{"id":4684,"date":"2019-01-09T19:43:54","date_gmt":"2019-01-10T00:43:54","guid":{"rendered":"https:\/\/www.amyork.ca\/academic\/zz\/?p=4684"},"modified":"2019-05-25T22:54:49","modified_gmt":"2019-05-26T02:54:49","slug":"contributions-to-mental-in-children-youth","status":"publish","type":"post","link":"https:\/\/www.amyork.ca\/academic\/zz\/mental-health-nursing\/contributions-to-mental-in-children-youth\/","title":{"rendered":"Contributions to mental in children &#038; youth"},"content":{"rendered":"<p><strong>Risk factors\u00a0 <\/strong><\/p>\n<ul>\n<li>Genetics<\/li>\n<li>Biochemical<\/li>\n<li>Pre &amp; post-natal influences<\/li>\n<li>Individual temperament<\/li>\n<li>Psychosocial development<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h3>Infancy &amp; rarly Childhood<\/h3>\n<p><strong>General behaviour areas to assess <\/strong><\/p>\n<ul>\n<li>Internalising problems<\/li>\n<li>rxternalising behaviours<\/li>\n<\/ul>\n<p><strong>Specific behaviour areas to assess\u00a0 Protective factors\u00a0 <\/strong><\/p>\n<ul>\n<li>Attachment to family<\/li>\n<li>Supportive parenting<\/li>\n<li>Social competence<\/li>\n<li>rconomic security<\/li>\n<li>Positive school\/work environment<\/li>\n<\/ul>\n<table width=\"0\">\n<tbody>\n<tr>\n<td width=\"621\">\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Somatic complaints \u2013 expressing their mood physical<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Delinquent behaviour \u2013 e.g. rule breaking, misbehaving<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Attention problems<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Aggressive behaviours &#8211; e.g. bullying, teasing<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Social problems \u2013 e.g. social impairment<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Withdrawal \u2013 e.g. socially isolated, don\u2019t take risks because of being afraid<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Anxious\/depressed behaviour<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Thought disorders<\/p>\n<p>&nbsp;<\/p>\n<p>MSr For Children<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<ul>\n<li>Good networks<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul>\n<li>Appearance<\/li>\n<li>Sensorimotor development<\/li>\n<li>Manner of relating to clinician &amp; family<\/li>\n<li>Mood\/affect<\/li>\n<li>Capacity\/level of play \u2013 (obsessions with particular things)<\/li>\n<li>Thought processes\/content<\/li>\n<li>Perceptual abilities<\/li>\n<li>Cognitive abilities\/intelligence<\/li>\n<li>Attention level\/concentration<\/li>\n<li>Language\/speech<\/li>\n<li>Concept of self<\/li>\n<li>Positive attributes\/adaptive capacity<\/li>\n<li>Temperament (overall)<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Disorders Diagnosed in Infancy\/Early Childhood\u00a0 <\/strong><\/p>\n<ul>\n<li>Sleep, feeding &amp; eating disorders<\/li>\n<li>Pervasive development disorders<\/li>\n<li>Relationship problems\/attachment disorders<\/li>\n<li>Anxiety disorders<\/li>\n<li>Motor skill disorders<\/li>\n<li>Attention deficit hyperactivity disorders\/attention deficit disorder<\/li>\n<li>Pica (eating things that aren\u2019t food e.g. sand, rocks, grass etc)<\/li>\n<li>Rumination disorder Feeding disorder<\/li>\n<\/ul>\n<p>Tic disorders (e.g. Tourette&#8217;s syndrome)<\/p>\n<p>Separation anxiety disorder<\/p>\n<h3>Youth Mental Health<\/h3>\n<p>\u2212 High prevalence &amp; burden of mental ill health<\/p>\n<p>\u2212 Unique challenges that affect their wellbeing and increase their vulnerability\u00a0 \u2212 Peak period for emergence of mental ill-health: <strong>early teens to mid 20s<\/strong><\/p>\n<p>\u00d8 1 in 4 young people experience mental disorder in 12 month period<\/p>\n<p>&nbsp;<\/p>\n<p>\u2212 Related impact on families, communities and society\u00a0 \u2212 Youth mental health recognised as a speciality<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Impact of Mental Illness on Youth\u00a0 <\/strong><\/p>\n<ul>\n<li>Structural and functional changes in the brain<\/li>\n<li>Autonomy, individuality, work\/social networks, (sexual) relationships, (completing) education, employment<\/li>\n<li>Impaired social functioning, poor educational achievement, unemployment, substance