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9780763732721

Geropsychiatric and Mental Health Nursing

by ;
  • ISBN13:

    9780763732721

  • ISBN10:

    0763732729

  • Format: Paperback
  • Copyright: 2005-04-30
  • Publisher: Jones & Bartlett
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List Price: $118.95

Summary

Geropsychiatric and Mental Health Nursing addresses the knowledge and skills necessary in the assessment and nursing care of older adults who are experiencing common mental health and psychiatric problems of late life. The text covers assessment, diagnosis, psychopharmacology, and behavioral management strategies in nursing care of older adults, as well as incorporating social, cultural, and policy issues in mental health care, applying theory to practice, and utilization of research. Written by expert pioneers in the gerontological nursing and adult psychiatric mental health nursing fields, this book provides the essential information needed to provide care to older adults experiencing mental health and psychiatric disorders. CE Contact Hours based on this title are now available through Western Schools! Please visit this page for additional information.

Table of Contents

Contributors xv
Acknowledgments xxi
SECTION I Overview of Aging and Mental Health Issues
1(128)
Introduction and Overview of Aging and Older Adulthood
3(24)
Karen Devereaux Melillo
Introduction
3(1)
Mental Health and Older Adults
3(2)
Introduction to Mental Health Issues and Disorders
5(2)
Relationship of Functional Status and Mobility Impairments to Mental Health
6(1)
Vulnerable Populations
7(3)
Chronically and Persistently Mentally III
7(1)
Older Adults with Mental Retardation/Developmental Disabilities and Their Aging Family Caregivers
8(1)
The Homeless
8(2)
Summary of Mental Health Problems Experienced by Older Adults
10(1)
Introduction to Gerontology
11(10)
Demographics/Population Characteristics
11(1)
Facts About World Aging
11(2)
Theories of Aging
13(5)
Growth and Development in Old Age
18(1)
Cognitive Changes with Age
19(2)
Summary
21(4)
Acknowledgment
25(2)
Geropsychiatric Nursing as a Subspecialty
27(18)
Karen Devereaux Melillo
Lee Ann Hoff
Martha A. Huff
Geropsychiatric Mental Health Nursing---Introduction
27(2)
Review of Standards
29(2)
Theoretical Foundations for Geropsychiatric and Mental Health Nursing
31(8)
Psychoanalytic and Personality Theories
31(2)
Existential Stress and Social Learning Theories
33(1)
Crisis Theory, Public Health, and Preventive Psychiatry
34(1)
Crisis Care and Psychiatric Stabilization
35(1)
Community Mental Health
36(1)
Sociocultural and Feminist Influences
36(1)
Cross-Cultural and Diversity Influences
37(1)
Nursing Theories
38(1)
The Nursing Paradigm Applied to Geropsychiatric Nursing
39(6)
Application of Theory
40(5)
Comprehensive Mental Health Assessment: An Integrated Approach
45(24)
Lee Ann Hoff
Lisa Brown
Overview of Assessment Methods
46(5)
Nursing Diagnosis
46(1)
Diagnostic and Statistical Manual of Mental Disorders (DSM)
46(1)
Mini-Mental State Exam
47(1)
Comprehensive Mental Health Assessment Tool
48(2)
CMHA and McHugh's ``Essentials'': Description and Commonalities
50(6)
Data-Based Service Planning
56
Case Study
51(16)
Appendix
67(2)
Ethnic Elders
69(18)
Jane Cloutterbuck
Lin Zhan
Demographics
69(2)
Definitions of Race, Culture, Ethnicity, and Minority Group
