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“Early detection and treatment of depressive symptoms in the elderly living in residential homes”

“Early detection and treatment of depressive symptoms in the elderly living in residential homes”. Nienke van Haaster & Michel Ronkes April 2010. Mental health care in the Netherlands. Welcome and introduction Group experiences Signs and symptoms Measurement tools Break

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“Early detection and treatment of depressive symptoms in the elderly living in residential homes”

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  1. “Early detection and treatment of depressive symptoms in the elderly living in residential homes” Nienke van Haaster & Michel Ronkes April 2010 Mental health care in the Netherlands

  2. Welcome and introduction • Group experiences • Signs and symptoms • Measurement tools • Break • “Depression in the elderly’’ a short film • Nursing diagnoses • Nursing interventions • Other help? Content

  3. 1. Introduction, cause, purpose Introduction:

  4. Cause: • Depressive symptoms in the elderly are highly prevalent. • Own experiences • Previous studies Golden, J. et.al. (2009), Eikelenboom, P. et.al. (2008) & Krupinski, J. & Tiller, J.W.G. (2001)

  5. Purpose: • At the end of this workshop you will be able to: • Explain the relevance of this workshop; • Identify signs and symptoms of depression in the elderly living in care home; • Describe measurement tools to detect depression in an early stage.

  6. 2. ‘Group experiences’ • Please make subgroups of 4 or 5 persons • Share your experiences about depressive symptoms in the elderly • Write some keywords on a flip-over • Present your findings to the whole group.

  7. 3. ‘Signs’ and... • No expression • Negative thinking • Disorganized environment • Clothes and hair looks sloppy • Thoughts to give up life • Loss of weight • Nothing to do • Wants to be alone, without contact • Loss of energy, tired • Bad medication compliance • Lack of interest for help

  8. ..... ‘Symptoms’ DSM-IV main symptoms:1. Depressed mood 2. Loss of interest or pleasure Other symptoms: 3. Weight and appetite  4. Sleep disturbance 5. Motor activity: agitated or slowed 6. Thoughts of death, suicide or suicide attempt 7. Feeling worthless or guilty 8. Indecisive, loss of concentration 9. Loss of energy

  9. 4. Measurement tools Scales that can be used to confirm your presumption:

  10. GDS-15 geriatric depression scale (most frequently used all over the world). Easy to use 15 yes or no questions. However, a diagnoses of clinical depression should NOT be made on the GDS results alone. Other examples: • Zung self rating depression scale • Depression Anxiety Stress Scales (DASS) • Hamilton Rating Scale for Depression ( HRSD) • Beck Depression Inventory (BDI)

  11. Break

  12. 5. Depression in the elderly A short film

  13. 6. ‘Nursing diagnosis’ • Low self respect • Changing thinking process • Hopelessness/ loss courage • Thoughts of death of suicide • Sleep disturbance • Loneliness • Loss of interest and pleasure • Fear / Look up to everything • Ineffective coping • Compliance problems with medication • Inadequate feed and liquid consumption • Loss concentration • Reduced self care Herdman, H.T.(2009) Herdman, H.T. (2009)

  14. 7. ‘Nursing interventions’

  15. ‘Nursing interventions’ • Small talk improves quality of life • Exercise helps against depression Help with exercise! • Cassette for medication • Daily activity programs • Suitable support for self-care • Social support • Relaxation training • Stop negative thinking: Speak about thoughts and behavior • Search for options for better food and liquid reduction Nurses and nursing assistants: speak out and share! And last: Always ask patient and family: they know best! Bulechek, M., et. al. (2007)

  16. 8. Other help?

  17. Questions?

  18. Thanks for your attention and active participation during this workshop!

  19. Literature • Arehart-Treichel, J. (2005). Depression plus loneliness may hasten death in elderly, Psychiatric news, vol. 40, no. 2, 53. • Beekman, A.T.F., Deeg, D.J.H. & Stek, M.L. (1995). Het beloop van depressie bij ouderen in de bevolking, Vakgroep psychiatrie, 7. • Beekman, A.T.F., Deeg D.J.H. & Tilburg, W. van (1993). Depressie bij ouderen in de bevolking, Tijdschift voor de Psychiatrie, 35, 154-168. • Beer, M. de, & Lange, J. de ( 1993). Depressie bij ouderen, een literatuuronderzoek ten behoeve van de preventiepraktijk in de AGGZ, NCGV, Utrecht. • Brühl, K., Luijendijk, H.J. & Muller, M.T. (2007). Nurses’ and Nursing Assistants’ Recognition of Depression in Elderly who Depend on Long-Term Care. Review. Alkmaar, The Netherlands. • Buis, W.M.N.J., (1996). Biopsychosociaal model voor Diagnostiek en beleid, Tijdschrift voor psychiatrie; vol. 38 (1996), afl. 8, pag. 616-623 (8). • Bulechek, M., Butcher, G. & Dochterman, H. (2007). Nursing Interventions Classification, 5e druk, USA, Elsevier. • Butler, R. & Orrell, M. (1998). Late-life depression, Current opinion in Psychiatry, vol. 11, no. 4, 435-439. • Charney, D.S., Reynolds, C.F., Lewis, L. (2003). Depression and Bipolar Support Alliance consensus statement on the unmet needs in diagnosis ans treatment of mood disorders in late life, Arch Gen Psychiatry, vol. 60, 664-672. • Dhondt, T. & Woerkom, E. (2008). Addendum Zorgprogramma Depressie bij Ouderen, Kwaliteitshandboek GGZ Noord-Holland-Noord. • Eikelenboom, P., Beekman, A.T.F., Stek, M.L. (2008). Ouderenpsychiatrie in Nederland, Tijdschrift voor psychiatrie, 50, jubileumnummer 1959-2008, 131-136. • Festen, Th. & Verburg, H. (2005).Passende zorg voor ouderen met psychische problemen, SWP, 1e druk, Amsterdam. • Golden, J., Conroy, R.M., Bruce, I., Denihan, A., Greene, E., Kirby, M. & Lawror, B.A. (2009). Loneliness, social support networks, mood ans wellbeing in community-dwelling elderly, International Journal of geriatric psychiatry, 24, 694-700. • Hassall, S. & Gill,T. (2008). Providing care to the eldery with depression; the views of aged care staff, Journal of Psychiatric and Mental Health Nursing, 15, 17-23. • Heeren, T.J., Kat, M.G. & Stek, T.J. (2001). Handboek ouderenpsychiatrie, de Tijdstroom, Leusden, 2e herziene druk. • Herdman, H.T. (2009). NANDA International, Nursing Diagnoses Definitions and Classification 2009-2011, 1e druk, Oxford, Wiley-Blackwell. • Hosman, C.M.H. & Bosma, M.W.M. (1990). Preventie op waarde geschat, een studie naar de beïnvloedbaarheid van determinanten van psychische gezondheid, Bureau Beta, Nijmegen. • Krause, N. (1987). Chronic financial strain, social support, and depressive symptomes among older adults, School of Public Health’s, Psychology and aging, vol. 2, no. 2, 185-192. • Krupinski, J. & Tiller, J.W.G. (2001). The identification and treatment of depression by General Practitioners, Australian and New Zealand Journal of Psychiatry, 35, 827-832. • Passade, L. (2008). De relatie tussen reuma, depressie en eenzaamheid, Universiteit Twente. • Veer, J.T.B. van ‘t (2006).  Psychiatrisch stigma vanuit het perspectief van Nederlandse psychiatrische patiënten en hun niet-zieke verwanten, Survey onderzoek, Universiteit Twente.

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