The Science Journal of the American Association for Respiratory Care

1996 OPEN FORUM Abstracts

Mental Health and Aging: Perspectives, on Assessment and Preventive Techniques

Pam Z. Cacchione, RN, MSN, C-GNP Wednesday, November 6, 1996

The mental health of the older adult can greatly impact their ability to function. This presentation will focus on the three "D's" cognitive health: Dementia, depression and delirium. Definitions of these conditions, their causes and treatments will be discussed. A review of the normal changes of aging which impact on mental and cognitive health will also be provided. Prevention and tips on maintaining cognitive health will be discussed particularly for the areas of depression and delirium. Screening tools for dementia, depression and delirium will be described including the Folstein Mini-Mental Status Exam (1978), the Yesavage Geriatric Depression Scale (1983), and the Confusion Assessment Method by Inouye (1990). Community resources for supporting aging adults with mental health problems and their families will be discussed. Alternative living situations ranging from home care, assisted living and nursing homes will be described.

CLINICAL FEATURES OF DELIRIUM, DEMENTIA & DEPRESSION

CHARACTERISTICS DELIRIUM DEMENTIA DEPRESSION

Onset Sudden Insidious Precipitating

event

Course over Fluctuating, Stable Stable

24 hours with nocturnal

exacerbation

Consciousness Reduced Clear manic or

decreased

Attention Globally Normal except Disordered

disordered in severe

cases

Orientation Usually Often May be impaired

impaired impaired,

at least for time

Psychomotor Increased, Often normal, Agitated

Activity reduced or pacing or decreased

shifting,

unpredictable

Speech Often Word finding Decreased or

incoherent, problems forced

slow or rapid

Physical One or both Often absent Absent meds may

Illness are present with SDAT be a problem

drug toxicity

Sleep-wake Disturbed, Fragmented Insomnia,

cycle cycle reversed early morning

awakening

Mental Distracted from Frequent near Answers I don't

Status task misses know

Testing

Adapted From: Foreman, Grabowski, (1992). Journal of Gerontological Nursing, p. 5-12, Lipowski, (1989). The New England Journal of Medicine, 32(9), 578-582

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