Assessing and Treating Adults and Geriatric Clients with Mood Disorders
Introduction
According to Knight (2016), a geriatric is a person with impaired body functions with chronic diseases and physical impairment. They are mostly above 75 years of age. Aging is accompanied with mood disorders which disrupt the elderly’ later years with many of these depressive states remain unnoticed in most of the older patients. Depression complicates mental illness treatment and their management and also increases health care use and mortality rates. Between 10% and 20% of geriatric patients with mood problems also have bipolar disorders (Rosen et al, 2017).
A DSM diagnosis of major depressive disorder [MDD] is used as criterion for depression. An elderly person may display sadness, disguise of irritability or withdrawal from the rest. Delusions, a mental illness which is common among aging patients with depression problems may interfere with a health officers’ recognition of a minor mood disorder. For clinicians to distinguish between depression and personality disorder requires careful and thorough evaluation of the history, signs and symptoms (Hibbard et al, 2016). A client with a medical illness plus a mood disorder may confuse a clinician who attributes the mood disorder to the illness or psychological reaction to the disease. There is a relationship between the medical and mood condition which is addressed through continuous treatment of both situations. However, DSM criteria for depression should be avoided because these criteria may not have adequate specificity and a sense of sensitivity to the older people (Knight 2016). Early stages examination and laboratory testing which is usually performed by a clinician is necessary for adequate assessment for a geriatric client with mood disorders. Don't use plagiarised sources.Get your custom essay just from $11/page
Decision point one
I will administer a dose of Effexor 37.5 gm. to the patient through swallowing once in a day either in the evening or in the morning and preferably almost the same time each day. Each capsule should be swallowed whole and not divided nor crushed nor chewed or leaving it in water for a while, the capsule can also be taken through a careful opening and sprinkling its contents in a spoon. When the contents of the capsule are mixed with food, it should be swallowed immediately without chewing and followed with a glass of water to make sure that all the pellets are swallowed. The medicine will be given to the patient 37.5mg per day for 4 to7 days to allow the new patient to adjust to the new medication started. This medication should be taken for a period of 4 weeks and the patient reported that there was no Improvement in depressive symptoms
Decision point two
At this point, I will increase the Effexor dose to 75 mg XR daily. The increment will be done due to the unresponsive nature of the medicine when administered by ½. The increment will be made in four weeks’ time since steady-state plasma levels of venlafaxine and its major metabolites are achieved by majority of the patients by day 4. After the diagnosis followed by treatment, I will require my patient to return to the clinic in four weeks’ time so as to better monitor his progress. I will need to know whether my patient has any improvement in depression. I will conduct this by using the Montgomery – Asberg Depression Rating Scale.
Decision point three.
This will be the final decision of treating my client. I will decide on what PMHNP should be doing daily. If the conditions of my patient will not have reached a favorable scale. Then I will increase my doze 112.5 mg orally and which should be administered on daily bases. If my client is feeling better and he is not giving any complaints, then I will maintain the current dose. I expected the client to be affected by the high dose intake. My ethical consideration is that, I should monitor my client and provide the right dose to him.
In conclusion of my treatment, I will make sure that I develop a close relation with my client, in such a way that I will be in a position to invite him and discuss more about his conditions so as to prevent the long terms effects of the mood disorders. A geriatric patient has complicated situations and should closely monitored so as to make sure that the whole condition is brought in to a standstill.
Works cited
Hibbard, M. R., Breed, S., Ashman, T., & Williams, J. (2016). 12 Co-occurring psychiatric and neurological impairments in older adults. Geriatric Neuropsychology: Practice Essentials, 327.
Knight, C. A., & Alarie, R. M. (2016). Improving Mental Health in the Community: Outcome Evaluation of a Geriatric Mental Health Day Treatment Service. Clinical Gerontologist, (just-accepted).
Rosen, D., Engel, R., McCall, J., & Greenhouse, J. (2017). Using Problem-Solving Therapy to Reduce Depressive Symptom Severity Among Older Adult Methadone Clients: A Randomized Clinical Trial. Research on Social Work Practice, 1049731516686692.