71(1)
Mental Illness: Social and Ethnocultural Contexts
72(9)
Explanatory Models of Mental Illness
73(1)
Idioms of Distress/Culture-Bound Syndromes
74(1)
Family Influence
75(2)
Stigma Associated with Mental Illness
77(1)
Level of Trust
77(1)
Help-Seeking Behavior
78(1)
Sociostructural Contexts of Mental Health Care
78(1)
Access to Care
79(1)
Quality of Care
79(2)
Cultural Competence
81(1)
Summary
81(6)
Mental Health Promotion
87(20)
Charles Blair
Mental Health and Wellness
87(1)
Stressors Impacting Mental Health
88(3)
Gender
88(1)
Race and Ethnicity
89(1)
Challenges of Late Life
89(1)
Chronic Illness
90(1)
Financial Problems
90(1)
Admission to Nursing Home
91(1)
Comprehensive Mental Health Assessment in Clinical Practice
91(3)
Physical Functioning
91(1)
Mental and Emotional Functioning
92(1)
Emotional Functioning
93(1)
Family and Social Support
93(1)
Assertiveness and Problem-Solving Skills Training as Part of Social Skills Training
94(1)
Late Life Challenges that Contribute to Mental Health Problems
95(2)
Caregiving Role and Stressors
95(1)
Dysphoria
95(1)
Loneliness and Isolation
95(1)
Role Loss, Change, and Coping
96(1)
Burden of Illness and Disability
96(1)
Common Maturational and Situational Crises of Older Adults
96(1)
Therapeutic Interventions to Address Mental Health Promotion and Wellness
97(4)
Counseling and Support
97(1)
Crisis Intervention
97(1)
Pharmacological Therapies
98(1)
Individual, Group, and Family-Focused Interventions and Treatment Modalities
98(1)
Complementary and Alternative Therapies
99(1)
Botanical and Nonbotanical Therapies
100(1)
Nontraditional Psychosocial Therapies
100(1)
Consultation and Referral
100(1)
Education
101(1)
Family and Community Resources to Enhance Mental Wellness
101(1)
Clinical Research Pertaining to Mental Health Promotion in Older Adults
102(5)
Clinical Issues
102(5)
Psychopharmacology
107(22)
Barbara Edlund
James Sterrett
Geoffry McEnany
Introduction
107(1)
Challenges in Prescribing for Older Adults
108(1)
Factors Influencing Pharmacotherapy in Older Adults
109(4)
Absorption
109(1)
Distribution
109(1)
Metabolism
110(1)
Excretion
110(3)
Psychotropic Drugs
113(11)
Antidepressants
114(4)
Antipsychotics
118(4)
Anxiolytics
122(2)
Summary
124(5)
SECTION II Psychopathology of Late Life
129(272)
Nursing Assessment and Treatment of Depressive Disorders of Late Life
131(20)
Eve Heemann Byrd
Etiology
132(1)
Assessment and Screening of Late-Life Depression
133(1)
Diagnosis of Mood Disorders
133(5)
Suicide
138(1)
Treatment Options
139(1)
Pharmacologic Treatment Options
140(3)
Psychotherapy
143(2)
Electroconvulsive Therapy
145(1)
Nursing Interventions
145(6)
Nursing Assessment and Treatment of Anxiety in Late Life
151(22)
Marianne Smith
Introduction
151(1)
Anxiety Disorders in Late Life
152(2)
Comorbid Conditions
154(3)
Depression and Anxiety
154(1)
Cognitive Impairment and Anxiety
154(1)
Physical Health Conditions and Anxiety
155(1)
Late-Life Change and Anxiety
156(1)
Assessment of Anxiety in Later Life
157(3)
History and Physical
158(1)
Anxiety Symptoms
159(1)
Assessment Scales
159(1)
Treatment of Anxiety in Late Life
160(9)
Nonpharmacological Interventions
160(5)
Pharmacological Interventions
165(3)
Community and Family Resources
168(1)
Summary
169(4)
Psychosis in Older Adults
173(20)
Janet C. Mentes
Julia K. Bail
Introduction
173(5)
Schizophrenia
175(1)
