An Older Person with Depression

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Kenyatta University School of Economics *

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Nursing

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Nov 24, 2024

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Running head: AN OLDER PERSON WITH DEPRESSION 1 An Older person with Depression Student’s Name Institutional Affiliation Course

AN OLDER PERSON WITH DEPRESSION 2 An Older Person with Depression Introduction Depression is among the most depressive disorders that cause severe mental and medical illness. This disorder can negatively affect individuals in terms of thinking and how people act and feels. According to O’Neill et al. (2022), depression is a condition that can be treated and can lead to sadness and loss of interest by a person in daily activities. Besides, the person may lose interest in their hobbies and everything else they enjoy doing during their leisure time. This may also result in different emotional and physical issues that can affect how people carry out their tasks. Depression ranges on being mild and severe, and this condition is associated with the loss of appetite, weight gain of loss that is not related to the diet, increase in fatigue, loss of sleep or too much sleep, loss of energy and poor thinking, and sometimes one feels suicidal and worthless (Taylor, et al., 2018). Depressed elderly people face low motivation, physical issues, lack of energy, and some physical complaints such as severe headaches and arthritis. Prevalence of the illness in Ireland and worldwide In Ireland, depression is a leading mental illness, with 23 per cent of the population affected. Some of the features of this condition are persistent sadness, loss of interest, and lack of pleasure (Yapici Eser ET AL.,2018). Depression is known to be caused by social, biological and psychological factors. Some factors like loss and unemployment may contribute to depression development. Depression has two treatments that are psychological and pharmacological treatments but cannot be achieved in low-income and middle-income class nations because these services are not available in these areas. About 85 % of people suffer from depression and do not get any medication. In the United Kingdom, national surveys show that some individuals are getting mental healthcare from primary caregivers ( Johnson et al., 2018). This primary care is

AN OLDER PERSON WITH DEPRESSION 3 referred to as a de facto mental health services system that fulfills the clients' intellectual, emotional, and physical care needs. Impacts of Cultural and ethical issues on the Disease In the ethnomedical study, Sharma et al., (2021) state that the difference between the cultural and social groups is based on the amount of depression in an individual. Every culture has a different way of looking at mental health, which can affect the amount of support one gets from the community or family members. However, some of the differences are due to collective and personal orientation on a certain culture. According to psychiatric studies on ethical impacts, several significant ethical issues have been highlighted that vary from other medical disciplines (Sharma et al., 2021). These are placebo-related issues, vulnerability, therapeutic misconception, confidentiality, and operational problems. Discussion Care Needs of the Client (Physical, Emotional, and Intellectual) Provision of support and building trust is a wise idea, and this is attained by spending enough time with the clients to express themselves well about their problems and make the care provider understand their needs. The major need is to understand the client's needs, which is achieved through communication and asking the patient about their history to make informed decisions as a caregiver. An integrated approach by caregivers is the best approach preferred by most clients for primary care. This is where the provider addresses the patient's medical health and behavioral needs. This comprises emotional, physical, and intellectual needs. Intellectual Needs The care provider must possess the emotional intelligence to help understand the client’s needs. There is a fragmented system where social services, medical and mental health, and other

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AN OLDER PERSON WITH DEPRESSION 4 services are geographically and organizationally delivered. However, in most cases, there is no efficient cooperation that ultimately affects the care need of the patients ( Johnson et al., 2018). Studies show that two-thirds of primary care caregivers have reported that they could not get good services based on the patient’s needs. This is because there is a lack of know-how and barriers to providing services. Based on the Johnson et al., (2018) study, there are more issues involving the inadequacy of the care providers in the country. Physical Needs In order to gather for the patient’s physical needs, the patient’s self-care is necessary, proper diet, good sleep routines, and setting up routines. The intellectual and emotional needs require emotional support and understanding to help the patient in their self-care and mitigate the cases of depression ( Drigas & Papoutsi, C. (2020). Emotional Needs The patient’s emotional needs are met after providing then emotional support and then preventing any disability in the patient that may arise due to stress and depression follows. Changed Made on Diagnosis Over the past two decades, about forty randomized control trials have been developed and have been a shred of proof of collaborative care ways for depression ( Drigas & Papoutsi, C. (2020). According to the studies done, it has highlighted the importance of a collaborative care approach for patients with anxiety and depression and the ones with comorbid medical disorders such as diabetes. The main caregivers are part of the collaborative care team that gives medication treatment to the patient and provides adequate care to the elderly suffering from depression. Older people are more likely to develop other conditions from depression and due to this, it is advisable to pay much attention to them through supervision. In the care setting the

