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N450 - Psychological and Cognitive Function (1).
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N450 - Psychological and Cognitive Function (1).
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N450 - Psychological and Cognitive FunctionPsychological and Cognitive Function - ANS-- Undiagnosed and untreated mental disorders
such as depression or despondent mood marked by decreased energy, feeling worthless and
guilty, problems with concentration, and thoughts of death or suicide can lead to increased
disability, premature death, increased morbidity, cognitive decline, increased risk of
institutionalization, and a significant decrease in an older person's quality of life.
***Positive mental health is a necessary component of successful aging***
- Mimics normal age related changes
- Assume depression normal consequence of aging
- Older adults--> atypical presentation- won't say crying or sad --> withdrawn or somatic
symptom (hx fatigue/abdominal pain)
- Mental health problems in older adults is lower than any other population (when first retired not
as many responsibilities)
**Positive attitude can help older adult cope w/a lot of changes of aging**
Mental Health Themes - ANS-- Don't have geriatric mental health providers
- Healthy tips: for pt/resident to stay active, engage in social activities, thinking games, read,
new hobbies or cont old hobbies, continue w/education (ex. community college lower cost
courses), control stress, yoga or tai chi
- Mental health is fundamental to health
- Mental illnesses are real health problems.
- The efficacy of mental health tx is well documented
- Mind and body are inseparable
- Shortage of trained mental health professionals to meet the need for services
- Stigma is a major obstacle preventing older people from getting help
Normal Age Related Changes - ANS-- Mental Health remains relatively stable
- Information processing speed declines but intelligence remains the same
- Ability to divide attention between 2 tasks declines (multitasking decreased)
- Ability to maintain sustained attention declines
- Ability to filter out irrelevant information declines
- Minor decrease in recent memory, word finding and remembering names (someone you
haven't seen in a while)
**Vocabulary improves (b/c they tend to read more)**
- Visuospatial task ability declines, such as drawing and construction ability
- Abstract thinking and mental flexibility declines
Cultural Considerations - ANS-The older population is highly heterogeneous and includes a
diverse mix of immigrants, refugees, and multigenerational Americans with vastly different
histories, languages, spiritual practices, demographic patterns, and cultures.
, - Cultural considerations - current population = more caucasian = new generation much more
heterogeneous
- Non whites: Language- barrier, not as high education, lack/lower health literacy, lack insurance
- Delay in seeking treatment, lack trust in healthcare providers, use mental health services less
Personality and Self-Concept - ANS-- An older person's self-concept can be eroded or
enhanced over time as a result of circumstance and life experiences.
- An older person's personality influences self-concept and adaptation to role transitions, such
as widowhood or retirement.
- How much they have to adapt as they age is a big deal - some might not want to use a hearing
aide b/c of stigma but then will be social isolated b/c cant hear
- Its about pt acceptance and about how they can adapt to their situation
Life Satisfaction and Life Events - ANS-Life satisfaction is an attitude toward one's own life; it
may be defined as a reflection of feelings about the past, present, and future.
Life satisfaction and morale are closely related to well-being.
Recent studies document that life satisfaction increases until about the age of 65 and then
begins to decrease.
***Two major components of wellbeing are happiness (affect) and satisfaction (realized
expectations)**
**Independence with IADL's and perceived sense of control can aide in adjustments such as
death of SO, family, friends, and/or pets, negative attitudes towards aging, retirement, chronic
illness, functional impairment, relocation, and loss of driving privileges**
**Consider how these events alone or in combination may affect the mood and personality of
the older adult and do not dismiss risk for anxiety or depression during coping** **Be alert to
significant changes in mood, cognitive ability, and personality**
Stress and Coping - ANS-- Excessive and persistent stress has been linked to the development
of illness.
- Gerontological nurses should recognize and understand stress and its influence on older
persons.
- Most older adults are far less stressed
- More are stressed if --> financial problems, health problems --> can be stressful as they age to
have more than 1 change at a time
Stress= sleep problems Decrease in immune system, increase in anxiety, increase bp,
exasterbate hrt disease and cancers, lead to substance abuse
Stress - ANS-causes:
- sleep problems
- decrease in immune system
- increase in anxiety, increase bp, exacerbate heart disease & cancers, lead to substance abuse
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