Care for Mental Health Patients PDF

Care for Mental Health Patients Acquired Brain Injuries (ABI)  Definition: Acquired brain injury (ABI) is a sudden injury or illness causing temporary or permanent brain damage.  Emotional Impact: Clients with ABI may experience:  Frustration, Anxiety, Mood swings, Depression...

Care for Mental Health Patients Acquired Brain Injuries (ABI)  Definition: Acquired brain injury (ABI) is a sudden injury or illness causing temporary or permanent brain damage.  Emotional Impact: Clients with ABI may experience:  Frustration, Anxiety, Mood swings, Depression  Family Adjustment: Families may need to adapt to:  Changes in the client's personality  Loss of the client’s financial contributions  Challenges of Undiagnosed ABI:  Clients with mild or undiagnosed ABIs may be:  Mislabelled, Misdiagnosed, Misunderstood  This can lead to increased frustration and anxiety.   Reassurance: Follow care plans to reassure clients their symptoms are due to the brain injury. Remind them of the injury to reduce fear and anxiety, as they may forget the event but feel "different."  Establish Routines: Encourage routines for daily tasks (e.g., bathing, eating) to build self-esteem, a sense of accomplishment, and reduce decision-related anxiety. Supporting  Set Goals: Help clients set realistic short-term and long-term goals to stay motivated and focused. Support them in handling setbacks and trying again if goals aren’t achieved. Clients with  Adaptive Devices: Ensure clients’ adaptive devices (e.g., wheelchairs, memory aids) are easily accessible for their needs. Acquired Brain  Focus on the Present: Encourage clients to move past focusing on lost abilities and engage in rehabilitation activities to reach their full Injuries potential.  Follow Protocols: Adhere to guidelines for supporting clients with anxiety or depressive disorders if directed by a supervisor.  Monitor Substance Use: Watch for and report signs of alcohol or drug use, as clients with ABI may misuse substances due to depression or impaired judgment. Anxiety Disorders  Definition: Anxiety disorders involve extreme anxiety with fears or worries disproportionate to the situation, affecting normal functioning.  Nature of Anxiety: Anxiety is a vague, uneasy feeling in response to stress.  Onset: Most anxiety disorders begin in childhood and persist without treatment.  Symptoms:  Feelings of dread, danger, or harm.  Varying impact: Some individuals are debilitated, while others remain high-functioning.  Treatment:  Often treated with medication.  Continuous use of medication typically reduces symptoms.  Learning coping strategies:  Relaxation techniques (deep breathing, meditation, progressive muscle relaxation)  Healthy lifestyle  Challenge negative thoughts  Journaling   Avoid Triggers: Keep clients away from situations or environments known to cause anxiety (e.g., small, closed spaces).  Redirect Conversations: Avoid discussing anxiety- Supporting inducing topics; focus on other subjects. Clients with  Provide Comfort:  Stay with the client during extreme anxiety or panic Anxiety attacks.  Use reassuring touch if appropriate.  Offer clear, limited choices to reduce stress.  Report the situation to your supervisor.   Definition: Trauma and stressor-related disorders, including PTSD, develop after experiencing or witnessing major trauma, overwhelming normal psychological coping mechanisms.  Examples of Traumatic Events: Residential schools, war, fires, accidents, torture, kidnapping, concentration camps, incest, or violent crimes.  Post-Traumatic Stress Disorder (PTSD):  Affects: People of all ages, ethnicities, cultures, and genders.  Signs and Symptoms:  Vivid nightmares of the trauma.  Nervousness and edginess. Trauma &  Avoidance of trauma-related triggers.  Difficulty concentrating or sleeping. Feelings of loss of control. Stressor Related   Symptom Categories (at least one symptom in each):  Reliving the trauma: Flashbacks or nightmares. Avoidance: Disorders   Avoiding thoughts, people, or situations that trigger memories. Increased anxiety/arousal: Constantly on guard, easily startled.  Associated Issues:  Substance abuse, phobias, chronic pain.  Poor concentration, sleep disturbances, extreme anxiety.  Anger or overwhelming survivor guilt.  Special Considerations: Older Adults:  PTSD may be triggered by significant life changes (e.g., deaths, loss of social contact).  Triggers in long-term care facilities may include rough treatment or loss of control during care.   