Delusional Disorder
175(1)
Mood Disorder with Psychotic Features
175(1)
Delirium
176(1)
Psychoses Manifested with Other Diseases
176(1)
Psychosis Related to Substance Use, Abuse, or Polypharmacy
177(1)
Benign Hallucinatory State: Charles Bonnet Syndrome
177(1)
Epidemiology of Psychotic Symptoms in Older Adults
178(1)
Risk Factors for Psychosis
178(1)
Assessment
178(3)
Determine Type of Psychosis
179(1)
Onset of Psychosis
180(1)
Obtain Accurate and Detailed Medical and Medication History
180(1)
The Interview
180(1)
Treatment
181(8)
Establishing an Environment of Trust
181(1)
Pharmacotherapy
182(2)
Primary Preventive Care
184(1)
Crisis Intervention
184(1)
Psychosocial Interventions
185(2)
Community and Family Resources
187(2)
Ethical and Legal Issues
189(4)
Psychiatric Advance Directives
189(1)
Social Stigmatization
189(1)
Role of the Geropsychiatric Nurse
189(4)
Substance Abuse in Older Adults
193(20)
Betty D. Morgan
Donna M. White
Ann X. Wallace
Introduction
193(1)
Prevalence of Substance Abuse in Older Adults
193(1)
Definitions
194(1)
Drugs of Abuse
195(2)
Prescription Drugs
195(2)
Review of the Literature
197(1)
Screening Tools for Identification of Substance Abuse in the Older Adult
197(3)
CAGE Questionnaire
197(1)
MAST-G (Michigan Alcoholism Screening Test---Geriatric)
198(1)
IMADUS (Impressions of Medication, Alcohol, and Drug Use in Seniors)
199(1)
Alcohol Abuse and the Older Adult
200(1)
Health Assessment
201(1)
Medication Assessment
202(1)
Medical Consequences of Substance Abuse
203(1)
Review of Systems
203(3)
Gastrointestinal
203(1)
Cardiac
204(1)
Neurological
204(1)
Renal and Pharmacokinetics
205(1)
Musculoskeletal
205(1)
Hematological
205(1)
Immune
206(1)
Dermatological
206(1)
Nursing Interventions to Address Substance Abuse in the Older Adult
206(7)
Delirium
213(18)
Karen Dick
Catherine R. Morency
Case Study
213(1)
Introduction
213(1)
Terminology
214(1)
Definition
215(1)
Pathophysiology
215(1)
Risk Factors
216(1)
Subtypes and Patterns
217(1)
Clinical Course
217(1)
The Problem of Recognition
218(1)
Evaluation
219(2)
Identify the Presence of Delirium
219(1)
Identify and Treat Underlying Medical Conditions
220(1)
Supporting Safety and Recovery
221(3)
Documentation
224(2)
Ethical Issues
226(1)
Summary
226(5)
Nursing Assessment of Clients with Dementias of Late Life: Screening, Diagnosis, and Communication
231(20)
Kathleen Sherrell
Madelyn Iris
Alzheimer's Disease and Other Dementias
232(1)
The Neurobiology of Dementia
233(1)
Behavioral and Psychological Symptoms of Dementia
234(2)
Measures of the Behavioral and Psychological Symptoms of Dementia
235(1)
The Role of Nurses in the Dementia Assessment Process
236(5)
Instruments Used for Nursing Assessment
237(3)
Therapeutic Environment
240(1)
The Process of Diagnosis Seeking in Dementia
241(3)
Communicating the Diagnosis
244(2)
Summary
246(5)
Nursing Management of Clients Experiencing Dementias of Late Life: Care Environments, Clients, and Caregivers
251(16)
Ruth Remington
Linda A. Gerdner
Kathleen C. Buckwalter
Introduction
251(1)
Care Environments
251(2)
Adult Day Care
251(1)
Home Health Care
252(1)
Assisted Living
252(1)
Long-Term-Care Facilities
252(1)
Hospice Care
252(1)
Frameworks for Interventions
253(1)
Interventions Directed Toward the Person
254(4)
Group Activity
254(1)
Reminiscence
254(1)
Remotivation
255(1)
Art
255(1)
