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Caring for Older Adults Holistically, 4th Edition Chapter Sixteen Psychological Assessment.

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Presentation on theme: "Caring for Older Adults Holistically, 4th Edition Chapter Sixteen Psychological Assessment."— Presentation transcript:

1 Caring for Older Adults Holistically, 4th Edition Chapter Sixteen Psychological Assessment

2 Caring for Older Adults Holistically, 4th Edition Psychological Assessments  Important for evaluating the mental health of older adults  Need to identify psychological areas of decline and recognize appropriate interventions  Assessment tools provide a brief methodological approach for noting changes

3 Caring for Older Adults Holistically, 4th Edition Mental Health  Absence of mental disease  Mental health wellness includes  Clear meaning and purpose in life  Strong reality orientation  Ability to cope with life’s situations  Capable of maintaining open, creative relationships

4 Caring for Older Adults Holistically, 4th Edition Cognition  Mental activity that involves processing information  Complex and involves several abilities or functions  Memory  Active individuals have better memory  Decrease in memory is symptom of most cognitive disorders common in older adults

5 Caring for Older Adults Holistically, 4th Edition Cognition  Memory (cont.)  Memory is important to a person’s ability to think  Short term memory measured in seconds  Long term memory measured in minutes and longer  Perception  One’s awareness of environment  Nurses need to understand the perceptual world of their patients

6 Caring for Older Adults Holistically, 4th Edition Cognition  Perception (cont.)  Perception has an emotional component  Normally evaluated based on past experiences  Perceptional distortions also known as hallucinations and delusional thinking

7 Caring for Older Adults Holistically, 4th Edition Cognition  Orientation  Person’s awareness of self in the context of a particular time and place  Assess orientation for person, place, and time  Poor orientation is symptom of brain disease

8 Caring for Older Adults Holistically, 4th Edition Cognition  Thinking  Higher level  Form concepts and think in an abstract manner  More fragile  Lower level  Concrete thoughts  More enduring  Less effected by brain injury

9 Caring for Older Adults Holistically, 4th Edition Cognition  Communicating  Human thoughts reflected in language  Language problems common in cerebrovascular and dementing disorders  Calculating  Assessed in relationship to person’s education level and intelligence

10 Caring for Older Adults Holistically, 4th Edition Cognition  Problem solving  Problem-solving skills are essential for a person to function in any environment

11 Caring for Older Adults Holistically, 4th Edition Assessment Tools  Mental status examinations  Most commonly used for psychological assessment  Assess for cognitive ability as well as level of consciousness  Brief assessment tools are easier to use with older adults

12 Caring for Older Adults Holistically, 4th Edition Assessment Tools  Easy tools to use  Mini Mental Status Exam (MMSE)  Short Portable Mental Status Questionnaire (SPMSQ)  Mental Status Questionnaire (MSQ)  Cognitive Capacity Screening Exam (CCSE)  Test results influenced by educational level of person being tested

13 Caring for Older Adults Holistically, 4th Edition Assessment Tools  Initial tests provide a baseline for comparison of changes over time  Assessment of memory includes reception, storage, and retrieval  Assessment for orientation includes time, place, and person

14 Caring for Older Adults Holistically, 4th Edition Assessment Tools  Assessment of level of orientation includes four levels  Alert  Lethargy  Stuporous  Comatose

15 Caring for Older Adults Holistically, 4th Edition Assessment Tools  Delirium is assessed by recognizing changes in levels of consciousness and levels of orientation  Validity  Does the question really measure what is being tested?  Reliability  Will two nurses get the same response from a patient?

16 Caring for Older Adults Holistically, 4th Edition Assessment Tools  Assess an individual  On admission  When acute changes occur  Assessment techniques  Timing  Allow person to select the appropriate time  Privacy  Ensure confidentiality

17 Caring for Older Adults Holistically, 4th Edition Assessment Tools  Assessment technique (cont.)  Eliminate interruptions  May have affect on reliability and validity of results  Positively introduce assessment tool  Assessment results  Use to patient’s benefit  Make information accessible

18 Caring for Older Adults Holistically, 4th Edition Applications in Clinical Practice  Use for unit assignment for new admission  Identify person’s strengths and weaknesses  Use as basis for care planning  Broad determination of the effects of an intervention  Assist with diagnosis  Monitor improvement or decline

19 Caring for Older Adults Holistically, 4th Edition Other Assessments  Assessing depression  Depression is prevalent in older adults  May predict the onset of a disability  Assessing pain  Chronic pain may impact persons ability to rehabilitate  Behavioral problems may stem from pain

20 Caring for Older Adults Holistically, 4th Edition Other Assessments  Assessing pain  Barriers to assessing pain include cognitive impairments, delirium, dementia  Methods of assessing  Visual observation  Assessment questions  Pain scales


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