AN OLDER PERSON WITH DEPRESSION 5 collaborative care team has a head care attendant and a designated psychiatric consultant that lead the management of depression among the patients. Changes in care based on the diagnosis of depression is crucial to medication management in monitoring and having a proactive follow- up, educating the patients, and having an evidence-based psychological treatment. Nurses manage depression among patients through CAREPATH since this is the only feasible strategy ( Drigas & Papoutsi, 2020). Besides, the care providers should consider the protocols of the care setting. Among other components are the goal settings, medical management, education, clinical assessment, and care coordination. Besides, it has been suggested that in randomized control trials of depression, CAREPATH patients have much improvement in the mitigation of depressive symptoms than in normal care. Roles Role in Care of Client As a nurse, my role in giving care to the patient entails considering the patient’s care needs and paying attention to the client's history while ensuring that they get their daily basic needs. My main role is to act as an intermediary between the patient and the doctor and ensure the patient’s information is provided so that they can get good care according to their needs and care requirements. I review the patient’s patients in the care setting on a daily basis to know their progress in order to take other initiatives accordingly based on the level of improvement. Role of Care Setting Care setting plays an important role in managing cases of depression. It focuses on the population-based approach, which needs a systematic focus from the multidisciplinary team, education, entailing the case finding and diagnosis, patient engagement through evidence-based treatments like medications and close monitoring (Yapici Eser et al., 2018).

AN OLDER PERSON WITH DEPRESSION 6 Role of MDT The role of MDT is to coordinate and organize the services of care and health to meet the needs of clients who require complex care. It brings together the skills and experiences of various professionals so as to manage, assess and plan care together (Yapici Eser ET AL.,2018). The multidisciplinary team comprises of various groups of people with good experience and skills. The nurses, clinical psychologists, social workers, housemen, registrar, dietician, the organization chaplain, consultant psychiatrist and occupational therapist are among them. Team members play a crucial role and responsibility in the client’s health and hold meetings regularly to discuss the treatment and the client's progress. Some of the members are not actively involved but provide services to the patients when needed. However, every team member should clearly understand the needs and requirements and most importantly, understand their roles while providing healthcare services to the clients (Taylor, et al., 2018). Some people in the multidisciplinary team may not relate the same when it comes to the patient’s needs whereas some may be the leads towards the certain patient and all this depends on the patient’s need. This can be a social worker, psychologist, therapist or any person from other disciplines. Therefore, the multidisciplinary team has an important duty to understand and help patients who are depressed. Three Services for Improving Quality of Care Multiple services can be used to improve the quality of care in patients with depression. Three services help in improving the quality of care among patients suffering from depression and they include; counselling services, recovery-oriented services and mental health services ( Bombard et al., 2018). Recovery-Oriented Services

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AN OLDER PERSON WITH DEPRESSION 7 Recovery-oriented mental health practice assists patients to cope with depression. This is an application that contains a set of capabilities that helps and support patients with depressive signs and symptoms. This allows one to be responsible and recognize well-being and recovery through defining aspirations, goals and aims. The rule of the approach is made clear to the therapist or nurses to understand that everyone is different and should be given support in making decisions regarding their choices and be listened to and treated with respect and dignity ( Bombard et al., 2018). Thus, the nurses, therapists, or anybody else in the multidisciplinary team should not be judgemental and should respect all the patients and their information regarding their health. The principles are the highlighted uniqueness of individuals, attitudes, rights, real choices, communication and partnerships, the evaluation of recovery, respect, and dignity. Counselling Services The time of being depressed and having the symptoms of a depressive person indicates the services or therapy it requires. The more time staying depressed shows that one needs to be taken to a psychiatrist and a psychologist. Conversely, if the symptoms haven’t stayed for a long period, counselling will be recommended since it will help the patients prevent themselves from getting into a severe condition of depression. Counselling entails having talk or communication therapy that can help a person have positive thinking thus positive results. The counsellor should listen to the issues of working with the patient, give feedback and come up with strategies accordingly. While undergoing counselling, the patient is given feedback after his side has been heard and thereafter the counsellor will develop strategies for solving the issue of the depressed client. The patient’s progress will be evaluated and sessions adjusted accordingly as this will assist the counsellor in tracking the moods and feelings of the patient ( Taylor et al.,