Indications for Pharmacological Therapies
255(1)
Monitoring Medication Side Effects
256(1)
Complementary and Alternative Therapies
257(1)
Interventions Directed Toward the Environment
258(3)
Environmental Modification
258(1)
Home
259(1)
Snoezelen
260(1)
Music
260(1)
Interventions Directed Toward the Caregiver
261(2)
Family Caregivers
261(1)
Education and Support in Caregiving Responsibilities
261(1)
Referral to Support Groups for Care and Assistance
262(1)
Nursing Home Placement
262(1)
Staff Training and Management
262(1)
Staff-Family Partnership in Care
262(1)
Dementia Care Resources
263(1)
Summary
263(4)
Addressing Problem Behaviors Common to Late-Life Dementias
267(20)
Ruth Remington
May Futrell
Introduction
267(1)
Pain
267(3)
Barriers to Effective Pain Management
268(1)
Indicators of Pain
268(1)
Pain Assessment Tools
269(1)
Agitation
270(10)
Antecedents
271(2)
Interventions to Manage Agitation
273(4)
Wandering
277(3)
Other Problem Behaviors
280(2)
Sleep Disturbances
280(1)
Eating Disorders
280(1)
Sexual Disturbances
281(1)
Summary
282(5)
Family Caregiving
287(20)
Susan Crocker Houde
Introduction
287(1)
Emotional Responses to Caregiving
288(8)
Well-Being and Positive Responses to Caregiving
288(2)
Stress and Burden in Caregivers
290(1)
Psychiatric Health Effects
291(1)
Physical Health Effects
292(1)
Grief and the Family Caregiver
292(4)
Caregiver Assessment and the Geropsychiatric Nurse
296(2)
Interventions to Support Caregivers
298(4)
Summary
302(5)
Sleep Disorders of Late Life
307(16)
Barbara Resnick
Marianne Shaughnessy
Marjorie Simpson
Introduction
307(1)
Physiology of Sleep
307(2)
Common Sleep Disturbances in Older Adults
309(1)
Obstructive Sleep Apnea
309(1)
Restless Legs Syndrome (RLS)
309(1)
Periodic Limb Movement Disorder (PLMD)
310(1)
Insomnia
310(1)
Assessment of Sleep Disorders in Late Life
310(1)
Therapeutic Nursing Interventions to Address Sleep Disorders
311(2)
Behavioral Interventions
311(1)
Sleep Hygiene
311(1)
Relaxation Techniques
312(1)
Exercise
312(1)
Light Therapy
313(1)
Massage Therapy
313(1)
Dietary Supplements
313(1)
Environmental Approaches in Institutional Settings
313(2)
Indications for Pharmacological Therapies
315(1)
General Recommendations for Medication Use for Insomnia
316(1)
Pharmacotherapy for Insomnia
316(2)
Nonbenzodiazepine and Nonbarbiturate Hypnotics
316(1)
Benzodiazepines
316(1)
Barbiturates
317(1)
Antidepressants
317(1)
Antihistamines
317(1)
Consideration for Use of Sedative-Hypnotics Among Institutionalized Older Adults
318(1)
Discontinuation of Sedative--Hypnotics
318(1)
Review All Pharmaceutical Agents Used to Avoid Exacerbations of Insomnia
318(1)
Patient Education and Counseling
319(1)
Referral and Consultation
319(1)
Evaluation of Treatment Effectiveness with Follow-Up
320(3)
Problem and Pathological Gambling Among Older Adults
323(14)
Cindy Sullivan Kerber
Introduction
323(1)
A Brief History of Gambling in the United States
323(1)
Gambling Accessibility
323(1)
Gambling Accessibility and Older Adults
323(1)
Prevalence of Pathological Gambling in the General Population
324(1)
Prevalence of Pathological Gambling Among Older Adults
324(4)
Assessment of Pathological Gambling
328(3)
Assessment of this Disorder as It Relates to Older Adults
331(1)
Therapeutic Nursing Interventions for Problem and Pathological Gambling
332(2)
Support Groups
332(1)
Indications for Pharmacological Therapies
