Geriatric Depression Scale in Encyclopedia

Discuss about the Geriatric Depression Scale in Encyclopedia.

Introduction:

A person centered care assures the best treatment for individuals who are suffering from a large number of critical complications not only physically but also mentally. It helps the nurse to develop her interventions for the patient in way that helps to attend to all the symptoms effectively (Kogan, Wilber and Mosqueda 2016). This type of approach often requires the nurse to critically analyze the patients’ condition, his present as well as the past scenario and thereby propose a plan of intervention addressing all the issues of the patients. Critical reasoning cycle helps the nurse to gather all valuable information, develop an idea from the information and thereby process them to provide the best health interventions (Ross, Todd and Clarke 2015). The reports will thereby show how their tool is used in helping the nurse to plan her interventions. It will also implement three best practice assessment tools for the best benefits and also how the nurse will provide person centered approach that will ensure quality life of the patient.

Clinical reasoning cycle is an effective tool which helps the nurse in collecting different cues of the patient and process the information to develop an understanding of the patient’s problem or the situation that he is facing. Following these steps, the nurses develop a planning as well implement interventions and then evaluate the outcomes. Then reflecting upon the positive and negative outcomes helps the nurse to develop her own skills (Edvardson 2015).

The first step of the cycle is considering the patient’s condition and describing list facts, objects, contexts and others (Dalton, Lee and Levette-Jones 20150. The patient in the case study has suffered a fall and had upon through diagnosis, it was found that he is suffering from decompensate liver cirrhosis. The patient had suffered bruises but not has suffered any fractures.

The second step consisted of gathering important information about the patient and his situation. The nurse should first look over the history of the patient. It was found that he had been committed to alcohol after his wife death which had resulted him in liver cirrhosis. Moreover he is also having problems with his motor skills for which he had been mostly immobile and had been dependent on social worker. He is also anorexic and suffers from dyspnoea. He suffers from alcohol addiction and has behavioral and mental disorders. He has also developed lathery.

The third step consists of processing the information associated with the cues. It includes interpretation, discrimination, relating to the scenario, drawing inference, matching the situation and also predicts the outcome. The death of his wife had made him addicted to alcohol and in course of time he had got addicted to him. Excessive drinking had caused liver cirrhosis and as a result jaundice, ascitis and other are found (Owen & Sox 2014). Due to loss of his motor skills, he has lost his stability in balancing himself and often has severe falls. He had become anorexic due to his improper diet and all these had resulted him in feeling lethargic to his daily activities. he has become dependent although he tries his best to stay as an independent. His mental health has deteriorated due to the various physical issues he is facing, losing of mobility and the burden of living alone in his life.

The fourth step mainly contains synthesis of information and identification of the problem. The main issues found in the patient are that he is suffering from alcohol addiction for which his liver cirrhosis has resurfaced. He is anorexic due to improper diet. He is suffering from depression. He is also at a high risk of fall due to his inability to balance himself and loss of mobility (Delany and Golding 2014).

The fifth and the sixth step would mainly involve the setting up of the important goals as well as different actions that are taken for the different meeting the goals which are set. The main goal which should be of immediate importance is making strategies to prevent falls. The main action to be taken is to assess the risks associated with fall and implements fall prevention strategies. Proper interventions to control his alcohol addiction should be handled. His mobility is restricted so care should be taken that he tries to develop skills which would improve his motor ability skill. His mental problems should be handled with proper counseling techniques and with different behavioral therapies. Moreover his diet would be such that he overcomes his symptom of anorexia.

The seventh and eight problems is to evaluate the steps taken by the nurse and then to reflect her experience form the case. He should properly evaluate the activities the patient to look how he is fairing in the intervention. Development of his weigh would ensure his taking of proper diet. Alcohol dependence should be reduced gradually with proper behavioral therapy and depression should be handled with care. The nurse would then reflect her entire tenure of the case effectively and hence make it sure that the negative aspects she faced do not repeat again.

A large number of assessment tools are often used by different nurses to assess the present condition of the patients. This will help the nurse to gather information about the patients’ present condition and the different interventions that the nurse will need to take, this also help the nurses to properly evaluate the patient condition even after the interventions have been provided successfully.

Geriatric Depression Scale:

The geriatric Depression scale can be used by the nurse to understand the particular type of depression that the patient is going through. This scale is chosen because even the condition of the patient was different six months before but several societies had changed which had made him come in to a depressive state due to lot of factors (Brink, Yesacage and Lum 2013). This involves death of his wife, loneliness, loss of mobility, loss of his ability to keep up with regular activities, his hobbies, development of physical ailments and others.  All these had made an impact on his mental ability and this mental health along with his addiction to alcohol has reduced the quality of his life. Therefore the nurse can use the Geriatric Depression scale which is a five category response to routinely assess a patient as the part of the comprehensive geriatric assessment. One point is provided to each answer and the added points lead to three categories. These are normal when points are 0-9, mildly depressed when points are 10-19 and severely depressed when 20-30. The assessment tools is chosen for assessment of his mental state after analyzing the different situation he is involved in and the thirty questions present in the list will help to develop the nurses’ idea about which part had been the contributor to his ill mental state and hence the nurse will provide interventions according to that (Molton 2013).

The second tool that can be sued here is the John Hopkins fall rate assessment tool which is an evidence based assessment tools that can be used extensively by nurses to assess the risks of fall for students. Evidence suggests that such a tool has helped in reduction of fall rate by 21% and fall injury rate by 51% (Hnizdo et al. 2013). The main benefits are that it helps the nurses take interventions that reduces fall rates, reduces fall injury rates, standardized fall risk assessment, improvement in hospital as well as patient safety and adapt to the needs of the patients. It contains two sets of assessments. In adult care tools, it helps in providing an idea that from 6 to 13 score shows moderate risk of fall and score above that shows high risk of fall (DiGerolamo and Davis 2017).

