Mental Health and Social Service Needs
Concepts you must understand
Every resident has psychosocial needs alongside physical ones: safety, belonging, self-esteem, dignity, control, and meaningful activity. Recognize common presentations of depression (withdrawal, poor appetite, hopelessness, sleep change), anxiety (restlessness, pacing, repeated questions), grief, delirium (sudden onset, fluctuating, often from infection, medication, or dehydration), and dementia (gradual, progressive). Distinguishing delirium from dementia is a frequent test item: delirium is sudden and reversible with treatment, and it must be reported.
Use therapeutic responses: sit at eye level, listen without judging, acknowledge feelings ("That sounds frightening"), offer simple choices, and encourage participation in activities and contact with family, clergy, or social services per the resident's wishes. Respect cultural, religious, and sexual expression needs.
Traps in questions
Arguing with a delusion or hallucination, playing along with a false belief as if it were true, or trying to "cheer up" a depressed resident. Statements like "You shouldn't feel that way" and "My grandmother had that too" are wrong answers. Any expression of suicidal ideation, hopelessness, or a wish to die must be taken seriously, reported to the nurse immediately, and never kept as a secret.
Rule of thumb
Acknowledge the feeling, don't argue with the content; report risk immediately.
Worked example: A resident says, "There's no point in living anymore." The wrong answer is to reassure them that things will get better. The right answer is to stay with the resident, listen, take the statement seriously, and report it to the nurse right away without promising secrecy.