LU 12 Psychosocial Functioning & Depression

What is psychosocial functioning ?

• psychological : how the person thinks, feels and adapts

• social : relationships and participation

• functional : roles and everyday engagement

• identity : purpose and sense of self

What are the common psychosocial challenges ?

• loneliness and social isolation

• loss of spouse, friends or peers

• retirement and changing social roles

• loss of independence

• financial difficulties

• ageism and discrimination

What can impair psychosocial functioning ?

• loss or major life change

• reduced mobility

• reduced social contact

• loss of meaningful roles

• reduced participation

What are the 4P for psychosocial assessment ?

• person : what matters to you now ?

• people : who do you connect with ?

• place : do you feel safe and connected here ?

• participation : what activities have you stopped ?

What are the nursing care for elderly with psychosocial functioning problem ?

• connect with family contact, peer groups

• engage in meaningful activities, hobbies, spiritual activities

• empower choice and autonomy, maintain independence

How to recognise depression ?

• mood : persistent sadness, hopeless, irritability

• interest : loss of pleasure, withdrawal, reduced motivation

• body : sleep & appetite changes, fatigue

• thinking : poor concentration, worthlessness

Why older adults are at risk at depression?

• health : chronic illness

• loss of independence

• social : reduced contact

• personal : low coping resources

What are the features differences between depression and dementia ?

• onset : relatively rapid (depression), usually gradual (dementia)

• memory complaint : person often notices and reports it (depression), awareness may be reduced (dementia)

• mood : prominent (depression), less prominent early (dementia)

• motivation : markedly reduced (depression), decline as disease progresses (dementia)

What are the nursing assessment for older adults depression ?

• mood and depressive symptoms

• sleep, appetite and energy

• cognition and concentration

• functional ability and self care

• medication and physical health

• social support and recent losses

What are the nursing care for older adults with depression ?

• listen : therapeutic communication and validate feelings

• assess : physical and psychosocial factors

• connect : engage in meaningful activity

• protect : escalate concerns

• collaborate : family and multidisciplinary care planning