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Slide 1 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Textbook For Nursing.

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Presentation on theme: "Slide 1 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Textbook For Nursing."— Presentation transcript:

1 Slide 1 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Textbook For Nursing Assistants Chapter 35 – Caring for People with Mental Illness

2 Slide 2 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. What is Mental Illness?

3 Slide 3 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. A mental illness is a disorder that affects a person’s mind, causing the person to Act in unusual ways Experience emotional difficulties Or both In many societies and cultures, mental illness is viewed as something to be ashamed of A mentally ill person’s odd behavior may be frightening to those who do not understand it What is mental illness?

4 Slide 4 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Movies, television, and books have contributed to the popular image of mentally ill people as Crazy Violent Out of control Some people who are mentally ill may behave in violent or dangerous ways, but most do not There are many different types of mental illness, and mental illness varies in severity from person to person Mental Illness and the Role of Media

5 Slide 5 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Simply put, mental health is the absence of mental illness One of the main qualities of mental health is a state of emotional balance Physical health is related to the body’s ability to make adjustments to maintain a state of physical balance, or homeostasis Similarly, mental health is characterized by a person’s ability to make adjustments to maintain a state of emotional balance Mental Health

6 Slide 6 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Life events that cause mental stress include: Getting married Getting divorced Starting a new job Having a baby Losing a loved one For most of us, stress is a constant in our lives Mental Stress

7 Slide 7 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Stress, which results from any change from the normal routine, affects a person’s ability to maintain a state of balance. Changes that affect us physically, such as illness or disability, cause physical stress. Physical Stress

8 Slide 8 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Stress that is not managed properly can affect a person’s physical health, as well as his mental health For example, not being able to manage stress can put a person at risk for Cardiovascular problems, such as a heart attack Digestive disorders, such as ulcers Effects of Stress on our System

9 Slide 9 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Each person has a limit to the amount of stress that she can effectively deal with at any given time Fatigue, illness, and everyday stress sometimes affect our ability to cope well with change Many times, stress does not come from a single source A person may be able to cope fairly well with one type of stress, such as the loss of a job…. But when other stresses, such as a sick child, are added, the person may reach his “breaking point” Stress: How much is too much?

10 Slide 10 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The person may: Cry Sleep excessively or be unable to sleep Have difficulty concentrating Feel depressed for a time Most people with good mental health are able to eventually overcome these feelings and regain their emotional balance Signs of Excessive Stress

11 Slide 11 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The mentally ill cannot cope effectively with stress and may become unable to: Work Care for their children Make simple decisions Think clearly, or even provide their own self- care A mentally ill person may need medication, counseling, or support groups to help regain emotional balance. Signs of Stress

12 Slide 12 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. What do you do when you start to feel overwhelmed or “stressed out”? Over time, many people come to know what they can do to make themselves feel better when they start to feel overwhelmed by life’s pressures These conscious and deliberate ways of dealing with stress are called coping mechanisms Coping Mechanisms

13 Slide 13 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Many people rely on positive coping mechanisms, such as: Exercise Prayer Meditation Getting together with friends Engaging in a hobby Positive Coping Mechanisms

14 Slide 14 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Other people rely on negative coping mechanisms, such as: Nail biting Pacing Overeating or not eating enough Smoking Abusing drugs or alcohol Initially, these behaviors may help the person to reduce stress, but over time, they place the person at risk for serious physical problems, mental problems, or both. Negative Coping Mechanisms

15 Slide 15 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Our bodies are “programmed” to try and return to a state of balance. When a person is under stress, the mind may try to return the person to a state of emotional balance by using defense mechanisms. Defense mechanisms are methods of dealing with stress that “just happen”…usually the person is not even aware that he is using them. Defense mechanisms help to protect us from emotionally traumatic events. Defense Mechanisms

16 Slide 16 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Common defense mechanisms include: Compensation Conversion Denial Displacement Projection Rationalization Regression Repression Common Defense Mechanisms

