfill ADL
What are the nursing interventions to help provide a simple, structured environment with the rational being to minimize confusion?
Provide a simple, structured environment!!
- Identify self care deficit and provide assistance as needed
- Promote independence as abled!
- Allow plenty of time for client to perform tasks
- Provide guidance and support for independent actions by talking through it step by step
- Structured schedule of activities that DO NOT change from day to day
- ADLs should be like home routine as much as possible
- Allow consistency of daily caregivers
Low self-esteem r/t loss of pre-retirement status; earl cognitive decline AEB verbalization of negative feelings about self and life
Encourage client to express honest feelings in relation to loss of their _____. Acknowledge pain of ___. Support client though process of grieving.
Loss of their prior status; acknowledge pain of loss
Do this bc client may be fixed in ANGER stage of grieving, which is turned INWARD on the self, resulting in diminished self-esteem
Low self-esteem r/t loss of pre-retirement status; earl cognitive decline AEB verbalization of negative feelings about self and life
If lapses in memory are occurring, we need to devise method for assisting client with memory deficit. How?
- Name on door identify client
- Sign on outside of room door so they know it is dining room, restroom, etc
- Large clock, oversized numbers and hands (appropriately placed) & large calendar, indicating one day at a time with month, day and year in BOLD
- Printed, structured daily schedule for client and one on unit wall
- “News board” on unit wall so client can see current news
*These aids assist client to function more independently–> increases self esteem
Low self-esteem r/t loss of pre-retirement status; earl cognitive decline AEB verbalization of negative feelings about self and life
Encourage clients attempts to communicate. What if verbalizations are not understandable?
Express to client what you think he/she meant to say–it may be necessary to reorient client frequently
*the ability to communicate with others may enhance self esteem
Low self-esteem r/t loss of pre-retirement status; earl cognitive decline AEB verbalization of negative feelings about self and life
Encourage ____ and discussion of ______. How? Also discuss what?
Reminiscence and discussion of life review
Ex: pictures
Also discuss present day events
Reminiscence and life review help client resume progression through grief process associated with disappointing life events and increase self esteem as successes are reviewed
Low self-esteem r/t loss of pre-retirement status; earl cognitive decline AEB verbalization of negative feelings about self and life
We need to encourage participation in group activities. Is it okay to accompany the client?
Yes, at first until he/she feels secure that group members will be accepting, regardless of limitations in verbal communication
*Positive feedback from group members= increase self esteem
Low self-esteem r/t loss of pre-retirement status; earl cognitive decline AEB verbalization of negative feelings about self and life
Encourage client to be as independent ad possible in self care activities!! How can we help with this?
Give a written schedule of tasks to be performed
*intervent when client needs assistance
Ability to perform independently–> preserves self esteem!!
Reminiscence and life review: “Stimulation of life memories helps older adults to work through their _____ and maintain _____. Life review provides older adults with an opportunity to come to grips with ___ and ____, and to emerge feeling good about themselves”
“Stimulation of life memories helps older adults to work through their LOSSES and maintain SELF-ESTEEM. Life review provides older adults with an opportunity to come to grips with GUILT and REGRETS, and to emerge feeling good about themselves”
Thinking about the past and reflecting on it
Reminiscence
- can promote better mental health in old age
- can take place one-on-one or in group
Life review is RELATED to reminiscence. How does it differ?
Differs from reminiscence in that life review is more GUIDED or DIRECTED cognitive process that constructs a history or story in an autobiographical way