session 7 mental health in older adults

Question 1

Common Mental Health Conditions

Answer 1

Anxiety disorders
Depression (most common in late life)
Severe cognitive impairment
Alcohol and substance use disorders

Question 2

Contributing Factors

Answer 2

Cultural stigma around mental illness
Limited access to mental health care
Symptoms often present atypically (e.g., physical complaints)
Mental illness often underdiagnosed and undertreated

Question 3

Anxiety Disorders

Answer 3

Normal stress response becomes pathological when exaggerated or persistent.
May include: worry, panic attacks, restlessness, physical symptoms like tachycardia and sweating.
Interferes with daily function and quality of life.

Question 4

Post-Traumatic Stress Disorder (PTSD)

Answer 4

Triggered by trauma (past or witnessed).
Can manifest as flashbacks, nightmares, hypervigilance.
Important to use trauma-informed care practices

Question 5

Schizophrenia

Answer 5

Not part of normal aging.
Onset usually in younger years, but can persist into older adulthood.
Symptoms: delusions, hallucinations, flat affect, apathy, disorganized thinking.
Requires long-term psychiatric support and medication

Question 6

Depression in Aging

Answer 6

Often missed due to overlap with physical illness.
May present with: fatigue, insomnia, memory loss, weight loss, physical complaints (pain, GI issues)

Question 7

depression in aging contribuing factors

Answer 7

Chronic illness
Loneliness, bereavement
Functional decline
Side effects of medications

Question 8

depression in aging is accosciated with

Answer 8

neurotransmitter imbalances (e.g., serotonin)

Question 9

Substance Use Disorders

Answer 9

alchol, marjuana

Question 10

Alcohol substance abuse

Answer 10

Often underdiagnosed in older adults.
Affects men more, but women are more sensitive to effects.
Interacts with many medications (50% of drugs older adults use).
Aging reduces liver and kidney function, affecting alcohol metabolism

Question 11

Marijuana substance abuse

Answer 11

is the most commonly used illegal substance

Question 12

Cognitive Assessment Tools

Answer 12

Geriatric Depression Scale (GDS)
Mini-Mental State Exam (MMSE)
Mini-Cog (includes recall + clock drawing)
Clock Drawing Test (CDT)
Confusion Assessment Method (CAM) – for delirium

Question 13

Delirium

Answer 13

Acute, sudden onset of confusion; often reversible.

Question 14

Delirium causes

Answer 14

infection, dehydration, anesthesia, medications, illness

Question 15

Delirium symptoms

Answer 15

inattention, confusion, fluctuating alertness, hallucinations

Question 16

Delirium complications

Answer 16

falls, hospital readmission, long-term cognitive decline

Question 17

Delirium managment

Answer 17

Identify underlying cause
Use nonpharmacologic interventions first
Reorient gently, involve family, reduce environmental stress

Question 18

Dementia

Answer 18

Chronic, progressive cognitive decline

Question 19

Dementia impairments

Answer 19

aphasia, apraxia, agnosia, impaired executive function

Question 20

Aphasia

Answer 20

difficulty speaking

Question 21

Apraxia

Answer 21

inability to perform purposeful movements

Question 22

Agnosia

Answer 22

failure to recognize objects

Question 23

Impaired executive function

Answer 23

poor planning, decision-making

Question 24

Types of Dementia

Answer 24

Alzheimer’s Disease (AD)
Vascular Dementia
Lewy Body Dementia
Frontotemporal Dementia

Question 25

Alzheimer’s Disease (AD)

Answer 25

50–70% of dementia cases Plaques (beta-amyloid) and tangles (tau) disrupt brain cells. Slow progression: memory loss → speech/movement issues → total dependence. No cure

Question 26

Alzheimer’s Disease (AD) medications

Answer 26

No cure, but medications help symptoms: Cholinesterase inhibitors: Donepezil (Aricept), Rivastigmine (Exelon) NMDA antagonist: Memantine (Namenda)

Question 27

Vascular Dementia

Answer 27

Caused by stroke or decreased brain perfusion. Symptoms appear suddenly or in steps. Risk: hypertension, diabetes, smoking, history of stroke

Question 28

Lewy Body Dementia

Answer 28

Includes visual hallucinations, Parkinson-like symptoms. Fluctuating cognition and movement. Sensitivity to antipsychotic meds.

Question 29

Frontotemporal Dementia

Answer 29

Early onset, often under age 65. Affects personality, behavior, judgment more than memory.

Question 30

Person-Centered Approach

Answer 30

-Focus on the person not the disease. -Respect autonomy, dignity, and preferences. -Tailor care to each person’s retained abilities.

Question 31

Models of Care

Answer 31

PLST (Progressively Lowered Stress Threshold): reduce stress triggers. NDB (Need-Driven Dementia-Compromised Behavior): behavior has meaning. Retained Abilities: Focus on strengths.