17 Slide 17 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Compensation: to make up for a loss by “filling in” or “substituting” something else For example, a person who feels lonely may eat too much (substituting food for affection) Defense Mechanisms: Compensation

18 Slide 18 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Conversion: changing one thing into another For example, a person who is depressed (an emotional problem) may develop a stomach ache (a physical problem) Defense Mechanisms: Conversion

19 Slide 19 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Denial: refusing to believe something that is true, especially if the truth is unpleasant For example, a person who has been diagnosed with cancer may truly believe that the doctor has made the wrong diagnosis, and that she does not have cancer Defense Mechanisms: Denial

20 Slide 20 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Displacement: shifting an emotion from one person to another who is less threatening For example, a resident who is angry with her daughter for moving her to a long-term care facility—and who is afraid of expressing this anger because she fears the daughter will abandon her—may take her anger out on the nursing assistant instead Defense Mechanisms: Displacement

21 Slide 21 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Projection: blaming someone else for your own uncomfortable or unacceptable actions or feelings For example, a resident may accuse a nursing assistant of breaking a vase when in fact, the resident actually broke the vase herself Defense Mechanisms: Projection

22 Slide 22 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Rationalization: making excuses or creating acceptable reasons for poor behaviors or actions For example, a student who does not study for a test and then fails it may tell herself that the reason she failed is because the teacher is "too hard" Defense Mechanisms: Rationalization

23 Slide 23 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Regression: to turn back to a former or earlier state For example, an older child who is hospitalized begins to suck his thumb Defense Mechanisms: Regression

24 Slide 24 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Repression (suppression): the refusal to remember or think about a frightening or painful memory For example, a person who was a victim of a terrible crime may not be able to remember the event Defense Mechanisms: Repression

25 Slide 25 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Causes and Treatment of Mental Illness

26 Slide 26 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. There are many different types of mental illness, and many different causes. Some types of mental illness run in families (that is, they are inherited). Others result from chemical imbalances in the chemicals called neurotransmitters. Some mental illnesses may be caused by a person’s environment (for example, a person who is abused by a family member may develop ineffective coping or defense mechanisms that lead to mental illness). Causes of Mental Illness

27 Slide 27 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The word psychiatric comes from the Greek words psyche (the soul) and iatreia (healing). A psychiatrist is a medical doctor trained in diagnosing and treating mental illness. A psychiatrist is allowed to prescribe medications. A psychologist, while not a medical doctor, has education and training that allows him to provide counseling services to help people with mental illness. A psychologist is not allowed to prescribe medications. Depending on the person’s situation, he may need the services of a psychiatrist, a psychologist, or both. With treatment, many people with mental illnesses are able to lead happy, productive lives. Treatment of Mental Illness

28 Slide 28 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Treatment for mental illness has changed dramatically over the last 50 years In the past, mentally ill people were usually sent to special hospitals (“mental institutions”), where they were given large doses of medications to keep them quiet and sedated Techniques such as electro-shock therapy (passing electricity through the brain to cause a seizure) and lobotomy (surgical removal of part of the brain) were used frequently, often with little success Treatment for Mental Illness

29 Slide 29 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Now we know more about why mental illnesses occur and how they should be treated. Medications are used to restore the brain’s chemical balance. Rather than simply sedating the person into submission, these new medications help the person to act and think more “normally.” And electro-shock therapy, while still used in some cases, is used much more effectively. Treatment is important because with treatment, many people with mental illness are able to lead happy, productive lives. Without treatment, they may suffer needlessly and may even be at risk for suicide. Treatment for Mental Illness

30 Slide 30 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Types of Mental Illness

31 Slide 31 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The more common mental illnesses include: Anxiety disorders Depression Bipolar disorder (manic depression) Schizophrenia Eating disorders Types of Mental Illness

32 Slide 32 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Anxiety is a feeling of uneasiness, dread, apprehension, or worry Anxiety is a normal feeling that we have in response to situations that are threatening to our body, lifestyle, values, or loved ones A certain level of anxiety is normal and may actually lead us to do something positive about a bad or potentially dangerous situation But too much anxiety or prolonged periods of anxiety can make it hard for us to function or cope with everyday situations Mental Illnesses: Anxiety Disorders