abuse, violence<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><strong>Early intervention\u00a0 <\/strong><\/p>\n<ul>\n<li>Preventing mental health disorders are greatest during childhood and youth<\/li>\n<li>Aims is to prevent\/minimise serious mental illness<\/li>\n<li>rarly stages is critical as essential treatment is important to reduce risk of ongoing disability and focus on recovery<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><strong>Engagement\u00a0 <\/strong><\/p>\n<ul>\n<li>Crucial aspects of service delivery<\/li>\n<li>Allow for enough time, patience &amp; effort \u00e0 trust\/rapport<\/li>\n<li>Helping parents develop skills around how to manage behaviours<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><strong>Detection &amp; Assessment\u00a0 <\/strong><\/p>\n<ul>\n<li>rarly intervention<\/li>\n<li>Families\/carers<\/li>\n<li>GPs<\/li>\n<li>Teachers\/sporting couches<\/li>\n<li>Law enforcement (police, courts)<\/li>\n<li>Mental state examination (MSr)<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><strong>Psychosocial Assessment\u00a0 <\/strong><\/p>\n<p>Holistic assessment<\/p>\n<p>Developmental stage is important<\/p>\n<p><em>Don\u2019t make assumptions such as<\/em>: asking about mum\/dad, young women about &#8216;boyfriends&#8217;<\/p>\n<ul>\n<li><u>10 Domains:<\/u>\n<ol>\n<li>Home &amp; environment<\/li>\n<\/ol>\n<\/li>\n<\/ul>\n<p>\u2212 Do you live at home? Do you like living at home?<\/p>\n<ol start=\"2\">\n<li>rducation &amp; employment<\/li>\n<\/ol>\n<p>\u2212 Have you missed school recently?<\/p>\n<ol start=\"3\">\n<li>Activities<\/li>\n<\/ol>\n<p>\u2212 What do you like doing?<\/p>\n<ol start=\"4\">\n<li>Alcohol &amp; other drugs<\/li>\n<\/ol>\n<p>\u2212 Do you drink\/smoke? What have you tried?<\/p>\n<p>\u2212 Has anyone taken advantage of you while you\u2019ve been intoxicated?<\/p>\n<ol start=\"5\">\n<li>Relationships &amp; sexuality<\/li>\n<\/ol>\n<p>\u2212 Are you in a r\/ship? Have you been in one? \u2212 How would you describe your sexuality?<\/p>\n<ol start=\"6\">\n<li>Conduct difficulties &amp; risk-taking<\/li>\n<\/ol>\n<p>\u2212 Have you harmed yourself\/others?<\/p>\n<p>\u2212 Have you been involved with the police?<\/p>\n<ol start=\"7\">\n<li>Anxiety<\/li>\n<\/ol>\n<p>\u2212 Have there been situations that make you stressed?<\/p>\n<ol start=\"8\">\n<li>rating<\/li>\n<\/ol>\n<p>\u2212 Do you worry about your weight\/food calories? \u2212 How do you feel about yourself?<\/p>\n<ol start=\"9\">\n<li>Depressions &amp; suicide<\/li>\n<\/ol>\n<p>\u2212 Have you thought about killing yourself?<\/p>\n<ol start=\"10\">\n<li>Psychosis &amp; mania<\/li>\n<\/ol>\n<p>\u2212 Have you ever felt that people are trying to hurt you\/get you? \u2212 Have you seen\/heard things you cant explain?<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Underlying Principles\u00a0 <\/strong><\/p>\n<ul>\n<li>Behaviour ranges\/abilities expected at each age<\/li>\n<\/ul>\n<p>\u2212 Intrinsic &amp; extrinsic factors interweave<\/p>\n<p>\u2212 Different psychological processes at different ages<\/p>\n<p>\u2212 May change form, but still are manifestations of initial process<\/p>\n<ul>\n<li>Major life events and transitions in social contexts<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><strong>Immediate Management\/Treatment\u00a0 <\/strong><\/p>\n<ul>\n<li>Identity immediate risk to self or others<\/li>\n<li>Drug\/alcohol use<\/li>\n<li>Psychological interventions (individual &amp; families\/carer)<\/li>\n<li>Pharmacological interventions<\/li>\n<li>Group\/peer programmes<\/li>\n<li>Multidisciplinary team input<\/li>\n<\/ul>\n<p><strong>\u00a0<\/strong><\/p>\n<p><strong>Early\/Late recovery\u00a0 <\/strong><\/p>\n<ul>\n<li>Recovery is possible<\/li>\n<li>Family\/carer involvement Cultural\/personal identity<\/li>\n<\/ul>\n<p>Promote wellness &amp; prevent relapse<\/p>\n<p>Vulnerability to future exacerbations of mental health problems<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Resources &amp; Services\u00a0 <\/strong><\/p>\n<ul>\n<li>Headspace (National Youth Mental Health Foundation)<\/li>\n<li>ReachOut<\/li>\n<li>Youth Beyond Blue<\/li>\n<li>Young &amp; Well Cooperative Research Centre (YAW CRC)<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<h3>Older Persons Mental Health<\/h3>\n<p><strong>AGEISM\u00a0 <\/strong><\/p>\n<ul>\n<li>Negative stereotypical perceptions of older people<\/li>\n<li>Ageist views \u00e0 misdiagnosis\/unwillingness to diagnose &#8220;because they&#8217;re old&#8221;<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>WHY DOrS IT OCCUR?