Mental Health and Wellness in Later Life

Question 1

Delusion

Answer 1

A fixed, false belief

Question 2

Dysthmia

Answer 2

2+ years of depressed mood for more days than not, with more depressive symptoms not aligning with a major depressive episode

Question 3

Illusion

Answer 3

Misinterpretation of a real experience

Question 4

Insight

Answer 4

Recognition one has a health problem or illness

Question 5

Mood

Answer 5

A person’s internal, self-reported emotional state

Question 6

Paranoia

Answer 6

An intense and strongly defended irrational suspicion

Question 7

Mental Health

Answer 7

A state of wellbeing in which every individual realizes their own potential, can cope with the normal stresses of life, can work productively and fruitfully, able to contribute to community

Question 8

Components of an MSE

Answer 8

Mental Status Examination

Appearance, behaviour, affect, mood, speech, language etc.

Question 9

Most common anxiety disorders in older persons

Answer 9

Generalized anxiety disorder and specific phobias

Question 10

Symptoms of GAD

Answer 10

Unwarranted worries, feelings of apprehension, restlessness, on edge, fatigue that develops readily, difficulty concentrating

Question 11

Phobia

Answer 11

Unrealistic or irrational fear that interferes with a persons life

Question 12

Anxiety - Non pharm interventions

Answer 12

Family support, community resources and therapists, support groups, provision of information

Question 13

Obsessive-Compulsive disorder

Answer 13

Recurrent and persistent thoughts, impulses, or images that are repetitive and purposeful; and by intentional ritualistic behaviour

Question 14

PTSD

Answer 14

Development of symptoms after a traumatic event

Question 15

Psychosis

Answer 15

Syndrome or constellation of psychiatric symptoms that occurs in a number of physical and mental disorders

Question 16

Schizophrenia

Answer 16

Severe mental disorder characterized by two or more of the following symptoms:

Delusions
Hallucinations
Disorganized thinking
Apathy

Question 17

Bipolar Disorder and Mania

Answer 17

Periods of mania and depression, often level out later in life

Question 18

Age related changes

Etiology

Answer 18

Decrease in neurons and neurotransmitters

Modifications in cerebral dendrites, glial support cells, synapses

Compromised thermoregulation

Question 19

Age related changes

Implications

Answer 19

Impaired muscle strength, deep tendon reflexes

Slowed motor skills, balance and coordination

Decreased temp sensitivity

Slowed processing

Question 20

What is cognition

Answer 20

Process of acquiring, storing, sharing and using information

Includes language, thought, memory, executive function, judgement, attention and perceptions

Question 21

3 D’s

Answer 21

Delirium, dementia, depression

Question 22

Which is the only irreversible D?

Answer 22

Dementia

Question 23

Delirium is characterized by

Answer 23

• Sometimes they may altered LOC
• Sometimes they may have no interest in eating
• They have forms of delusions or they hallucinate

Question 24

What causes delirium?

Answer 24

Any for of pathology
Alcohol withdrawal
Trauma
Antibiotics
Infection
medication

Question 25

How do nurses assess for delirium?

Answer 25

Urinary test

Question 26

Patients who experience delirium are at greater risk for

Answer 26

Longer hospitalization Further functional decline Institutionalism

Question 27

Interventions For delerium

Answer 27

Keep calm Routine Don't feed into the delusion Be conscious of body movement

Question 28

Primary Dementia

Answer 28

Progressive disorders caused by pathological conditions of the brain

Question 29

Secondary

Answer 29

Produce pathological conditions of the brain

Question 30

Examples of Primary Progressive Dementias

Answer 30

``` Alzheimer's Fronto-temporal Lewy bodies Creutzfeldt-Jakob Huntington's ```

Question 31

Common Secondary Dementias

Answer 31

``` Parkinsons Alcohol-associated HIV Post-stroke Post Anoxic Ecephalopathy ```

Question 32

Medications should _____ be the first or even second line of response

Answer 32

NOt

Question 33

Understand that behavioural expressions communicate

Answer 33

Distress

Question 34

Wandering

Answer 34

can lead to falls. elopement, disturbances in care routines Can be predicted through observation

Question 35

Prevalence: Depression

Answer 35

In hospitals: 12-45% | In LTC: as high as 45%

Question 36

Onset

Answer 36

Delirium: Acute, often at twilight Dementia: Slow and gradual Depression: Rapid, coincides with life changes

Question 37

Progression

Answer 37

Delirium: Abrupt Dementia: Slow but even Depression: Variable & uneven

Question 38

Duration

Answer 38

Delirium: Hours-days, seldom 1 month Dementia: Months to years Depression: At least 2wks, can be months to yrs

Question 39

Speech

Answer 39

Delirium: Incoherent, disorganized Dementia: Aphasic, words difficult to find Depression: Normal

Question 40

Attention

Answer 40

Delirium: Impaired, fluctuates Dementia: Generally normal, present in late stages Depression: Distractible

Question 41

Orientation

Answer 41

delirium: Impaired, fluctuates Dementia: Impaired Depression: Selective

Question 42

Thinking

Answer 42

Delirium: Disorganize, fragmented Dementia: Memory impaired, no abstraction Depression: Intact with themes of hopelessness

Question 43

LOC

Answer 43

Delirium: Altered, fluctuates Dementia: Not altered Depression: Not altered