Natcep day 33

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Information about Natcep day 33

Published on March 5, 2014

Author: payneje


NATCEP Day Thirty Three

Objectives Define depression  Identify signs and symptoms  Describe possible causes  Identifies the nurse aide’s role and responsibility in caring for the resident with depression  Possible interventions 

Definition An emotional disorder that involves the body, mood, and thoughts. The person loses interest in daily activities.  Most commonly overlooked disorder in the elderly   Misdiagnosised as a cognitive disorder  Can mimic physical illness

Signs & Symptoms              Sadness Inactivity Difficulty thinking Problems concentrating Feelings of despair Problems sleeping Changes in appetite Fatigue Agitation Withdrawn Thoughts of death or suicide Pain Irritability

Causes Death of family or friends  Loss of health  Loss of body functions  Loss of independence  Loneliness/boredom  Medications – side effect  Lose of purpose 

Nurse Aide Roles/Responsibilities Recognize signs & symptoms  Report observations to nurse  Maintain safety  Follow care plan 

Nurse Aide Roles/Responsibilities  Don’t make light of or ignore resident comments or behaviors  Suicidal?  Suicide Precautions according to policy  Observant for clues of attempts ○ High risk categories include  75 years of age and older  Recent diagnosis of terminal illness  Unrelieved chronic pain  Sudden loss of spouse  Elderly with recent multiple losses

Possible Interventions One on One interaction  Activities  Learn the resident’s preferences and habits 

NATCEP Day Thirty Three

Objectives Identify possible causes of confusion  Identify symptoms that indicate a resident may be confused  Discuss implications of confusion for the resident  Identify ways in which some of the causes of confusion may be minimized  Identify behaviors hat may be seen  Describe appropriate therapeutic interventions 

Possible Causes of Confusion  Medical issues  Chronic illnesses  Surgery & injury  Degenerative brain diseases – Alzheimers, dementia, arteriosclerosis    Poor nutrition Poor fluid intake Medication  Reaction  Combo of meds    Social Isolation Hearing & Vision Loss Changes in the usual environment

Symptoms of Confusion          Does not know self or others Talks incoherently Forgetful Does not pay attention Does not understand when someone else is speaking Sleep disorders Hallucinates – visual or auditory Hostile/combative SUNDOWNING

Implications  The resident may be  Frightened, unhappy, bewildered or angry  Unaware of environment – doesn’t       recognize danger Reduced contact with others Less self expression Less independence Insecure Verbal or physical aggression Socially inappropriate behavior

Ways to reduce confusion Treat medical condition  Improve nutrition & hydration  Change prescribed medications  Encouraging socialization  Avoid overstimulation  Calm, relaxed and peaceful setting  Hearing aids and glasses 

Behaviors Combative  Withdrawn  Socially inappropriate  Verbal or physical aggression  Wandering  Abnormal sexual behavior  Repetitive behaviors  Catastrophic reactions 

Therapeutic Interventions Reality orientation to maintain reality contact  Reminiscing = life review  Validation therapy   Focuses on responding to the affect or emotion expressed by the patient rather than the actual content, which may be distorted. Rather than correct and attempt to reorient a disoriented person, positive reinforcement is continually given.  Helps them feel more secure and oriented within their own reality

Therapeutic Interventions  Begin conversation by identifying yourself  Do not ask if they remember you          Eye level with eye contact Pleasant facial expression Place hand on resident’s arm or hand unless it causes agitation Control background noise – be sure they can hear you Lower tone of voice Short, common words; short, simple sentences Give resident time to respond One question at a time – if need to repeat, say same way Ask resident to do only one task at a time

Therapeutic Interventions  Dementia: eventually unable to understand verbal communication  Use pictures and point, touch, or hand the resident items  Demonstrate an action when you want resident to complete a task  Resident may use word substitutes  Consistent – find out what they mean & use yourself  Avoid abstract, common expressions  “You can hop into bed now”    Repeat resident’s last words to help stay on track during conversation Do not try to “make” resident understand = agitation Use nonverbal praise freely and always respect resident’s feelings

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