<\/p>\n<ul>\n<li>Old age is seen as:<\/li>\n<\/ul>\n<p>\u2212 A process of degeneration<\/p>\n<p>\u2212 Lack of productivity<\/p>\n<ul>\n<li>Arise from generalisations<\/li>\n<\/ul>\n<p>\u2212 &#8220;All old people are sick and depressed&#8221;<\/p>\n<p>\u2212 &#8220;They are just waiting to die&#8221;<\/p>\n<ul>\n<li>Results in<\/li>\n<\/ul>\n<p>\u2212 Social exclusion<\/p>\n<p>\u2212 Isolation<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Mental Health Risk Factors\u00a0 <\/strong><\/p>\n<ul>\n<li>Issues of retirement<\/li>\n<li>Loss of financial capacity<\/li>\n<li>Changes in family and friendship support networks<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul>\n<li>Increases rates of depression and anxiety due to:<\/li>\n<\/ul>\n<p>\u2212 Illness (including poor health)<\/p>\n<p>\u2212 Death of significant other<\/p>\n<p>\u2212 Unwillingness to talk about mood<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Prevention and Promotion\u00a0 <\/strong><\/p>\n<ul>\n<li>Personal growth and learning needs<\/li>\n<li>Interesting in health promotion activities (community activities)<\/li>\n<li>Listening, acknowledging and accepting<\/li>\n<li>Challenging of stereotypes<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Health Issues in Ageing\u00a0 <\/strong><\/p>\n<p>People over 65<\/p>\n<p>\u2212 Vision impairment affects 60%<\/p>\n<p>\u2212 Arthritis affects 49%<\/p>\n<p>\u2212 Hypertension 38%<\/p>\n<p>\u2212 Deafness 35%<\/p>\n<p>&nbsp;<\/p>\n<p><strong>MH Disorders in Older Populations\u00a0 <\/strong><\/p>\n<ul>\n<li>Anxiety affects 10%<\/li>\n<li>Depression affects 7%<\/li>\n<li>Suicide rates highest for male and females over 85<\/li>\n<\/ul>\n<p>\u2212 Use more violent methods (\u00e0 higher success rates)<\/p>\n<p>\u2212 Suicides by those 65+ make up 15% of total suicide rates<\/p>\n<ul>\n<li>Substance misuse<\/li>\n<\/ul>\n<p>\u2212 Dependence on prescription medications are common<\/p>\n<p>\u2212 Approx. 1.1% of older people present with substance abuse disorders<\/p>\n<p>\u2212 Under recognised\/undertreated<\/p>\n<ul>\n<li>Delirium<\/li>\n<li>Dementia affects 9% of people over 65, 30% over 85<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><strong>\u00a0<\/strong><\/p>\n<p><strong>Prior to Assessment\u00a0 <\/strong><\/p>\n<ul>\n<li>Persons willingness to participate<\/li>\n<li>rnsure person is able to hear the nurse \u2212 Be mindful of deafness<\/li>\n<\/ul>\n<p>\u2212 Use of functioning hearing aid<\/p>\n<p>\u2212 Face the older person<\/p>\n<p>\u2212 Turn off TV\/eliminate background noises<\/p>\n<p>&nbsp;<\/p>\n<p>** \u03a8 = psych. medications **<\/p>\n<table width=\"0\">\n<tbody>\n<tr>\n<td width=\"237\"><strong>BIOLOGICAL DOMAIN <\/strong><\/td>\n<td width=\"237\"><strong>PSYCHOLOGICAL DOMAIN <\/strong><\/td>\n<td width=\"238\"><strong>SOCIAL DOMAIN <\/strong><\/td>\n<\/tr>\n<tr>\n<td width=\"237\"><strong>PRESENT &amp; PAST HEALTH STATUS <\/strong><\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Health records <strong>\u00a0<\/strong><\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Collaborative info (patient, family\/carers)<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Identification of chronic health problems <strong>\u00a0<\/strong><\/p>\n<p><strong>\u00a0<\/strong><\/p>\n<p><strong>PHYSICAL EXAMINATION <\/strong><\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Laboratory levels <strong>\u00a0<\/strong><\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Urinalysis <strong>\u00a0<\/strong><\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 FBC, WBC, RBC<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Fasting blood glucose <strong>\u00a0<\/strong><\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Neurological tests <strong>\u00a0<\/strong><\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Many \u03a8 medications <strong>\u00a0<\/strong><\/p>\n<p>&#8211; \u2193seizure threshold<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Movement disorders <strong>\u00a0<\/strong><\/td>\n<td rowspan=\"2\" width=\"237\"><strong>RESPONSE TO MH PROBLEMS\u00a0 <\/strong><\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Reluctance to admit to psychiatric symptoms<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Avoid arguing or confronting the person<\/p>\n<p>&nbsp;<\/p>\n<p><strong>MENTAL STATE EXAMINATION (MSE) <\/strong><\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Mood\/affect<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Geriatric Depression Scale (GDS)<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Cornell Scale for Depression in Dementia (CSDD)<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Thought processes (logical thoughts?)