Severity of alcohol dependence questionnaire:

The third tool would be to handle his alcohol addiction as this had been one of the main reasons for the occurrence of the liver cirrhosis. Moreover, although he claims not to be addicted yet his physical condition state that he is not at all being able to overcome his addiction (Leclercq et al. 2014). Therefore it is necessary for the nurse to understand the level of dependence of the patient on the alcohol. A score of 31 says it to be severe alcohol dependence, 16 to 31 says to be moderate dependence and a score below 16 shows mild physical dependency. It would help the nurse to understand his condition and thereby help him with proper therapies (Litten et al 2015).

It is seen from the assessments that the patent is suffering from an acute depression which had resulted in destroying his mental behavior. This depression is the result of loneliness in life, physiological issues regarding decompensate liver cirrhosis as well as from acute addiction to alcohol. His diet is not also maintained properly. Hence it is extremely important for the nurse to provide a person centered approach to help him overcome his ailments (Sannibale et al. 2013). This would include not only the physiological care of the each of the symptoms of the patient with proper medication, but also different therapies can be applied to make him overcome his mental instability. A holistic approach is very necessary for Leonard at this stage as his feelings and thinking have become negative and therefore he had sought for alcohol as resort.  An emotional support would help him to overcome his depression and look at life in a new way. The fear that he developed for from the time of his wife’s death should be handled with an expertise that the patient overcomes it and becomes ready to take support from experts (Zoffman et al. 2016). For his alcohol addiction, it is very important for him to overcome his depression and to treat his physical symptoms properly. Cognitive behavioral therapy is of immense help for such patients. Often music therapy helps them healing the mental stress that they are facing. Moreover he is at a higher risk of fall, and therefore proper arrangements should be made in his house so that it reduces the risk of fall like the floor should not be kept slippery, arrangement of proper slippers, making proper rail arrangements where he can hold on to (Herlitz et al. 2016). Teaching him proper exercises and advising him with meditation would help him develop his mobility.

References:

Brink, T. L., Yesavage, J. A., and Lum, O. 2013. Geriatric depression scale. Evidence-Based Diagnosis: A Handbook of Clinical Prediction Rules, 297.

Dalton, L., Gee, T., and Levett-Jones, T. 2015. Using clinical reasoning and simulation-based education to'flip'the Enrolled Nurse curriculum. Australian Journal of Advanced Nursing, The, 33(2), 29.

Delany, C., and Golding, C. 2014. Teaching clinical reasoning by making thinking visible: an action research project with allied health clinical educators. BMC medical education, 14(1), 20.

DiGerolamo, K., and Davis, K. F. 2017. An integrative review of pediatric fall risk assessment tools. Journal of Pediatric Nursing.

Edvardsson, D. 2015. Notes on person-centred care: What it is and what it is not.

Herlitz, A., Munthe, C., Törner, M., and Forsander, G. 2016. The counseling, self-care, adherence approach to person-centered care and shared decision making: Moral psychology, executive autonomy, and ethics in multi-dimensional care decisions. Health communication, 31(8), 964-973.

Hnizdo, S., Archuleta, R. A., Taylor, B., and Kim, S. C. 2013. Validity and reliability of the modified John Hopkins Fall Risk Assessment Tool for elderly patients in home health care. Geriatric Nursing, 34(5), 423-427.

Kogan, A. C., Wilber, K., and Mosqueda, L. 2016. Person?Centered Care for Older Adults with Chronic Conditions and Functional Impairment: A Systematic Literature Review. Journal of the American Geriatrics Society, 64(1), e1-e7.

Leclercq, S., Matamoros, S., Cani, P. D., Neyrinck, A. M., Jamar, F., Stärkel, P., ... and De Timary, P. 2014. Intestinal permeability, gut-bacterial dysbiosis, and behavioral markers of alcohol-dependence severity. Proceedings of the National Academy of Sciences, 111(42), E4485-E4493.

Litten, R. Z., Ryan, M. L., Falk, D. E., Reilly, M., Fertig, J. B., and Koob, G. F. 2015. Heterogeneity of alcohol use disorder: understanding mechanisms to advance personalized treatment. Alcoholism: Clinical and Experimental Research, 39(4), 579-584.

Molton, I. 2013. Geriatric Depression Scale. In Encyclopedia of Behavioral Medicine (pp. 857-858). Springer New York.

Owens, D. K., and Sox, H. C. 2014. Biomedical decision making: probabilistic clinical reasoning. In Biomedical Informatics (pp. 67-107). Springer London.

Ross, H., Tod, A. M., and Clarke, A. 2015. Understanding and achieving person?centred care: the nurse perspective. Journal of clinical nursing, 24(9-10), 1223-1233.

Sannibale, C., Teesson, M., Creamer, M., Sitharthan, T., Bryant, R. A., Sutherland, K., ... and Peek?O'Leary, M. 2013. Randomized controlled trial of cognitive behaviour therapy for comorbid post?traumatic stress disorder and alcohol use disorders. Addiction, 108(8), 1397-1410.

Zoffmann, V., Hörnsten, Å., Storbækken, S., Graue, M., Rasmussen, B., Wahl, A., and Kirkevold, M. 2016. Translating person-centered care into practice: a comparative analysis of motivational interviewing, illness-integration support, and guided self-determination. Patient education and counseling, 99(3), 400-407.

MyAssignmenthelp.co.uk is a name in assignment writing services that students trust. We offer our assignment writing services for a wide variety of assignments including essays, dissertations, case studies and more. Students can place their order with us anytime as we function 24x7, and get their copies at unbeatable prices. We guarantee that all of our solutions are plagiarism-free.