332(1)
Counseling
333(1)
Alternative Therapies
333(1)
Education
333(1)
Evaluation of Treatment Effectiveness with Follow-Up
334(1)
Research Issues Pertaining to Problem and Pathological Gambling in Older Adults
334(1)
Summary
335(2)
Elder Mistreatment
337(10)
Terry Fulmer
Lisa Guadagno
Marguarette M. Bolton
Introduction
337(1)
Types of EM
337(1)
Incidence and Prevalence
338(1)
Population at Risk
338(1)
Theories of EM
339(1)
Institutional Mistreatment
339(1)
Clinical Presentations
340(3)
History
340(2)
Physical Examination
342(1)
Psychological Assessment
342(1)
Laboratory and Diagnostic Testing
343(1)
Evaluation and Referral
343(1)
Legal Considerations
344(1)
Prevention
344(3)
End of Life
347(16)
Michelle Doran
Karyn Geary
Introduction
347(1)
Gold Standard for End-of-Life Care: Hospice and Palliative Care
348(3)
Hospice
348(1)
Palliative Care
349(1)
Barriers to Quality Care at End of Life
350(1)
Advanced-Care Planning
351(2)
Determining Prognosis
353(2)
Patient-Family Assessment
355(1)
Pain
356(1)
The Dying Process
357(1)
Grief and Bereavement
358(1)
Future End-of-Life Care
359(4)
Social, Health, and Long-Term Care Programs and Policies Affecting Mental Health in Older Adults
363(18)
Kathy J. Fabiszewski
Introduction
363(1)
Role of the Professional Nurse
363(1)
Federal Programs Supporting and Financing Mental Health Care
364(10)
Administration on Aging: State and Community Programs
365(2)
Community Health Centers
367(1)
Community Mental Health Block Grants
367(1)
HUD Section 232: Mortgage Insurance for Board and Care, Assisted-Living, and Other Facilities
367(1)
Medicaid (Title XIX)
367(1)
Medicare (Title XVIII)
368(3)
PATH (Projects for Assistance in Transition from Homelessness)
371(1)
PAIMI (Protection and Advocacy for Individuals with Mental Illness)
371(1)
Social Services Block Grant (Title XX)
371(1)
Supplemental Security Income (Title XVI)
372(1)
Veterans' Benefits
372(1)
Managed Care Organizations (MCOs)
373(1)
Senior Centers
373(1)
Substance Abuse and Mental Health Services Administration
374(1)
Reimbursement Issues for the Geropsychiatric Nurse
374(2)
Federally Funded Programs (Medicare, Medicaid) and APNs
374(1)
Managed Care Organizations
375(1)
Indemnity Insurance Companies
376(1)
Creating a Mental Health Policy Agenda for Older Adults
376(5)
Future of Geropsychiatric and Mental Health Nursing in Addressing Older Adult Health Care Needs
381(20)
The Future of Geropsychiatric and Mental Health Nursing
381(6)
Priscilla Ebersole
Cohort Effects
382(1)
Defining Standards
383(1)
Depression, Anxiety, Psychoses, Substance Abuse, Chronicity, Delirium, and Dementia
383(1)
Where Are the Elders?
383(1)
Who Are the Nurses?
384(1)
Changing Situations
384(1)
Caregiving
385(1)
Effects of Prolongevity
385(1)
Gender
385(1)
Self-Care
386(1)
Presumptuous Projecting for a Decade
386(1)
The Future of Technology in Mental Health Nursing---a Nurse Geropsychtechnologist?
387(6)
Diane Feeney Mahoney
Envisioning the Future of Geropsychiatric Nursing
393(8)
Kathleen Coen Buckwalter
New Service Delivery Models/ Settings for Care
394(2)
Expanded Roles
396(1)
Needed Research
396(1)
Emphasis on Translation of Research into Practice
396(1)
Need to Prepare More Geropsychiatric Nurses
397(1)
Health Promotion and Disease Prevention
398(1)
Conclusion
398(3)
Index 401

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