Nursing Old People Essay Example

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    Nursing
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    Undergraduate
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8NURSING OLD PEOPLE

Nursing Old People

Nursing Old People

Introduction

Depression is defined as the mental disorder that affects the moods, state of mind, which is characterized by changing mod behaviours. Depression is one of the mental disorders that occur in older people with a high prevalence (Pirkis et al., 2009). It is estimated that over 2 million Americans above the age of 65 years old are suffering from depression (Antigoni & Theofanidis, 2009). This prevalence is high such that it makes depression as one of the functional disorder in most parts of the world. Despite the high prevalence, most incidences of depression are not detected for one reason or the other. The disease has affected more people especially older people, hence increasing the need for care. The increased cases of depression among the elderly people are associated with family histories of depression cases, age, gender, social interactions and changing life conditions and patterns (Davison et al., 2007). Different perceptions and perspectives relating to depression have been researched. The depression in older people affects the lives of both the depressed individual and the family members. In addition, caregivers including nurses in nursing homes have different perspectives on depression among older people. The nursing perspective is crucial in detecting and diagnosis of depression in old people. Nurses also have the role of managing depression and treating depression in older people especially at the hospital or in nursing homes (Davidson, 2008). The adoption of better intervention and treatment techniques and programs helps to reduce the problems associated with depression. In addition, proper nursing if the depressed older people rely on identifying the causes and characteristics associated with depression in older people. The aim of this paper is to discuss the nursing perspective of the nurse in depression. This paper will include the presentation of depression in old people and the ways in which depression can be managed.

Presentation and Causes of Depression in Old People

Health problems: Nurses have observed different features and ways in which depression manifests in old people. Physical impairment and physical illness are one of the symptoms associated with depression in older people (Chew-Graham, 2008). The various physical disabilities such as arthritis have been found to be one of the major causes in depression. Nurses have observed that a patient who are not treated earlier with arthritis have increased risks of suffering from depression. In addition, old patients who are suffering from chronic pain due to stroke experience depression (Bienenfeld, 2009). The chronic pain may result from biological illnesses such as mental diseases. This may lead to decline in cognition of the patient. Older people who suffer from mental illnesses such as schizophrenia and dementia experience a decline in mental cognition, which may result in depression. Diseases such as diabetes which may result in loss of body parts such as limbs may result to physical impairment and decline in memory loss. In addition, damages resulting from surgery are the main causes of depression among older people (Olivera et al., 2008).

Loneliness and Isolation: Loneliness among the old people is one of the factors that nurses have associated it with depression. The loss of a partner in old people may contribute to loneliness in old people. Some old patients may live alone due to relocation of their families to other places. This creates a feeling of loneliness and isolation. Loneliness may also arise due to mobility problems among the elderly people. Caregivers have observed that most of the elderly people spend time on a single spot and have less time to interact with bother family members. This creates a feeling of loneliness with may manifest itself into depression. A lonely person is mostly dissatisfied with his or her life (Singh & Misra, 2009).

Fears: Fears may result from various sources, which may result to depression in old age. The fears of death among some old age people results in depression, which results to changes in moods and stress. Fears may also arise due to financial problems, which bring about anxiety in the individual. The fears and anxiety may also arise from loss of family members of due to health issues (Singh & Misra, 2009).

Nursing Intervention

The ability to diagnose depression in old age people determines the best intervention for depression in old people. The intervention required in managing the nursing of older people with depression address various areas such as physical health of the patient and his or her disability status, social interactions and financial problems that are associated with depression the ability of the patient to abide to pharmacological interventions and psychological problems experienced by the individual patient (Pfaff et al., 2009).

The Role of the Nurse

The nurses are involved in caring for the old people in different settings. Despite this factor, nurses ensure a general approach in caring and treatment for people with depression in old age. The most common approach on how nurses should care and treat older people with depression applies to all settings (Tolson et al., 2011). In addition, a fundamental approach is necessary in order to achieve the best outcomes. However, in the fundamental approach there are variations, which apply to specific settings. The general approach to care for the old depressed people applies on both the general nurse as well as the specialist mental nurse. The general nurse is mostly concerned with nursing approaches that address the physical needs of the patient while the specialist mental nurse focuses on the psychological aspects that result in depression in old people (Trivedi et al., 2007).

Principles of Care and Treatment

When nursing an old person who is depressed certain principles should always be followed. The nursing approach applied should be problem solving and involve thorough assessment. In addition, the intervention or care should incorporate all aspects including physical, social and psychological issues related to depression. Moreover, there is the need to involve family, members in the nursing approaches (Parker & Hyett, 2009).

