Mental Health and Social Service Needs
Needs do not stop at the skin
A resident's psychosocial needs - belonging, safety, esteem, autonomy, spiritual comfort - matter as much as a bath. Ask about routines, faith, hobbies, and family, and connect residents to activities and social services. Social services handles discharge planning, finances, advance directives, and referrals; your job is to notice a need and report it.
Common presentations
Anxiety, depression, grief, anger, and withdrawal are common and are not a normal part of aging. Depression in older adults often shows as apathy, appetite change, sleep change, or vague complaints rather than stated sadness. Grief follows loss - of a spouse, a home, a body that worked. In dying, residents may move through denial, anger, bargaining, depression, and acceptance, and they may revisit stages. Anger is usually about loss of control, not about you; do not take it personally or argue. Any statement of hopelessness, self-harm, or suicide must be reported to the nurse immediately - never dismissed as talk.
The traps
Do not judge a resident's choices, lifestyle, religion, or family. Do not minimize feelings (you shouldn't feel that way). If a family asks you not to tell a resident a diagnosis, do not agree or break the news yourself - refer them to the nurse; residents generally have the right to information about their own care. Report changes in mood or behavior just as you would a change in vital signs.
Rule of thumb: a resident who says nobody would miss me has just given you a reportable statement.