Question 32

Communication Tips

Answer 32

Approach calmly, avoid arguing. Offer choices, explain care simply. Use non-verbal cues and supportive touch. Use alternative bathing methods if client refuses

Question 33

Supporting Family Caregivers

Answer 33

Caregiving can cause burnout, depression, and social isolation. Nurses support caregivers through: Education Referrals to support groups Encouraging respite care Validating their feelings

Question 34

Nonpharmacologic Interventions

Answer 34

Cognitive stimulation Therapeutic activities (art, music, gardening) Validation therapy Reminiscence therapy Regular exercise for mood and function

Question 35

Pharmacologic Interventions

Answer 35

Used cautiously. Always rule out delirium, depression, or reversible causes first. Monitor closely for side effects and drug interactions. Start low and go slow.

Question 36

1. Which mental health condition is the most common in late life but often underdiagnosed? a) Anxiety b) Schizophrenia c) Depression d) PTSD

Answer 36

c) Depression

Question 37

2. List two common physical signs of depression in older adults. → Short Answer:

Answer 37

Examples: insomnia, weight loss, fatigue, memory complaints, physical pain

Question 38

3. Which of the following is a key contributing factor to underdiagnosed mental illness in the elderly? a) Overactive social life b) Cultural stigma c) High self-reporting d) Rapid symptom onset

Answer 38

b) Cultural stigma

Question 39

4. PTSD in older adults may be triggered by: a) Physical illness b) Hearing loss c) Past trauma (experienced, witnessed, or heard about) d) Lack of exercise

Answer 39

c) Past trauma (experienced, witnessed, or heard about)

Question 40

5. True or False: Alcohol use is easily recognized and commonly addressed in older adults. → Short Answer:

Answer 40

False – Alcohol use is often underrecognized in older adults.

Question 41

6. Why are older adults more sensitive to alcohol's effects? → Short Answer:

Answer 41

Decreased liver/kidney function, slower metabolism, increased sensitivity to alcohol

Question 42

7. What is the most commonly used illegal substance among older adults? a) Cocaine b) Marijuana c) Heroin d) Methamphetamines

Answer 42

b) Marijuana

Question 43

8. Name two tools used to assess cognition or mental status in older adults. → Short Answer:

Answer 43

Examples: MMSE (Mini-Mental State Exam), Mini-Cog, Clock Drawing Test (CDT), CAM, Geriatric Depression Scale (GDS)

Question 44

9. What condition is defined by acute, sudden confusion and is usually reversible? a) Dementia b) Delirium c) Depression d) Alzheimer’s

Answer 44

b) Delirium

Question 45

10. What assessment tool is commonly used to identify delirium? a) MMSE b) GDS c) CAM d) CDT

Answer 45

c) CAM

Question 46

11. What are two potential causes of delirium? → Short Answer:

Answer 46

Examples: infection, anesthesia, medication side effects, dehydration, illness

Question 47

12. Which symptom is most indicative of dementia rather than delirium? a) Acute onset b) Fluctuating attention c) Progressive memory loss d) Reversible confusion

Answer 47

c) Progressive memory loss

Question 48

13. What is the most common form of dementia? a) Vascular dementia b) Lewy body dementia c) Alzheimer’s disease d) Frontotemporal dementia

Answer 48

c) Alzheimer’s disease

Question 49

14. Name one medication used to treat Alzheimer’s symptoms. → Short Answer:

Answer 49

Examples: Donepezil (Aricept), Rivastigmine (Exelon), Memantine (Namenda)

Question 50

15. Which type of dementia is associated with visual hallucinations and Parkinson-like symptoms? a) Alzheimer’s b) Lewy body dementia c) Vascular dementia d) Huntington’s disease

Answer 50

b) Lewy body dementia

Question 51

16. What brain regions shrink in frontotemporal dementia? → Short Answer:

Answer 51

Frontal and temporal lobes

Question 52

17. What does “person-centered care” focus on? a) Disease management b) Institutional routines c) The individual’s preferences, dignity, and needs d) Standardized procedures

Answer 52

c) The individual’s preferences, dignity, and needs

Question 53

18. What is one strategy you could use if a person with dementia refuses bathing? → Short Answer:

Answer 53

Examples: offer choice of time or method, use warm cloths or sponge bath, try again later, use music or distraction

Question 54

19. Name two nonpharmacologic interventions that may support people with cognitive decline. → Short Answer:

Answer 54

Examples: music therapy, cognitive stimulation, validation therapy, exercise, reminiscence therapy

Question 55

20. Why is supporting family caregivers important in dementia care? → Short Answer:

Answer 55

Caregivers face burnout, emotional strain, and health risks; nurses can provide education, support, and resources