Respect and Privacy: Provide care gently and respectfully, following the DIPPS principles (Dignity, Independence, Preferences, Privacy, and Safety).  Encourage Expression: Allow clients to talk or reminisce about their experiences; avoid dismissive reassurances like “Everything will be fine.” Supporting  Trigger Awareness: PTSD can be triggered at any time Clients with  due to past traumatic events. Monitor ADLs: Watch for changes in the client's PTSD willingness to perform activities of daily living (e.g., toileting, dressing, bathing, eating).  Report and Document: Report any changes in behavior or reactions to the supervisor immediately and document them.   Major Depressive Disorder Summary:  Definition: Severe feelings of worthlessness, sadness, and emptiness lasting weeks, interfering with ADLs such as sleeping, eating, working, and studying.  Impact: May lead to suicidal thoughts or attempts; common in older adults due to multiple losses and life changes.  Causes: Can be triggered by stressful events (e.g., death of a loved one, divorce) or recur throughout life.  Treatment Effectiveness: Medical intervention improves symptoms for 80% of those affected.  Treatment Options: Major Depressive  Psychotherapy: Exploring thoughts, feelings, and behaviors with a mental health professional.  Drug Therapy: Medications prescribed by a doctor; substance misuse can Disorder interfere with effectiveness.  Electroconvulsive Therapy (ECT): Alters brain chemicals through controlled seizures under anesthesia.  Depression in Older Persons:  Triggers:  Losses (e.g., loved ones, independence, body functions).  Loneliness, poor nutrition, or medication misuse.  Transitions to long-term care settings.  Challenges: Often overlooked or misdiagnosed as aches, pains, dementia, or delirium.   Build Connection: Show interest in the client’s life and actively listen to them.  Understand Depression: Recognize that undiagnosed clients may not realize they are depressed. Avoid dismissive statements like "Cheer up" or "Snap out of it."  Promote Positivity: Provide positive experiences to encourage further positive behaviors.  Encourage Rest: Ensure the client gets adequate rest to refresh and boost energy.  Encourage Nutrition: Support proper nutrition to maintain blood sugar and energy levels.  Support Activity: Promote light activities and social interactions to improve well-being, avoiding overexertion.  Watch for Suicidal Signals: Be alert for warning signs of suicidal intent and report them immediately…we’ll talk more about this soon. Supporting  Ensure Safety: Lock away sharp objects, belts, cords, or similar items if the client expresses suicidal intentions. Clients with  Encourage ADLs: Support or assist the client in completing activities of daily living (e.g., bathing, meal preparation, adequate fluid intake) to maintain physical health and homeostasis. Depression  Provide Stability: Create a safe, secure, and stable environment to reduce feelings of helplessness.  Follow the Care Plan: Adhere to care plans, such as managing medication access to ensure safety.  Ways to Reduce Depression in Older Clients:  Ensure proper nutrition, hydration, and regular bowel movements.  Promote medication adherence and prevent misuse of OTC drugs or alcohol.  Encourage social interactions, physical activity, fresh air, and sensory stimulation.  Facilitate reminiscence groups and interactions with pets.  Provide opportunities for the client to feel wanted and needed.  Ensure regular medical checkups for both physical and mental health.   Definition: Bipolar disorder, formerly called manic-depressive illness, is a long-term brain disorder causing extreme shifts in mood, energy, and functionality, ranging from emotional highs (mania) to lows (depression).  Symptoms:  Emotional swings from normal to grandiose (mania) and then to depressed.  Impact includes damaged relationships, poor performance in daily activities, and an increased risk of suicide.  Phases of Symptoms:  Acute Phase: Symptoms escalate. Continuation Phase: Symptoms are visible, and treatment is Bipolar Disorder  underway.  Maintenance Phase: Acute symptoms subside, but treatment continues to prevent relapse.  Management:  Continuous treatment is more effective than intermittent care.  Mood changes, even during treatment, should be reported promptly to a doctor for adjustments.  Collaboration with healthcare providers and open communication enhances treatment effectiveness.  Treatment Outcomes: With proper treatment, including medication and therapy, individuals with bipolar disorder can achieve mood stabilization and lead productive lives.   