Geropsychiatric and Mental Health Nursing

TITLE......Page 2
COPYRIGHT......Page 3
CONTENTS......Page 4
CONTRIBUTORS......Page 10
CONTRIBUTORS TO THE FIRST EDITION......Page 12
ACKNOWLEDGMENTS......Page 14
I: OVERVIEW OF AGING AND MENTAL HEALTH ISSUES......Page 16
MENTAL HEALTH AND OLDER ADULTS......Page 18
INTRODUCTION TO MENTAL HEALTH ISSUES AND DISORDERS......Page 20
INTRODUCTION TO GERONTOLOGY......Page 29
ACKNOWLEDGMENT......Page 40
REFERENCES......Page 41
2 GEROPSYCHIATRIC NURSING AS A SUBSPECIALTY......Page 46
REVIEW OF STANDARDS......Page 50
THEORETICAL FOUNDATIONS FOR GEROPSYCHIATRIC AND MENTAL HEALTH NURSING......Page 52
THE NURSING PARADIGM APPLIED TO GEROPSYCHIATRIC NURSING......Page 59
REFERENCES......Page 63
3 COMPREHENSIVE MENTAL HEALTH ASSESSMENT: AN INTEGRATED APPROACH......Page 68
OVERVIEW OF ASSESSMENT METHODS......Page 69
COMPREHENSIVE MENTAL HEALTH ASSESSMENT TOOL......Page 72
CMHA AND MCHUGH’S “ESSENTIALS”: DESCRIPTION AND COMMONALITIES......Page 75
DATA-BASED SERVICE PLANNING......Page 84
REFERENCES......Page 86
DEMOGRAPHIC CHANGE......Page 88
WHO ARE ETHNIC ELDERS?......Page 89
DISPARITIES IN MENTAL HEALTH CARE......Page 90
KEY TERMINOLOGY: RACE, CULTURE, ETHNICITY, AND MINORITY GROUP......Page 91
THE SOCIOCULTURAL CONTEXT OF MENTAL ILLNESS......Page 92
ACCESS TO CARE......Page 98
QUALITY OF CARE......Page 99
CULTURAL COMPETENCE......Page 102
SUMMARY......Page 103
REFERENCES......Page 107
5 MENTAL HEALTH PROMOTION......Page 116
STRESSORS IMPACTING MENTAL HEALTH......Page 117
COMPREHENSIVE MENTAL HEALTH ASSESSMENT IN CLINICAL PRACTICE......Page 120
ASSERTIVENESS AND PROBLEM-SOLVING SKILLS TRAINING AS PART OF SOCIAL SKILLS TRAINING......Page 122
LATE LIFE CHALLENGES THAT CAN CONTRIBUTE TO MENTAL HEALTH PROBLEMS......Page 123
THERAPEUTIC INTERVENTIONS TO ADDRESS MENTAL HEALTH PROMOTION AND WELLNESS......Page 125
CLINICAL RESEARCH PERTAINING TO MENTAL HEALTH PROMOTION IN OLDER ADULTS......Page 129
REFERENCES......Page 132
6 PSYCHOPHARMACOLOGY......Page 136
CHALLENGES IN PRESCRIBING FOR OLDER ADULTS......Page 137
FACTORS INFLUENCING PHARMACO-THERAPY IN OLDER ADULTS......Page 138
PSYCHOTROPIC DRUGS......Page 143
REFERENCES......Page 156
II: PSYCHOPATHOLOGY OF LATE LIFE......Page 160
CONSEQUENCES OF DEPRESSION......Page 162
GLOBAL AND NATIONAL INITIATIVES FOR MENTAL HEALTH......Page 163
ETIOLOGY......Page 165
ASSESSMENT AND SCREENING OF LATE-LIFE DEPRESSION......Page 166
DIAGNOSIS OF MOOD DISORDERS......Page 171
SUICIDE......Page 172
TREATMENT OPTIONS......Page 175
PHARMACOLOGICAL TREATMENT OPTIONS......Page 176
PSYCHOTHERAPY......Page 179
NURSING INTERVENTIONS......Page 181
EVIDENCE-BASED MODELS OF CARE DELIVERY......Page 183
REFERENCES......Page 185
8 NURSING ASSESSMENT AND TREATMENT OF ANXIETY IN LATE LIFE......Page 190
ANXIETY DISORDERS IN LATE LIFE......Page 191