Therapeutic Relationship

Nurses have been shown to maintain a relationship with the old people, which reduce the level of depression. Old people who are depressed require understanding from the nurses and hence the nurses develop a rapport with sees patients. In this rapport, the nurses show a positive attitude to the patients. In addition, the nurse should show empathy and be able to understand the patient’s world (Davidson, 2008). The nurse should be able to listen, understand the problem of the old person, and offer viable solutions. In this way, the nurse should cheer up the depressed individual with a light-hearted approach. The nurse can also reassure the patient that recovering from depression is a slow process, which requires the participation of both the patient and the nurse. In fact, the generic nursing approach to depression changes patterns in the patient. The activities, thinking and skills of the patient are changed. This approach focuses on developing positive thinking and neglecting the negative thoughts. Therefore, the nursing approach focuses on enhancing communication between the nurse and the patient. This reduces loneliness and the feeling of isolation (Butler et al., 2008).

Psychological Intervention

Depressions that result from social problems such as social isolation and loss of a family member or spouse may be solved using psychological therapies. Therefore, factors that affect the psychology of the old person are addressed, and the best intervention recommended. There are a number of psychological interventions the nurses. The most commonly used is the cognitive behavioural therapy. In this therapy, the nurse tries to eliminate the negative thinking in the patients. The cognitive behavioural therapy focuses on adoption of positive thinking and change of behaviours (Bienenfeld, 2009).

Physical treatment

This involves the care of an old person using antidepressants. The pharmacological treatment given depends on the degree or level of depression. The time and duration of treatment are varying from one patient to another. In this approach, various antidepressants are administered to the patient on a regular basis for a specified period (Chew-Graham, 2008).

Conclusion

Depression is a mental, disorder characterised by mood changes and stress. The prevalence of depression ids high in older people compared to other ages. In addition, women experience high cases of depression compared to men. In managing depression, it is necessary to be able to detect the characteristics and features that are associated with depression. In addition, caring for the old people with depression is determined by the ability of the care give to establish the factors that contribute to depression. Some of the identified factors contributing to depression include health problems such as stroke, loss of a partner or family member, loneliness or isolation of a member of the family, financial problems and fear of death among the old people. Nurses can contribute to care of the old depressed persons in various ways. The general nursing approach employs both physical treatment and psychological interventions. The physical intervention involves the use of antidepressants to reduce depression. The psychological therapies that can be used to reduce depression in old people include the cognitive behaviour therapy.

References

Antigoni, F., & Theofanidis, D. (2009). Depression in the Elderly: Limits and Challenges -a Nursing Perspective. International Journal of Caring Sciences, 2(30, 108-117.

Bienenfeld, D. (2009). Cognitive therapy with older adults. Psychiatric Annals
39 (9), 828–832.

Butler, G., Fennell, M, and Hackmann A. (2008). Cognitive-Behavioural Therapy for Anxiety Disorders. New York: The Guilford Press.

Chew-Graham, C. (2008). Integrated Management of Depression in the Elderly. Cambridge: Cambridge University Press.

Davidson, T. (2008). Improving the Detection and Management of Depression in Aged Care. Australian Psychology Society. Retrieved fromhttp://www.psychology.org.au/inpsych/depression_aged_care/

Davison, T., McCabe, M. P., Mellor, D., Ski, C., George, K., & Moore, K. (2007). The prevalence and recognition of depression among aged care residents with and without cognitive impairment. Aging &
Mental Health, 11, 82-88.

Olivera, J., Benabarre, S., Lorente, T., Rodriguez, M., Pelegrin, C., Calvo, J., Lerris, J., & Idanez, A. (2008) Prevalence of psychiatric symptoms and mental disorders detected in primary care in an elderly Spanish population. The PSICOTARD Study: preliminary findings. International Journal of Geriatric Psychiatry, 23(9), 915-921.

Parker, G., & Hyett, M. (2009). Management of depression by general practitioners: impact of physician gender. Australian and New Zealand journal of Psychiatry, 43(4), 355-359.

Singh, A., & Misra, N. (2009). Loneliness, depression and sociability in old age. Industrial Psychiatry Journal, 18(1), 51–55.

Trivedi, M., Lin, E., & Katon, W. (2007). Consensus recommendations for improving adherence, self-management, and outcomes in patients with depression.CNS Spectrums. 12(13), 1-27.

Tolson, D., Booth, J., & Schofield, I. (2011). Evidence Informed Nursing with Older People. New York: John Wiley & Sons

Pfaff, J., Draper, B., Pirkis, J., Stocks, N., Snowdon, J., Sim, M., Byrne, G., Lautenschlager, N., Flicker, L., Kerse, N., Goldney, R., & Almeida, O. (2009). Medical Morbidity and Severity of Depression in a Large Primary Care Sample Of Older Australians: The DEPS-GP Project. Medical Journal, 190(7), 75-80.

Pirkis, J., Pfaff, J., Williamson, M., Tyson, O., Stocks, N., Goldney, R., Draper, B., Snowdon, J., Lautenschlager, N., Almeida, O. (2009).The Community Prevalence of Depression in Older Australians. Journal of Affected Disorder, 115(1-2), 54-61.