Doris Bowman is 79 years old. She is a patient on your psych floor at St....

Doris Bowman is 79 years old. She is a patient on your psych floor at St. Louis College Nursing Home. She has been diagnosed with paranoid schizophrenia and depression. She was very reclusive yesterday spending the entire day in her room. She tends to be depressed in the fall, every year, so the staff is aware to be watchful of her behaviors. (Learning Objectives 1, 3, and 4.)

What if…You are concerned with Doris becoming depressed. What behaviors do you need to be watchful for Doris?
What if…You want to develop a plan of care for Doris. What are some things that you need to do to help Doris get through this difficult time?
What if…You are concerned her depression is getting worse. One of the aides overhears her praying, saying she wants to die. What do you do to keep Doris safe?
What if…Doris’s family tend to believe her current mental state is “just a part of getting old.” What information can you reenforce for them to better understand the realities of mental health and illness in the older adult?

Solutions

Expert Solution

The behavior that needs to watch for suicidal tendencies, feeling of hopelessness, sadness, emptiness. Because of feeling hopeless, many people with depression have a chance to increase suicidal tendencies, so as a health worker this kind of behavioral change needs to be observed properly.

Plan to care for the patient is that

- Do not keep the patient alone

- Provide interpersonal therapy. In this, there is the involvement of the person who is more attached to the patient. The patient shares the thought and issue. By proper communication, the issue will be solved.

- Provide mind relaxation therapy like meditation can be provided to relax the mind.

- Exercise can be provided. Exercise helps to reduce symptoms of depression.

- Maintain adequate Sleep. Because a lack of sleep can increase depression.

- Counseling can be provided. Counseling should be done with the help of an expert to identify the problem, suggest the plan to solve the problem to the patient.

- Diversional therapy like dancing, playing, etc. It can be provided to divert the mind from depression.

In case the depression become worst and preventive measure include

- Close observation should be done.

- do not leave the patient alone. There is a need for an attendant with the patient always.

- Diversional therapy like talking, listening to music, playing can be provided under close observation.

- A safe environment should be maintained. Remove the drugs or equipment from the patient side to prevent self-harm by the patient.

Keep ward lock and security should be present at the gate where the patient is staying.

- Lastly, medication can be administered if prescribed by a doctor to reduce suicidal ideas.

There is need to give health education that the patient changes are not related to age. Proper education regarding mental illness and health is needed. Explain that the patient is having mental illness which can be a cure if treated. for the treatment of the patient-family support is very important. Educate the cause, risk, symptoms, diagnosis and treatment of depression. To maintain the mental health of the patient advise the family to encourage the patient for increase mingling with others, sharing the thought, proper sleep, proper exercise.

Nightingale answered 1 year ago

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