Fairfield University School of Nursing ELDER Project Best Practices in Care for Older Adults Nursing Assistants Session 2 Topic: Depression, Delirium and Dementia Fairfield University School of Nursing ELDER Project

Depression in Older Adults What is it? A disease with: Mood changes (sadness) Trouble thinking Feelings of loss or guilt Physical changes Sometimes thought of harming self

Different Kinds of Depression May have mild depression with a few symptoms May have major depression which is the most common and can last a long time if untreated May have short term depression because of something that just happened (loss of a spouse). This is normal grief.

What can you do? We need to help older adults to understand that depression is not a weakness Depression is a disease just like high blood pressure! Encourage them to talk to their doctor or nurse about it

Most Common Symptoms of Depression Sadness, Crying Trouble Concentrating Forgetful- May look like dementia Acting out Not interested in activities/hobbies Change in appetite (more or less) Change in sleep (more or less)

What can you do? Allow your patients to talk about their feelings Don’t ignore their feelings Encourage them to stay involved in activities If on medications: Watch for falls, dizziness, confusion, changes in blood pressure

Topic: Delirium Sudden change in patient’s behavior Not permanent, can be cured Sometimes from Medications Sensory Overload Medical Illness

Most at risk for delirium: Those who have fallen and fractured their hip

What can you do? Report changes in behavior immediately to the nurse Keep yourself and the patient safe

Topic: Topic: Dementia Mental Status Changes in Older Adults 60% of nursing home residents have dementia Dementia is: a major loss of intellectual abilities such as memory. severe enough to change ability to work or socialize.

What you might see: Changes in dressing, grooming, eating Not knowing who they are, where they are, what time or day it is Changes in mood Changes in memory Changes in judgment Changes come on slowly over time

What is Dementia? Changes in : Language Memory Motion and Function Personality Judgment Usually irreversible

Alzheimer’s Disease (AD) AD is one type of dementia About ½ of all dementia patients have AD Don’t know what triggers it

What can you do? Keep the same routine Allow them to rest Speak slowly and clearly Make eye contact Limit choices

What can you do? Keep the person as independent as possible Make simple changes to help them function at as high a level as possible You don’t need to correct them, sometimes it is ok to agree with them

Reference The content covered in this presentation is provided by the John A. Hartford Foundation Institute for Geriatric Nursing (2001, 2003) Some of the material in this presentation obtained from graciously shared by: Mather’s LifeWays, 2003