During the depressive phase: Follow the guidelines for major depression  During the manic phase: Supporting  Provide a calm environment without too many distractions Clients with   Provide a safe, secure and consistent environment Encourage periods of rest Bipolar  Encourage self-care; assist as required Disorder  Do not argue with the client; arguing could irritate the client  Offer finger foods with high nutritional density Disruptive, Impulse- Control and Conduct Disorders  Definition: Disorders characterized by difficult, disruptive, aggressive, or antisocial behaviors, often involving harm to self, others, or objects, or violations of others' rights.  Behavior Types:  Angry/Irritable Mood  Argumentative/Defiant Behavior  Vindictiveness  Behavior Nature: Actions can be defensive, premeditated, or impulsive.  Dementia Distinction: Aggressive behaviors in dementia are not premeditated but responses to environmental factors. Supporting  Approach: Be caring, nonjudgmental, and understand clients may lack insight into their feelings. Clients with  Safety: Maintain distance, keep an exit path open, avoid escalation, and leave if aggression occurs. Disruptive,  Verbal Aggression: Stay calm, identify triggers (e.g., Impulse- hunger, pain), and request polite communication professionally. Control &  Encourage Growth: Help clients reframe thoughts, recognize anger as a choice, and explore ways to Conduct achieve happiness. Disorders Eating Disorders  Definition: Disorders involving altered body image, disturbed eating behaviors, and excessive concern about weight and shape, primarily affecting teenage girls and young women but increasingly men.  Risk Factors:  Influenced by biological, psychological, and sociocultural factors.  Common in individuals seeking an "ideal" figure or professions emphasizing thinness (e.g., athletes, dancers, models).  Comparison to Older Adults: Unlike younger individuals, older adults may refuse food due to issues like fear of choking, depression, or food texture.  Treatment:  Early diagnosis and treatment improve outcomes.  Approaches include weight restoration (2.2–6.6 kg or 1–3 lbs per week), therapy (individual, family, group), and sometimes hospitalization for severe cases.  Common Disorders:  Anorexia Nervosa: Complications are reversible once weight is restored.  Bulimia Nervosa: May cause permanent damage to teeth, throat, or esophagus due to purging; emphasize oral and dental care.   Be Patient: Understand that anger or denial may stem from shame and pain.  Be Compassionate: Recognize that food and weight issues often reflect deeper psychological or cultural factors. Supporting  Be Encouraging: Focus on the client’s strengths and interests unrelated to food or body image. Clients with  Be Nonjudgmental: Avoid comments about appearance or weight, and do not blame or shame the client. Eating  Be Positive: Use neutral, supportive language and choose comfortable settings for discussions. Disorders  Prevent Harm: Monitor clients with pica to prevent eating nonfood items, and ensure they receive appropriate medical care if needed.  Report Concerns: Inform your supervisor of symptoms like vomiting or food refusal and seek guidance on handling these appropriately. Obsessive- Complusive and Related Disorders  Definition: Mental health disorders involving recurrent obsessions (persistent, distressing thoughts) and compulsions (uncontrollable urges to act) that disrupt daily life and relationships.  Common Obsessions:  Fear of harming others through thoughts.  Preoccupation with violent or harmful ideas.  Common Compulsions:  Repeated handwashing, cleaning, or checking.  Repeating names, phrases, or tunes.  Excessive hoarding or throwing away items of little value.  Support Role:  Report observed repetitive behaviors to a supervisor.  Understand that these actions reduce stress for the client, and stopping them may cause significant anxiety.   Build Connection: Show interest in the client’s life and actively listen.  Avoid Minimizing: Acknowledge their experiences without arguing about their obsessions or compulsions.  Promote Positivity: Encourage positive experiences to build momentum for more.  Encourage Rest: Ensure the client has opportunities to rest and refresh. Supporting  Avoid Enabling Behaviors: Focus on the emotions behind OCD behaviors rather than avoiding triggers. Clients with  Provide Stability: Create a safe, stable environment, especially during stressful times. OCD  Follow the Care Plan: Adhere to guidelines, such as controlled access to medications.  