2. 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
3. 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
5. Causes
Death of family or friends
Loss of health
Loss of body functions
Loss of independence
Loneliness/boredom
Medications – side effect
Lose of purpose
7. 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
10. 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
11. 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
12. 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
13. 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
14. 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
16. 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
17. 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
18. 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