Geropsychiatric nurses should be knowledgeable about somatic and interpersonal treatments, including the safe use of psychotropic medication with elderly people. • Hitting If competencies change or decrease with age, an individual’s capacity to relate to the environment may be altered or diminished. Advanced practice geropsychiatric nurses may be employed by agencies to help the entire staff develop therapeutic evidence-based programs for seniors with psychiatric or behavioral issues resulting in improved clinical outcomes. Nursing diagnoses are based on observation of patient behaviors and are related to current needs. Stability of personality: An individual’s personality is established by early adulthood and remains fairly stable but adaptable, rather than being a developmental progression over the life span. 2. History of fallsDiurnal alertness levelFamiliarity with surroundingsEmotional state (e.g., agitated, angry)Willingness to request helpConfusionUsual activity levelType of activity The process of aging is genetically programmed in deoxyribonucleic acid (DNA). J Gerontol Nurs. The comorbidity of somatic and psychiatric illnesses makes accurate diagnosis more difficult. The onset of depression in later life is associated with greater chronicity, relapse, cognitive dysfunction, and an increased rate of dementia (Schultz, 2011). The occurrence of mental illness is underestimated in nonpsychiatric settings because symptoms may be incorrectly attributed to physical disorders, normal aging, cognitive impairment, or the lack of age-appropriate diagnostic criteria. If no, what does that mean for helping elders change maladaptive behaviors? Description of behavior and triggersAssessment of behavioral changeFrequently observed challenging behaviors Sociocultural theories of aging address the interplay of the individual and the environment: Activity theory: Activity produces the most positive psychological climate for older adults, and the aged should remain active as long as possible. Establishing a supportive and trusting relationship is essential to fostering a positive interview with the geriatric patient. The nurse should rephrase a question if the patient does not answer appropriately or hesitates when answering. Common challenging behaviors (behavioral excesses) in the elderly are listed in, CHALLENGING BEHAVIORS OBSERVED IN GEROPSYCHIATRIC PATIENTS, Emotional health and overall functional ability are interrelated and cognitive impairment contributes to functional. Psychological Theories Geriatric patients should be encouraged to be as independent as possible in self-care, although it is unrealistic to expect all patients to function independently, particularly in a hospital or long-term care setting. The nurse’s ability to collect useful data depends greatly on how comfortable the nurse feels during the interview. This discussion emphasizes the aspects of the functional assessment that have the greatest impact on mental and emotional status. Therapeutic Communication Skills Discuss how the wear-and-tear theory of aging compares with the current emphasis on nutrition and physical fitness in U.S. culture. Evaluate nursing care of geropsychiatric patients. Maintaining contact with others The nurse should never assume that the patient understands the purpose for the assessment interview. When a behavioral change occurs, it is important to analyze the underlying cause and meaning. 6. Geropsychiatric nursing practice offers flexibility in clinical practice settings. Nurses are in an ideal position to lead efforts in delirium evaluation, prevention, and treatment. • Threats of harm Many of the elderly will be better educated, healthier, and wealthier than those at the end of the twentieth century, resulting in a rethinking of our concepts of retirement, aging, and health care. Demonstrate interest and support by giving nonverbal cues and responses, such as direct eye contact, nodding, sitting close to the patient, and using touch appropriately. Promoting nurses' greater geropsychiatric and mental health knowledge and skills is critical for the health and well-being of older adults. They provide an opportunity for purposeful nurse-patient interaction. Activities of Daily Living Mini-Mental State ExaminationMental status examinationDepressionAnxietyPsychosis 1981 Oct;7(10):607-9. As a consultant, the geropsychiatric nurse helps other providers address the behavioral, social, and cognitive aspects of the patient’s care. Learning Objectives Discuss the elements of a comprehensive geropsychiatric nursing assessment. Providing nursing care to these patients can be complex because they are often involved with a number of agencies requiring coordination of services. Anxiety disorders decrease function and quality of life for many elderly people and increase the burden on family, care providers, and health services. • Hallucinations MobilityActivities of daily livingRisk for falls You must register to view the product, but registration is free. Taking medications (prescribed or over-the-counter) that cause the following:DrowsinessConfusionOrthostatic hypotensionIncoordinationDecreased sensationPolypharmacy Motor ability of the arms can be tested by observing the patient comb hair, shave, dress, and eat. 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