33 Slide 33 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Feelings of anxiety can cause many physical signs and symptoms, such as: Sleeplessness Restlessness Fatigue Changes in appetite Increased heart rate and blood pressure Irritability Difficulty thinking clearly Mental Illnesses: Anxiety Disorder

34 Slide 34 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Common anxiety disorders include: Panic disorder Obsessive–compulsive disorder Phobias:  Simple phobias  Social phobias  Agoraphobia Common Anxiety Disorders

35 Slide 35 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Panic is a sudden, overpowering fright. A person with a panic disorder has terrifying episodes or “panic attacks,” during which she experiences: extreme anxiety feelings of intense fear A person who is having a “panic attack” usually also has physical signs and symptoms, such as chest or abdominal pain a rapid heart beat shortness of breath dizziness These symptoms may be very similar to those of a heart attack or other severe physical illness. Anxiety Disorder: Panic Disorder

36 Slide 36 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Panic attacks can be very brief, or they may last for some time Some people will experience these attacks rarely while others will have them quite often It is important to remember that even though the physical symptoms may not be a sign of a serious physical condition, they are no less real and frightening to the person who is experiencing them Anxiety Disorder: Panic Disorder

37 Slide 37 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Obsessive–compulsive disorder is an anxiety disorder that causes a person to suffer intensely from recurrent unwanted thoughts (obsessions) The obsessions are usually associated with rituals that the person cannot control (compulsions) The rituals may include actions such as: Hand washing Counting Checking The rituals are repeated over and over again in hopes that the obsessive thoughts will go away Anxiety Disorder: Obsessive-Compulsive Disorder

38 Slide 38 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Not performing the rituals increases a person's level of anxiety When it is severe, obsessive–compulsive disorder takes over the person’s life The person becomes unable to perform the tasks that are associated with normal daily activities, because of his obsessions and compulsions Anxiety Disorder: Obsessive-Compulsive Disorder

39 Slide 39 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. A phobia is an excessive, abnormal fear of an object or situation. Phobias can be incredibly disabling for the person affected by them. The person will do anything to avoid the thing she is afraid of, to the point where she may be unable to do something as simple as leaving the house. There are three main groups of phobias: Simple phobia Social phobia Agoraphobia Anxiety Disorder: Phobias

40 Slide 40 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Simple phobias are the most common type. A person with a simple phobia is abnormally afraid of a specific thing, for example: Dogs or cats Insects Heights Water Flying in an airplane Anxiety Disorder: Phobias

41 Slide 41 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Social phobias involve a fear of being humiliated or embarrassed in front of other people. Social phobias may be related to: Feelings of inferiority Low self-esteem Social phobias may cause a person to: Drop out of school Avoid making friends Remain unemployed Anxiety Disorder: Phobias

42 Slide 42 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Agoraphobia is the fear of having a panic attack in a place from which there is no easy escape, and where help is not available For example, a person may be intensely afraid of having a panic attack in an elevator or on a crowded bus Anxiety Disorder: Phobias

43 Slide 43 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Depression is a feeling of excessive sadness or hopelessness Many events in life, such as the loss of a loved one, can cause temporary feelings of intense sadness and hopelessness In a person with good mental health, the painful emotions of an event-related depression go away over time Sometimes, short-term treatment with medication or counseling may be needed to help the person through the crisis Depression

44 Slide 44 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Some people, however, experience intense feelings of sadness and hopelessness that do not go away, even with time These feelings may or may not be brought on by a sad event, such as the death of a loved one When depression is severe and persistent, it is called clinical depression Depression

45 Slide 45 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Clinical depression is one of the most common mental illnesses It affects more than 19 million Americans each year Some research indicates that a family history of clinical depression increases a person’s risk of developing this mental illness Women seem to experience clinical depression about twice as much as men do Clinical depression is also the most frequently treated mental illness among elderly people Clinical Depression

