Mental Health and Psychosocial Needs
What you must understand
Maslow's hierarchy reminds you that physical needs - oxygen, food, water, elimination, safety - come before psychosocial ones. A resident who is hungry, in pain, or desperate to toilet cannot focus on conversation or activities.
Know the difference between delirium and dementia. Delirium is sudden, fluctuating, and often reversible; it is a medical emergency and must be reported, not dismissed as "getting old." Dementia is gradual and progressive, with short-term memory loss, difficulty with ADLs, wandering, sundowning, and sometimes hallucinations.
Caring for a resident with dementia
Keep routines consistent, give one-step directions, reduce noise, and use validation and redirection rather than argument. If a resident says their long-dead mother is coming to visit, do not correct them - respond to the feeling behind the statement. Remember that new or worsening confusion often signals a physical problem: pain, constipation, urinary retention, infection, or a medication effect.
Depression looks like sadness, withdrawal, poor appetite, sleep changes, and statements about being a burden. Ask directly about thoughts of self-harm and report immediately - never promise to keep such a statement secret.
Traps
Labeling behavior as manipulation instead of unmet need. Arguing with a delusion. Quizzing a confused resident ("Do you remember me?"). Saying "don't worry" or "I know how you feel." Ignoring religious, cultural, or sexuality-related needs.
Rule of thumb
Behind every behavior is a need. Look for pain, toileting, hunger, fear, or boredom before you look for a diagnosis.