Encourage ADLs: Support normal activities like bathing, meal prep, and hydration to maintain health.  Celebrate Progress: Acknowledge and encourage small steps toward managing OCD behaviors.   Definition: Disorders involving rigid, socially unacceptable behaviors that deviate from cultural expectations, affecting thinking, mood, personal relationships, or impulse control.  Characteristics: Individuals may be demanding, hostile, manipulative, inflexible, maladaptive, or antisocial, making it difficult to function in society.  Onset: Typically emerge in adolescence, linked to Personality  personal development and character. Impact: Not classified as illnesses but often result Disorders in unfulfilled potential and negative life outcomes.  Healing Process: Requires:  Desire and commitment to change.  Insight into experiences and behaviors, often tied to trauma.  Support systems, such as therapy, self-help groups, and family or friends.   Be Nonjudgmental: Accept clients in a caring, nonjudgmental way, understanding they may lack insight into their feelings. Supporting  Maintain Professionalism: Speak factually and professionally, and follow the care plan respectfully and Clients with efficiently.  Ensure Consistency: Work consistently with other staff Personality to avoid manipulation or conflicts. Disorders  Set Boundaries: Do not share personal contact information or private details. And, avoid accepting gifts or money to prevent misunderstandings.   Definition: Schizophrenia is a chronic and severe mental health disorder characterized by disruptions in thought processes, perceptions, emotions, and behaviors.  Symptoms:  Psychosis: Impaired perception of reality.  Delusions: False beliefs (e.g., grandeur, persecution).  Hallucinations: Sensory experiences without real stimuli (e.g., hearing voices).  Paranoia: Extreme suspicion or fear of being watched or controlled.  Disorganized Speech and Behavior: Incoherence, rambling, or disturbed communication.  Emotional Blunting: Reduced or dazed expressions.  Impact: Affects all aspects of life, including work, relationships, and self-care. Schizophrenia  Without treatment, it leads to severe mental impairment and difficulty relating to others. Onset: Usually gradual between late teens and mid-30s, though late-onset cases occur. Sudden onset is less common.  Causes: Likely related to biochemical imbalances and possibly triggered by substance abuse in genetically vulnerable individuals.  Course of the Disorder:  Symptoms can persist throughout life, with periods of remission.  Episodes may involve severe psychosis, hallucinations, or withdrawal from the world.  Key Characteristics:  Some experience frightening or peaceful hallucinations.  Others may have disorganized thoughts, speech, or prolonged withdrawal.   Focus Attention: Guide the client to concentrate on one task or activity at a time.  Nonverbal Communication: Use calm, non-threatening body language and facial expressions. Supporting  Address Delusions/Hallucinations:  Avoid arguing or pretending they are real. Clients with  Gently suggest they are not real and provide comfort and empathy. Schizophrenia  Report delusions or hallucinations to your supervisor.  Use Distractions: Redirect attention with calming activities like music or a walk.   Definition: Self-harm involves intentionally inflicting pain to cope with feelings like anxiety, depression, numbness, or loss of control. It is not an attempt to end life but a way to manage emotional distress, sometimes by triggering the release of neurochemicals like adrenaline, dopamine, and endorphins.  Motivations:  Coping with inner pain or numbing emotions.  Expressing feelings or dealing with abuse.  Managing low self-esteem or mental illness.  Common Methods:  Cutting, burning, scratching, hitting, biting, or minor overdoses. Who is at Risk: Self-Harm   Teenagers, especially due to peer pressure, loneliness, or emotional extremes.  Individuals with mental illnesses like depression, anxiety, eating disorders, or substance use disorders.  Warning Signs:  Unexplainable wounds or scars.  Frequent "accidents" or claims of being accident-prone.  Covering the body excessively, even in warm weather.  Self-harm may be impulsive or planned, and individuals often hide their injuries due to shame or fear   Address Wounds: Encourage proper treatment to prevent infection.  