Question

1--Discuss mental health in the patient in the hospital setting.

2--Discuss functional abilities in the geriatric patient. Give specific example in your text.

3--Discuss Assessment in the geriatric patient in the hospital. Fucus on 3 areas only.

Answer 1

1.Mental health includes our emotional,psychological , spiritual and social well being. It affects how we think ,feel,and act.It also determines how we handle stress and make choices.

Factors affecting the mental health of the patient:

a) A new environment: Being in hospital means ,being in a new environment,with a new set of people which include health care workers,other patients etc.A shift from an used to environment  of the client to a new one,itself can be stressful to the patient.

b)Existence of a disease/illness:A client comes to a hospital to get treatment for a existing disease or illness. Any deviation from the normal heath can have a impact on the mental well being of the patient.

c)Patient-health care workers relationship: There should be a healthy therapeutic relationship between the patient and the staff. If the relationship crosses the therapeutic boundaries and goes to a social or intimate one,it might result in stress ,not only for the patient ,also for the staff.

There should be mutual trust,respect and the relatioship should bring out a beneficial change n the patient.

d)Patient centered care:Active participation of the patient in the each stage of decision making is important.Patient should not have a left out feeling, otherwise it can be quite stressful for the patient.

HOW TO REDUCE THE STRESS OF THE PATIENTS IN HOSITAL SETTING.

a)Make a patient friendly atmosphere in hospital: The patient should be stepping in to friendly atomosphere right from the doctor appointment and should remain in a friendly one throughout the investigatios,procdures,hospital stay and discharge.

b) A good therapeutic relationship: it should be based on mutual respect, trust,empathy and finally resullts in a beneficial change in patient.Conflicts should be resolved through active communication.

c)Patient centered care:patient should be actively involved in the deision making.

d) Positive patient outcome:the aim of the patient's visit to the hospital shoud be achieved. mostly it is the adeuate treatment to the disease and returning to normal life.

2.FUNCTIONAL ABILITIES OF A GERIATRIC PATIENT

Functional abilities refers to a person's ability to perform tasks that required for living.Two important divisions of functional abiities are

a)Activities of daily living: these are self care activities that a person performs daily such as eating,bathing,dressing etc

b)Instrumental activities of daily living:these are activities that are needed to live independently such as preparing meals,doing housework etc

For assessing a patient for functional ability, a health care worker can acquire information by simply observing the patients . In a hospital setting we can observe whether patient is able to walk independently,climping up and down of an examination table etc.

3.PHYSICAL ASSESSMENT OF GERIATRIC PATIENT

(FOCCUSING ON ONLY 3 AREAS)

a) MUSCULO SKELETAL:

Assess for   

• Range of motion
• Pain
• Vertebral tendreness
• Back pain
• Gait disturbances
• Dorsal kyphosis
• Muscle wasting
• Weakness

b) SKIN

Assess for

• unexplained bruises
• ulcerations over pressure points
• erythema
• leisons
• elasticity of the skin

c)GASTROINTESTINAL

Assess for

• costipation
• fecal incontinence
• rectal mass
• occult blood