46 Slide 46 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Several factors can lead to the development of clinical depression, including: Chemical imbalances in the brain Low self-esteem and poor coping skills Hormonal changes, such as those that affect women during pregnancy, menstruation, childbirth, and menopause Medications Depression

47 Slide 47 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. A person who is depressed loses interest in activities that she usually finds pleasurable or fulfilling, such as: Eating Working Socializing with friends Pursuing hobbies The person may feel sad or anxious The person may cry frequently Depression: Signs and Symptoms

48 Slide 48 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Many people who are depressed have problems with sleeping. The person may: Sleep too much Sleep not enough The person may be restless or irritable Instead of being grateful when someone tries to help, the person may become angry and defensive The person may have feelings of guilt and worthlessness Depression: Signs and Symptoms

49 Slide 49 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The person may struggle with thoughts of death or suicide Physical complaints (for example, of pain or a digestive disorder) are also common among people who are depressed Prompt treatment is needed to help a clinically depressed person return to an enjoyable, productive life Depression: Signs and Symptoms

50 Slide 50 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The incidence of depression increases with age Elderly people are less likely to seek treatment for this disorder Many older people who are depressed feel that their depression is just part of getting older but this is not true! If you will be working with older patients or residents, pay attention to changes in their behaviors or moods that may indicate clinical depression By reporting these observations to the nurse, you play an important role in helping to ensure that the person receives treatment that will help him feel better Depression and the Older Person

51 Slide 51 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Bipolar disorder (manic depression) is a mental health disorder that causes mood swings Periods of excessive happiness and excitement that may cause the person to engage in impulsive or reckless behavior (mania) are followed by... Periods of excessive sadness and hopelessness (depression) Experts believe that bipolar disorder is caused by chemical imbalances in the brain that affect a person’s moods Bipolar Disorder

52 Slide 52 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Schizophrenia can be a very disabling form of mental illness It tends to run in families and may have a genetic basis Schizophrenia may be mild or severe A person with severe schizophrenia that is untreated may be a danger to himself, or to others Schizophrenia

53 Slide 53 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. A person with schizophrenia has trouble determining what is real and what is imaginary He may suffer from delusions, or false ideas For example: The person may believe that: He or she is someone famous Someone is spying on him or her Someone is trying to steal his or her belongings Schizophrenia

54 Slide 54 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. A person may experience hallucinations, or episodes where he or she: Sees Feels Hears Smells or Tastes something that does not really exist For example: The person may hear voices in his head telling him to perform a certain act. Schizophrenia

55 Slide 55 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The person’s thinking and speech becomes disordered He may switch from one topic to another during a conversation He may make up new words or patterns of speech The person may say or do very strange things, making it hard for him to function normally in social situations A schizophrenic person’s behavior is often very frightening and confusing to others Schizophrenia

56 Slide 56 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Two of the most commonly known eating disorders are: Anorexia nervosa Bulimia nervosa All eating disorders involve serious and potentially fatal changes in eating behavior, such as: Reducing the amount of food eaten to almost nothing Severe overeating Eating disorders cause many physical problems, including kidney failure and serious heart problems that can lead to death Eating Disorders

57 Slide 57 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Like people with other mental illnesses, people with eating disorders cannot voluntarily control their impulses, and they need treatment to help them learn to eat normally again Eating disorders usually start during adolescence or early adulthood Women are at higher risk than men for developing an eating disorder Many people who suffer from depression or anxiety disorders also suffer from eating disorders Eating Disorders

58 Slide 58 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. People with anorexia nervosa see themselves as very overweight, even though they are excessively thin Anorexia (loss of appetite) is a key feature of this disorder The person simply does not eat enough food She will skip meals, take tiny portions at meal times, or make excuses for why she cannot eat She may only allow herself to eat small amounts of very "safe” low-calorie foods Many people with anorexia nervosa exercise excessively Eating Disorders: Anorexia Nervosa

