Mental Health and Social Service Needs
Seeing the whole person
Residents have psychological and social needs just as real as their physical ones: safety, belonging, self-esteem, dignity, and a sense of purpose. Your work is to notice changes in mood and behavior and to communicate in a way that lowers fear.
Communication. Face the resident, speak clearly, and do not shout. For hearing loss, lower your voice and reduce background noise; for aphasia, ask yes-or-no questions and allow time. For vision loss, identify yourself and describe what you are about to do before touching.
Dementia and confusion. Behavior is communication. Look for a trigger - pain, hunger, a full bladder, noise, an unfamiliar face - before trying to stop the behavior. Do not argue with a delusion or hallucination; acknowledge the feeling and redirect. For a resident in an earlier stage, gentle orientation ("It's Tuesday; lunch is soon") helps; for later stages, validation of the feeling works better than correction. Sundowning - worsening confusion late in the day - calls for calm routines, light, and reduced stimulation, not restraints.
Mood and grief. Report signs of depression (withdrawal, poor appetite, hopelessness, sleeplessness) and any hint of suicide to the nurse at once. Grief and dying involve stages such as denial, anger, bargaining, depression, and acceptance; anger is not personal.
Trap to watch "Distract the resident" is often right; "tell them their mother died years ago" usually is not.
Rule of thumb: treat the feeling as true even when the fact is not. "You miss your mother. Tell me about her," preserves dignity while you redirect to a safe activity.