Improving geriatric mental health nursing care: Making a case for going beyond psychotropic medications

Abstract

Providing high-quality mental health nursing care should be an important and continuous preoccupation in the gerontological nursing field. As the proportion of elderly people in our society is growing, the emphasis on high-quality care will receive increasing attention from administrators, politicians, organized groups, researchers and clinical nurses. Recent findings illustrate unequivocally the important contribution of nurses to achieving the goal of high-quality geriatric care. However, the quality of care for the elderly with psychological difficulties has not been addressed. The objective of this article is to illustrate that while nurses can accomplish much to improve the well-being and mental health of the elderly, their skills are often underutilized. Psychotropic drugs are often the first-line interventions used by health-care professionals to treat mental health concerns of elderly persons. Alternative therapies that could be implemented and evaluated, such as psychological counselling, supportive counselling, education and life review, are infrequently used. Nevertheless, current scientific data suggest that it would be very advantageous if nurses were to play a dominant role in the care of elderly people who are depressed or experiencing sleep pattern disturbances. The same can be said about elderly chronic users of benzodiazepines, as well as those with cognitive impairment. Evidence for the use of psychotropic medications as a viable treatment option for the elderly both in the community and in the long-term care setting who are experiencing mental health challenges is examined. Alternative non-pharmacological approaches that nurses can use to augment care are also briefly discussed.

Unconventional Indicators of Drug Dependence Among Elderly Long-Term Users of Benzodiazepines

“…The latter seems especially important, given health care professionals' roles in maintaining dependence through prescription. The influence of the nurse over the physician's prescription pattern should not be minimized (Simonson 1984;Stevenson, Kellogg, Ernst, & Whinney, 1989;Voyer & Martin, 2003). Nurses themselves have prescriptive privileges in many states in the USA and in some provinces in Canada.…”

Baixa prevalência do uso de benzodiazepínicos por idosos atendidos em Pelotas (RS)

“…Entretanto, muitos idosos usam tais medicamentos de forma continuada, por meses e até anos. 9,10 A prevalência encontrada na literatura do uso de benzodiazepínicos varia de 10 a 43%. [11][12][13][14][15] Há evidências de que mesmo doses terapêuticas podem prejudicar as funções cognitivas em idosos.…”

Rehabilitation Programs for Elderly Women Inpatients with Schizophrenia

“…However, the inability of both older adults and their general practitioners to recognize declining medical and psychiatric states (Löpönen, Räiha, Isoaho, Vahlberg, & Kivelä, 2003;Mills, 2001;Voyer & Martin, 2003), the absence of specific training for professionals (APA, 2004;Murphy, 2000), and the specificities associated with old age psychopathology, which make it significantly different from earlier age pathological conditions (Frazer, Christensen, & Griffiths, 2005;Katona & Shankar, 2004), often obstruct the implementation of effective strategies to work with the elderly.…”