<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Cognition<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Orientation, attention, short and long term memory<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Some memory retrieval slowing<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Mini-mental state exam<\/p>\n<p>(MMSr)<\/p>\n<p>&nbsp;<\/p>\n<p><strong>BEHAVIOUR CHANGES <\/strong><\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Neuropathological processes<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Noticed first by family, carers<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Apraxia<\/td>\n<td rowspan=\"2\" width=\"238\"><strong>SOCIAL SUPPORT <\/strong><\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Relinquish life roles<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Isolation from others<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 A sense of being a burden<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Hopelessness<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Helplessness<\/p>\n<p>&nbsp;<\/p>\n<p><strong>FUNCTIONAL STATUS\u00a0 <\/strong><\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Activities of daily living (ADLs)<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Instrumental activities of daily<\/p>\n<p>living<\/p>\n<p>&nbsp;<\/p>\n<p><strong>SOCIAL SYSTEMS\u00a0 <\/strong><\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Community resources (health education, assessment)<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Income (personal superannuation, pension)<\/p>\n<p>&nbsp;<\/p>\n<p><strong>SPIRITUAL ASSESSMENT\u00a0 <\/strong><\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Reflect on successes and failures in life (Re-connect with God)<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/td>\n<\/tr>\n<tr>\n<td width=\"237\"><strong><u>PHYSICAL FUNCTION<\/u><\/strong><\/p>\n<p><strong>Mobility\u00a0 <\/strong><\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Personal devices (canes, walkers, wheelchairs)<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 rnvironmental devices (grab bars, shower chairs, hospital bed)<\/p>\n<p><strong>\u00a0<\/strong><\/p>\n<p><strong>\u00a0<\/strong><\/td>\n<\/tr>\n<tr>\n<td width=\"237\"><strong>Nutrition and Eating\u00a0 <\/strong><\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Weight loss (physical problem, psychiatric issue)<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Dysphagia- difficult swallowing<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Tardive dyskinesia <strong>\u00a0<\/strong><\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Xerostomia- dry mouth<\/p>\n<p>(common anticholinergic Sr)<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Assess alcohol intake <strong>\u00a0<\/strong><\/p>\n<p><strong>\u00a0<\/strong><\/p>\n<p><strong>Elimination\u00a0 <\/strong><\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Constipation <strong>\u00a0<\/strong><\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u2191 urinary frequency<\/p>\n<p><strong>\u00a0<\/strong><\/p>\n<p><strong>Sleep\u00a0 <\/strong><\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Sleep reduces in older age<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Insomnia (inability to fall or remain asleep)<\/td>\n<td rowspan=\"2\" width=\"237\">\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Other behaviours: wandering,<\/p>\n<p>irritability, aggression, apathy<\/p>\n<p>&nbsp;<\/p>\n<p><strong>STRESS AND COPING PATTERNS\u00a0 <\/strong><\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Unique stresses for older people<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Bereavement- responses