COMORBID CONDITIONS......Page 192
ASSESSMENT OF ANXIETY IN LATER LIFE......Page 198
TREATMENT OF ANXIETY IN LATE LIFE......Page 200
SUMMARY AND CONCLUSIONS......Page 210
REFERENCES......Page 212
BACKGROUND......Page 218
ASSESSMENT......Page 224
TREATMENT......Page 227
ETHICAL AND LEGAL ISSUES......Page 233
SUMMARY......Page 237
REFERENCES......Page 238
PREVALENCE OF SUBSTANCE ABUSE IN OLDER ADULTS......Page 242
DEFINITIONS......Page 243
DRUGS OF ABUSE......Page 244
SCREENING TOOLS FOR IDENTIFICATION OF SUBSTANCE ABUSE IN THE OLDER ADULT......Page 246
ALCOHOL ABUSE AND THE OLDER ADULT......Page 250
GENDER ISSUES, ALCOHOL, AND THE OLDER ADULT......Page 251
HEALTH ASSESSMENT......Page 252
MEDICAL CONSEQUENCES OF SUBSTANCE ABUSE......Page 253
REVIEW OF SYSTEMS......Page 254
TREATMENT PHILOSOPHIES......Page 257
MEDICATIONS USED IN TREATING ADDICTIVE DISORDERS......Page 260
NURSING INTERVENTIONS TO ADDRESS SUBSTANCE ABUSE IN THE OLDER ADULT......Page 262
REFERENCES......Page 264
III: ISSUES IN GEROPSYCHIATRIC AND MENTAL HEALTH OF OLDER ADULTS......Page 268
11 DELIRIUM......Page 270
INTRODUCTION......Page 271
DEFINITION......Page 272
RISK FACTORS......Page 273
SUBTYPES AND PATTERNS......Page 274
THE PROBLEM OF RECOGNITION......Page 275
ASSESSMENT AND EVALUATION......Page 276
SUPPORTING SAFETY AND RECOVERY......Page 280
DOCUMENTATION......Page 282
SUMMARY......Page 284
REFERENCES......Page 285
12 NURSING ASSESSMENT OF CLIENTS WITH DEMENTIAS OF LATE LIFE......Page 288
ALZHEIMER’S DISEASE AND OTHER DEMENTIAS......Page 289
THE NEUROBIOLOGY OF DEMENTIA......Page 290
BEHAVIORAL AND PSYCHOLOGICAL SYMPTOMS OF DEMENTIA......Page 291
THE ROLE OF NURSES IN THE DEMENTIA ASSESSMENT PROCESS......Page 292
THE PROCESS OF DIAGNOSIS SEEKING IN DEMENTIA......Page 298
COMMUNICATING THE DIAGNOSIS......Page 299
REFERENCES......Page 302
CARE ENVIRONMENTS......Page 306
FRAMEWORKS FOR INTERVENTIONS......Page 309
INTERVENTIONS DIRECTED TOWARD THE PERSON......Page 310
INTERVENTIONS DIRECTED TOWARD THE ENVIRONMENT......Page 316
INTERVENTIONS DIRECTED TOWARD THE CAREGIVER......Page 318
DEMENTIA CARE RESOURCES......Page 321
REFERENCES......Page 322
AGITATION......Page 328
PAIN......Page 332
OTHER PROBLEM BEHAVIORS......Page 339
SUMMARY......Page 344
REFERENCES......Page 345
15 FAMILY CAREGIVING......Page 350
EMOTIONAL RESPONSES TO CAREGIVING......Page 351
CAREGIVER ASSESSMENT AND THE GEROPSYCHIATRIC NURSE......Page 366
INTERVENTIONS TO SUPPORT CAREGIVERS......Page 369
REFERENCES......Page 376
16 NORMAL AND DISORDERED SLEEP IN LATE LIFE......Page 382
PHYSIOLOGY OF SLEEP......Page 383
COMMON SLEEP DISTURBANCES IN OLDER ADULTS......Page 385
ASSESSMENT OF SLEEP DISORDERS IN LATE LIFE......Page 389
THERAPEUTIC NURSING INTERVENTIONS TO ADDRESS SLEEP DISORDERS......Page 390
INDICATIONS FOR PHARMACOLOGICAL THERAPIES......Page 397