59 Slide 59 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. A person with bulimia nervosa regularly eats huge amounts of food (binging) and then induces vomiting or uses laxatives to rid the body of the food before it is digested (purging) A person with bulimia nervosa often is of normal weight for her age and height A person with bulimia nervosa is extremely focused on her body weight and shape, and believes that she is excessively overweight Eating Disorders: Bulimia nervosa

60 Slide 60 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Caring for a Person with Mental Illness

61 Slide 61 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Treatment facilities for people with mental health disorders differ in purpose Some facilities provide a form of long-term care for mentally ill people who cannot function on their own and need assistance with activities of daily living (ADLs) and safety Treatment Facilities for the Mentally Ill

62 Slide 62 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Other facilities specialize in acute care services and provide care to a person who is experiencing a mental crisis that may result in: Attempted suicide Drug overdose Danger to others After the crisis phase has passed, the person may be able to return home and receive treatment on an outpatient basis Treatment Facilities for the Mentally Ill

63 Slide 63 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Outpatient mental health clinics see people on a regular basis and offer services such as: Counseling Medication Support groups They may even help the person to obtain: Education Job training Employment Treatment Facilities for the Mentally Ill

64 Slide 64 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Even if you choose to work in a facility that does not specifically care for people with mental illness, you may care for people who have or develop mental illness Think about the stresses a person in a health care facility experiences: He may have fears of being disabled or disfigured from illness or injury He is separated from loved ones and in an unfamiliar place He may be worried about the loss of a job and income He may be worried about his current and future health Any of these additional emotional stresses can push a person toward mental illness if he has poor or ineffective coping mechanisms Caring for A Person With Mental Illness

65 Slide 65 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Elderly people are particularly at risk for mental illness They face the loss of spouses, friends, and sometimes children, often within a short period of time They face retirement, which can lead to a loss of structure, routine, and the sense of identity that their jobs gave them They may face worries about money, especially if they are living on a fixed income They face the loss of physical abilities and independence, either as a result of illness or the normal process of aging They may feel that they are a burden to their families They may fear the need to move to a long-term care facility, because of the associated loss of independence Caring For A Person With Mental Illness

66 Slide 66 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Listening and observation skills are very important when you care for a person with mental illness Be aware of comments or actions that may indicate that a person is thinking about suicide, and report your observations immediately to the nurse When you notice a change in a patient’s or resident’s behavior or mental status and report this change to the nurse, you are taking the first step toward making sure the person gets the help he needs The health care team will work to determine the cause of the person’s change in behavior, which will lead to prompt treatment Caring for A Person With Mental Illness

67 Slide 67 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. In an older person, a physical problem can cause behavior that may be similar to that seen in people with mental illness Never just assume that your elderly patient or resident is just “entering his second childhood” or becoming senile The person may have a serious mental or physical problem that needs to be treated Caring for a Person with Mental Illness

68 Slide 68 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Examples of physical problems that can cause an elderly person to appear to be mentally ill include: Nervous system disorders Kidney disorders Chronic illnesses, such as hypertension and diabetes Hypothyroidism Anemia Early signs of dementia Infections Dehydration Side effects of many medications Caring For A Person With Mental Illness

69 Slide 69 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. If you work in a facility that specializes in caring for mentally ill people, special methods of recording and reporting may be used Know what is expected of you and how to report and record according to facility policy When reporting and recording subjective information about patients and residents with mental illnesses, be very careful to: Use the person's own words Avoid adding your own opinions or judgments Caring For A Person With Mental Illness

70 Slide 70 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Certain phrases or words may have special meaning for a particular person To accurately gauge the person’s mental status, the health care team will need to know exactly what the person said Caring For A Person With Mental Illness

71 Slide 71 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Mental illness may affect a person’s ability to eat, sleep, rest, or manage routine grooming and hygiene. People with mental illnesses will need different levels of assistance with their ADLs, depending on the severity of their disorders. Always help to promote the person's independence by allowing the person to provide as much of his own self-care as possible. Some mental illnesses affect a person's ability to think through the steps of routine care. You may need to gently remind the person of what step comes next. Caring For A Person With Mental Illness

72 Slide 72 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. End of Presentation


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