to loss (crying, anxiety, insomnia, loss of appetite)<\/p>\n<p>&nbsp;<\/p>\n<p><strong>RISK ASSESSMENT <\/strong><\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Depression<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Previous suicide attempts<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Family history<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Means and access (firearms at home)<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Abuse of AOD<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Other stresses<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Chronic medical conditions (cancer, neuromuscular disorders)<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Social isolation<\/td>\n<td rowspan=\"2\" width=\"238\">&nbsp;<\/p>\n<p><strong>LEGAL STATUS\u00a0 <\/strong><\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Importance of advocacy<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Recognise signs of ageism, elder abuse or neglect<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Perceived loss of rights (to marry, to privacy, to control funds)<\/p>\n<p>&nbsp;<\/p>\n<p><strong>QUALITY OF LIFE\u00a0 <\/strong><\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Absence of distressing physical symptoms<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 rmotional well-being<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Functional status<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Quality of close interpersonal relationships<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Participation and enjoyment of<\/p>\n<p>social activities<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Satisfaction with medical and financial aspects of Tx<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Sexuality, body image and intimacy<\/td>\n<\/tr>\n<tr>\n<td width=\"237\"><strong>PAIN\u00a0 <\/strong><\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Greater likelihood due to chronic illness <strong>\u00a0<\/strong><\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Significant (under-recognised &amp; undertreated)<\/p>\n<p><strong>\u00a0<\/strong><\/p>\n<p><strong>PHARMACOLOGIC ASSESSMENT <\/strong><\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Polypharmacy very common <strong>\u00a0<\/strong><\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Assess all medications <strong>\u00a0<\/strong><\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u2191 sensitivity to medications with \u2191 age<\/p>\n<p>\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u2191 drug interactions<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Nursing Management of Older People <\/strong><\/p>\n<ul>\n<li>Active listening<\/li>\n<li>rncourage participation in physical and social activities<\/li>\n<li>Assist understanding of disease processes<\/li>\n<li>Assist understanding of safe administration of medication<\/li>\n<li>Coping strategies to assist with losses<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Risk factors\u00a0 Genetics Biochemical Pre &amp; post-natal influences Individual temperament Psychosocial development &nbsp; Infancy &amp; rarly Childhood General behaviour areas to assess Internalising problems rxternalising behaviours Specific behaviour areas&hellip; <a class=\"continue\" href=\"https:\/\/www.amyork.ca\/academic\/zz\/mental-health-nursing\/contributions-to-mental-in-children-youth\/\">Continue Reading<span> Contributions to mental in children &#038; youth<\/span><\/a><\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[121],"tags":[],"_links":{"self":[{"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/posts\/4684"}],"collection":[{"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/comments?post=4684"}],"version-history":[{"count":2,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/posts\/4684\/revisions"}],"predecessor-version":[{"id":4805,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/posts\/4684\/revisions\/4805"}],"wp:attachment":[{"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/media?parent=4684"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/categories?post=4684"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/tags?post=4684"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}