AN OLDER PERSON WITH DEPRESSION 8 2018). Mainly, counselling regarding depression focuses on the feelings, habits, and thinking and how it impacts a person’s life at that particular time. The main models that are commonly used in counselling sessions are interpersonal therapy and CBT. Some of the other types to consider while counselling is electroconvulsive therapy. Mental Health Services Mental health services assist in the provision of treatment, support and advocacy to individuals with problems with psychiatric illness that can involve social, medical, legal or behavioral services ( Yapici Eser et al., 2018). Conclusion Based on the above discussion, planning the care of elderly people suffering from depression is a lengthy procedure requiring a multidisciplinary team of professionals. Clients need better ways that are crucial in approaching the matter of end-of-life care. This is a sensitive and important topic to be discussed with the patient therefore the proper initiatives should be taken so that the client may feel positive and not offended by any terms used throughout this time. Therefore, it is wise to make time and space to hold a conversation with the client and ensure all the electronic gadgets are off to avoid distraction. Maintaining eye contact, full attention, and listening to the client keenly is important. However, knowing the patient’s goal before the conversation about the end-to-life care is good. This is the most vulnerable time for the client since the client is aware that death is nearing and it is a period of great personal growth. The care provider has a lot of work in helping the client during this journey. this is the most rewarding thing that a caregiver as they make the patient comfortable with mortality where they remove barriers between themselves and the patient. Physicians who have practiced end-of- life care before are aware that it is normal to get attached to patients and feel their emotions. The

AN OLDER PERSON WITH DEPRESSION 9 caregiver should know when to avoid aggressive therapies and start end-of-life care. It has been a main concern that the care providers have their full attention on curing the pathology when they should be focusing on the quality of life even as the patient approaches death. Collecting information concerning clients is very sensitive, and hospice communication should follow the current procedural terminology while counselling and coordinating care activity. While giving out a service it is important to document face-to-face time with the patient to be fully engaged in the conversation so as to gather all the necessary information about the client. Exercises and stepped-care initiatives are some of the health promotion initiatives that can be taken to ease depression condition. Van’t Veer- Tazelaar and colleagues initially provided the stepped-care initiative as an example of the stepped-care program for older people in primary care that lowered the likeliness of getting depression and anxiety. This initiative reduced the cases of depression by more than one-half and this has given long-term positive results. this approach is very economical and makes good use of the clinical resources by intervening as required by the clients. Exercise is another initiative that is associated with boosting clients’ moods and reducing the symptoms of depression in clients. Depressed patients can be given a timely exercise period to help improve their depression symptoms. A lot of studies support the idea of these initiatives of promoting health among patients suffering from depression that have proven there are positive results on the clients.

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AN OLDER PERSON WITH DEPRESSION 10 References Bombard, Y., Baker, G. R., Orlando, E., Fancott, C., Bhatia, P., Casalino, S., ... & Pomey, M. P. (2018). Engaging patients to improve quality of care: a systematic review. Implementation Science , 13 , 1-22. Drigas, A., & Papoutsi, C. (2020). The Need for Emotional Intelligence Training Education in Critical and Stressful Sit uations: The Case of Covid-19. Int. J. Recent Contributions Eng. Sci. IT , 8 (3), 20-36 . Johnson, J., Hall, L. H., Berzins, K., Baker, J., Melling, K., & Thompson, C. (2018). Mental healthcare staff well‐being and burnout: A narrative review of trends, causes, implications, and recommendations for future interventions. International journal of mental health nursing , 27 (1), 20-32. LeMoult, J., & Gotlib, I. H. (2019). Depression: A cognitive perspective. Clinical Psychology Review , 69 , 51-66.

AN OLDER PERSON WITH DEPRESSION 11 O’Neill, S., Minehan, M., Knight-.Agarwal, C. R., & Turner, M. (2022). Depression, is it treatable in adults utilising dietary interventions? A systematic review of randomized controlled trials. Nutrients , 14 (7), 1398 Sharma, P., Bajaj, S., Fuloria, S., Porwal, O., & Subramaniyan, V. (2021). Ethnomedicinal and pharmacological uses of Curcuma caesia. NVEO-NATURAL VOLATILES & ESSENTIAL OILS Journal| NVEO , 14902-14910. Taylor, H. O., Taylor, R. J., Nguyen, A. W., & Chatters, L. (2018). Social isolation, depression, and psychological distress among older adults. Journal of aging and health , 30 (2), 229- 246. Yapici Eser, H., Kacar, A. S., Kilciksiz, C. M., Yalcinay-Inan, M., & Ongur, D. (2018). Prevalence and associated features of anxi ety disorder comorbidity in bipolar disorder: a meta-analysis and meta-regression study. Frontiers in psychiatry , 9 , 229.

An Older Person with Depression

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