Pain
What are the processes in the elderly that impacts all aspects of life?
PAIN
What is the importance of a clinical interview
Establish good rapport
Gathering information
Accurate diagnosis of client
What is NOT a psych intervention for pain (answer may increase pain)
"Telling them it won't hurt or it won't be bad"
What is a consideration for suicide in older adults?
Older adults are use more lethal means such as firearms or hanging
What intervention is best suited for increasing meaning of life in older adults?
Narrative Therapy
Why is pain often under-reported in elderly population?
Denial
Lack of acceptance by caregivers
Polypharmacy
fear of aging or appearing weak
Difficulty verbalizing
What are impacts of lack of meaning of life for older adults?
Increased depressive Symptoms
Risk of Dying Faster
What is the difference between Neuropathic Pain and Nociceptive Pain?
Neuropathic pain is associated with or caused by a disease
Nociceptive Pain is associated with injury (arthritis)
Which of the following not true regarding level of acculturation?
Plays little role in psych testing when
Effects the perception in caregiver fatigue
Effects performance of neuro psychological testing
Often predicts how older population conceptualizes their illness
Effects performance of neuro psychological testing
What is an example of negative impacts of spirituality?
Fear of end of life judgement
What are the symptoms in neuro psycho testing that often indicate pain in a patient?
- Changes in attention, processing speed, and psychomotor speed
- In testing cognitive functioning, it can be difficult to tease out pain from other more neurological causes
- Testing environment – alter for comfort (use of cushions/multiple sessions)
What outcomes are associated with increased life satisfaction for adults over the age of 50?
Reduced number of chronic conditions
Increased physical activity
Increased Optimism and Positive Affect
What is the Apnea Hypopnea Index (AHI)?
number of apneas and hypopneas divided by the total number of hours slept
5 – 15 mild
15 – 30 moderate
30 or more severe
Name two reasons why depression is underdiagnosed and undertreated in the elderly population?
Similar symptoms to those of medical illnesses
- Older adults do not report depression but anhedonia
- Aging stereotypes
- Primary care settings, where most older adults are treated, emphasize medical rather than mental health issues.
- Adherence to antidepressants is 25% to 60%
What neurodegenerative disease is directly related to multiple mTBIs that can only be diagnosed after death?
Chronic Traumatic Encephalopathy (CTE)
What are the differences between the visual pain scale, verbal pain scale, and number scale?
Verbal Descriptor Scales: on a continuum, but use verbal descriptors instead of Numbers: no pain, mild, moderate
Visual Analog Scale: 10 cm line with extremes of "No pain" and "Worst Pain Ever"
Numerical Rating Scales - places patient's pain on a numerical scale from 0 - 10
What is the difference between an End of Life Dream and Vision and clinical hallucinations?
The presence of significant distress for hallucinations. ELDVs are peaceful and insightful to the individual.
What are the side effects of sleep apnea?
Greater Risk of:
- Hypertension
- Congestive heart failure
- Cardiac arrhythmia and ischemia
- Cerebrovascular disease
Explain the difference between depression with and without Alzheimer's
Similar: Overlapping symptoms ( Diminished social activity/ Anhedonia)
Differences: Depression in Alzheimer’s Disease may be different with 3 or more of the symptoms being present for some 2 week period & represent a change in functioning
- Duration shorter
- fewer symptoms
- decreased positive affect or pleasure
What are the components of the definition for the meaning of life?
Individual's sense of purpose
Individual's sense of understanding
Individual's sense of significance
What are the non - verbal indicators of pain?
More reflexive
Less cognitive control
More ambiguous
More open to misinterpretation
What are some environmental interventions that can be helpful for those with FTD, especially as the disease progresses?
Changing patient, family, and caregiver schedules to meet patient needs and preferences.
Posting reminders in easy-to-access areas for the patient's convenience.
Limiting access to environmental risks.
What is the path of the illness (depression) in the elderly?
Sleep
Appetite
Memory
Concentration
Anhedonia
Loss of energy
Psychomotor agitation or retardation
Feelings of worthlessness or guilt
Recurrent thoughts of death or suicide
What are testing considerations with elderly minorities?
- URMs may be less familiar with testing
- Less trust due to higher rates of negative experience with the healthcare system
- Valid/ reliable tests for this population: Few neuropsych tests have been standardized for use with culturally/linguistically diverse older adult (Note these limitations in your report)
What is important to remember when interviewing older adults?
Remind them of their success and point out why they are successes
Ask them how their day is going
Everything you observe and ask is valuable information