1. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. CHAPTER Gerontological Nursing, Second Edition Patricia A. Tabloski Psychological and Cognitive Function 7 Lecture Note PowerPoint Presentation

2. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski LEARNING OUTCOME 1 Describe age-related changes that affect psychological and cognitive functioning.

3. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Incidence of Diagnosable Psychiatric Disorders in Older People Mental disorders occur less for older adults than any other age group 20% of older persons suffer from mental health problems Rate of suicide highest among older adults compared to other age groups

4. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Normal Age-Related Changes Decline in speed of information processing Decreased ability to divide attention between two tasks Difficulty in switching attention rapidly from one auditory input to another

5. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Normal Age-Related Changes Difficulty with –Sustained attention –Filtering out irrelevant information –Performing certain tasks such as visuospatial –Short word finding –Use of abstracting –Maintaining mental flexibility

6. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Long-Term or Secondary Memory Exhibits more substantial age-related changes Decline is greater for recall than for recognition

7. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Intellectual Abilities Decline greatest in individuals experiencing physiological disorders

8. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Personality Increasingly stable in the older adult

9. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Depression A clinical syndrome characterized by low mood tone, difficulty thinking, and somatic changes Depressive symptoms are seen in 13% of community-dwelling older adults ( meaning those who are not in assisted living or nursing homes ) 43% of institutionalized elderly adults may exhibit depressive symptoms Symptoms may be emotional and physical

10. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Depression Experienced twice as often in men as women Symptoms may be caused by medications

11. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Nursing Assessment of Depression Geriatric Depression Scale (GDS) Mini-Mental State Examination (MMSE) Cornell Depression Scale (CDS)

12. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski LEARNING OUTCOME 2 Explain the impact of age-related changes on stress and coping.

13. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Methods for Coping with Age- Associated Cognitive Changes Making lists Memory training and memory enhancement techniques Playing computer games emphasizing eye/hand coordination and memory Keeping the mind challenged and mentally active

14. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Methods for Coping with Age- Associated Cognitive Changes Use of assistive devices Seeking support from others Staying positive

15. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Examples of Common Events Requiring Psychological Adjustments Widowhood (The condition or period of being a widow) Confronting negative attitudes of aging Retirement Chronic illness Functional impairments Decisions about driving a car Death of friends and family

16. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Examples of Common Events Requiring Psychological Adjustments Relocation from home to assisted living or long-term care The longer a person lives, the more likely events will occur that require coping and adaptation

17. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski LEARNING OUTCOME 3 Identify risk factors for high levels of stress, poor coping, and impaired mental health, including alcoholism, stress-related disorders, and depression.

18. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Risk Factors that Influence Psychosocial Functioning High levels of stress and poor coping Impaired mental health

19. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Risk Factors for High Levels of Stress and Poor Coping Diminished economic resources Unanticipated events, such as the death of a spouse Many daily hassles at the same time in one day Many major life events occurring in a short period of time Unrealistic appraisals of situations

20. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Depression Associated with Stroke Heart disease Parkinson disease Endocrine disorders Cancer Epilepsy B12 deficiency Chronic pain

21. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Depression Associated with Viral illness Serious losses Difficult relationships Changes in social roles Retirement Widowhood Loneliness

22. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Depression Associated with Poverty Unplanned moves, such as a move to assisted living or long-term care Medication side effects

23. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Minorities at Greater Risk of Poor Mental Health Increased segregation (isolation) Poverty Poor quality education Discrimination Healthcare disparities

24. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski LEARNING OUTCOME 4 Examine risk factors that influence cognitive functioning in older adults.

25. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Cognitive Impairment Associated with Physical illness Stroke Heart disease Parkinson disease Endocrine disorders Cancers Epilepsy B12 deficiencies

26. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Cognitive Impairment Associated with Chronic pain Viral illness Psychosocial factors Serious or multiple losses Difficult relationships Changes in social roles Loneliness

27. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Cognitive Impairment Associated with Poverty Unplanned moves Medication side effects

28. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski LEARNING OUTCOME 5 Define appropriate nursing interventions directed toward assisting the older adult to develop coping resources, use effective coping mechanisms, and minimize the functional consequences of stress.

29. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Nursing Actions Assisting older persons in identifying stressors and rating their levels of stress Educating the older person and family about stress theory and the stress cycle Helping the older person identify successful coping mechanisms used in the past during periods of high stress

30. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Nursing Actions Assisting the older person in examining current coping mechanisms and behaviors and altering or eliminating negative or maladaptive mechanisms Reinforcing and strengthening positive coping mechanisms

31. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Nursing Actions Investigating community resources, support groups, stress-reduction clinics, and other stress relievers that may be appropriate and useful to the older person.

32. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Stress-Reducing Techniques Listening to music Reading a book Watching a movie Exercises such as yoga, tai chi, and walking

33. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Nursing Interventions Suicide self-restraint contracts( The patient signed a suicide prevention contract ) Encourage appropriate self-care behaviors Identify and encourage effective coping strategies Encourage hopeful attitudes

34. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski LEARNING OUTCOME 6 Identify means to strengthen social support groups and healthy aging.

35. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Fostering Healthy Aging and Social Interaction Support groups Alzheimer’s Association American Cancer Society Other groups focused on specific illnesses (cardiac, arthritis, lung, etc.) Grief and bereavement groups Travel with senior citizen groups Outside activities

36. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Fostering Healthy Aging and Social Interaction Taking classes Elder hostels Volunteer work Regular exercise Hobbies and crafts Increased family involvement

37. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski LEARNING OUTCOME 7 Identify interventions directed toward alleviating risk factors for late-life depression, treating depression in older adults, and preventing suicide.

38. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Ways to Decrease Depression Risk Alternative and complementary therapies –Relaxation techniques –Massage –Acupuncture –Yoga

39. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Ways to Decrease Depression Risk Light therapy for SAD Seasonal Affective Disorder (SAD), also known as winter depression or winter blues, is a mood disorder in which people who have normal mental health throughout most of the year experience depressive symptoms in the winter or, less frequently, in the summer, [1] spring or autumn, repeatedly, year after year.mood disordermental healthdepressive [1] Electroconvulsive therapy (ECT) Support groups such as AA and bereavement groups Alcoholics Anonymous (AA): Is a fellowship of men and women who share their experience, strength and hope with each other that they may solve their common problem and help others to recover from alcoholism