Psychosocial and Mental Health Care
Concepts to master
Older adults face loss, isolation, and role changes that can contribute to depression. Know the signs of depression: withdrawal, poor appetite, sleep changes, and hopelessness. Distinguish depression from delirium (acute, fluctuating, often caused by illness or medication) and dementia (progressive cognitive decline). Delirium is a medical emergency and must be reported. Know that suicide risk exists in older adults, especially men with recent loss or illness.
Therapeutic approaches
Use active listening, empathy, and validation. Encourage social participation and independence. For residents with dementia, use redirection and routines. Address grief and loss with sensitivity. Provide privacy and dignity during emotional moments.
Traps
Questions often bait with "the resident is just sad about aging" - the correct answer is to assess and report possible depression. Another trap is dismissing a resident's statement about wanting to die; always report it. Also watch for answers that ignore cultural or spiritual needs.
Worked example
A resident says, "I don't see the point anymore." The correct action is to listen, take the statement seriously, and report it to the nurse; the wrong action is to change the subject. Rule of thumb: any statement about not wanting to live is reported, never dismissed.