ENVIRONMENTAL APPROACHES IN INSTITUTIONAL SETTINGS......Page 403
EVALUATION OF TREATMENT EFFECTIVENESS WITH FOLLOW-UP......Page 404
REFERENCES......Page 407
PREVALENCE OF PATHOLOGICAL GAMBLING......Page 410
PATHOLOGICAL GAMBLING AMONG OLDER ADULTS......Page 411
ASSESSMENT AND DIAGNOSIS OF PATHOLOGICAL GAMBLING AMONG OLDER ADULTS......Page 412
THERAPEUTIC NURSING INTERVENTIONS FOR PROBLEM AND PATHOLOGICAL GAMBLING......Page 419
RELATED ISSUES PERTAINING TO PROBLEM AND PATHOLOGICAL GAMBLING IN OLDER ADULTS......Page 421
SUMMARY......Page 422
REFERENCES......Page 423
TYPES OF EM......Page 426
INCIDENCE AND PREVALENCE......Page 427
INSTITUTIONAL MISTREATMENT......Page 428
CLINICAL PRESENTATIONS......Page 429
PREVENTION......Page 433
REFERENCES......Page 435
19 END OF LIFE......Page 438
GOLD STANDARD FOR END-OF-LIFE CARE: HOSPICE AND PALLIATIVE CARE......Page 439
ADVANCE-CARE PLANNING......Page 442
DETERMINING PROGNOSIS......Page 444
PATIENT–FAMILY ASSESSMENT......Page 446
THE DYING PROCESS......Page 447
GRIEF AND BEREAVEMENT......Page 448
REFERENCES......Page 451
20 SOCIAL, HEALTH, AND LONG-TERM CARE PROGRAMS AND POLICIES AFFECTING MENTAL HEALTH IN OLDER ADULTS......Page 454
ROLE OF THE PROFESSIONAL NURSE......Page 456
FEDERAL PROGRAMS SUPPORTING AND FINANCING MENTAL HEALTH CARE......Page 458
REIMBURSEMENT ISSUES FOR THE GEROPSYCHIATRIC NURSE......Page 469
CREATING A MENTAL HEALTH POLICY AGENDA FOR OLDER ADULTS......Page 472
REFERENCES......Page 476
21 ENVISIONING THE FUTURE OF GEROPSYCHIATRIC NURSING......Page 480
NEW SERVICE DELIVERY MODELS AND SETTINGS FOR CARE......Page 481
EXPANDED ROLES......Page 483
NEEDED RESEARCH......Page 484
EMPHASIS ON TRANSLATION OF RESEARCH INTO PRACTICE......Page 485
NEED TO PREPARE MORE GEROPSYCHIATRIC NURSES......Page 486
CONCLUSION......Page 487
REFERENCES......Page 488
APPENDICES......Page 492
APPENDIX A: RECOMMENDED GEROPSYCHIATRIC COMPETENCY ENHANCEMENTS FOR ENTRY LEVEL PROFESSIONAL NURSES......Page 494
APPENDIX B: RECOMMENDED GEROPSYCHIATRIC ENHANCEMENTS FOR GERONTOLOGICAL CLINICAL NURSE SPECIALISTS......Page 498
APPENDIX C: RECOMMENDED GEROPSYCHIATRIC COMPETENCY ENHANCEMENTS FOR GERONTOLOGICAL NURSE PRACTITIONERS......Page 502
APPENDIX D: RECOMMENDED GEROPSYCHIATRIC ENHANCEMENTS FOR CLINICAL NURSE SPECIALISTS WHO PROVIDE CARE TO OLDER ADULTS BUT ARE NOT GERIATRIC SPECIALISTS......Page 509
APPENDIX E: RECOMMENDED GEROPSYCHIATRIC COMPETENCY ENHANCEMENTS FOR NURSE PRACTITIONERS WHO PROVIDE CARE TO OLDER ADULTS BUT ARE NOT GERIATRIC SPECIALISTS......Page 513
APPENDIX F: RECOMMENDED GEROPSYCHIATRIC COMPETENCY ENHANCEMENTS FOR PSYCHIATRIC MENTAL HEALTH CLINICAL NURSE SPECIALISTS......Page 521
APPENDIX G: RECOMMENDED GEROPSYCHIATRIC COMPETENCY ENHANCEMENTS FOR PSYCHIATRIC NURSE PRACTITIONERS......Page 525
INDEX......Page 534