Focus on Issues: Prioritize understanding their concerns over the self-harm act itself. Supporting  Promote Positive Coping: Support learning healthy alternatives to replace harmful behaviors. Clients who  Foster Communication: Listen openly without pressuring them to talk. Self-Harm  Encourage Professional Help: Advocate seeking mental health support for both the individual and their loved ones. Sleep-Wake Disorders  Definition: Disturbed sleep patterns causing distress and impairing daytime functioning.  Importance of Sleep:  Essential for immune system function, physical and mental performance, learning, and cell growth.  Inadequate sleep negatively affects health.  Prevalence:  Insomnia is the most common sleep disorder, particularly affecting women and older adults.  About 50% of adults over 65 experience sleep issues, possibly due to aging or medication use.  Treatment: Most sleep disorders can be managed effectively after proper diagnosis.   Avoid Sleep Disruptors: Advise avoiding caffeine, certain medications (e.g., antidepressants), smoking, and alcohol, as these can disrupt REM and deep sleep. Supporting  Monitor for Sleep Apnea: Watch for signs like periods of not breathing or waking with headaches and encourage Clients with medical evaluation if suspected. Suggest side-sleeping with a pillow for support. Sleep-Wake  Address Excessive Sleep: Recommend a physical checkup to rule out narcolepsy for clients who sleep Disorders excessively.  Document Sleep Patterns: Record the duration of sleep stages and note any use of drugs or alcohol that might contribute to sleep disturbances.   Definition: The misuse and inability to stop using substances such as prescription/OTC medications, illegal drugs, alcohol, or marijuana, leading to relationship and work problems.  Effects on the Body:  Substances affect the central nervous system, causing calming, stimulating, or mood-altering effects.  Effects can include hallucinations, aggression, or exaggerated self-confidence. Substance-  Tolerance and Withdrawal: Tolerance: Increasing amounts needed for the same effect. Related &   Withdrawal: Severe physical reactions when stopping use, including depression, agitation, nausea, cramps, and muscle Addictive spasms.  Risks: Disorders   Potential for criminal acts, overdose, suicide, or diseases from contaminated needles. Without treatment, substance abuse can be fatal.  Treatment:  Detoxification: Removing substances naturally or medically, often requiring hospitalization to manage withdrawal symptoms.  Psychotherapy: Involves mental health professionals to help clients address underlying issues and manage recovery. Supporting  Report Suspicions: Notify your supervisor immediately if you suspect substance abuse (e.g., smelling alcohol or Clients with noticing medications depleting too quickly). Keep the information confidential. Substance-  Avoid Confrontation: Do not argue with the client; report concerns directly to your supervisor. Related and  Maintain Professional Boundaries: Never purchase Addictive alcohol, drugs, or substances for clients. Report any such requests to your supervisor. Disorders   Definition: Recurrent thoughts or preoccupation with ending one’s own life, often stemming from feelings of hopelessness or believing loved ones are better off without them.  Gender Differences:  Men die by suicide at four times the rate of women, often using violent methods. Suicidal Behavior  Women attempt suicide more frequently but often survive due to less violent methods. Disorders  An attempted suicide indicates a serious mental health issue requiring professional care and a suicide prevention program.  Action Required if patient discloses suicidal feelings, discussions, or attempts in individuals.  Suicide intent of any age should be taken seriously, with immediate help from a mental health specialist  Mental Health: Depression, bipolar disorder, schizophrenia.  Personal History: Abuse, family or friend suicide, prior attempts, early life losses, changes in appearance (e.g., neglecting hygiene), giving away possessions or discussing final wishes, Loss of interest in friends, hobbies, or activities.  Life Crises: Relationship issues, family or societal problems, financial or legal troubles, life-threatening diagnoses.  Emotional and Social: Hopelessness, pressure to succeed, isolation, sexual identity issues. Risk Factors &  Substance Abuse: Alcohol or drug misuse. Warning Signs   Specific suicide plans. Additional Risk Factors for Older Adults: for Suicidal  Personality Traits: Emotional instability, rigid personality, poor coping skills. Intent  Medical Issues: Chronic pain, sensory impairments, or other illnesses.  Negative Events: Loss of independence, financial struggles, or difficulties with ADLs.   3. Ask them what their reasons to live  "What has kept you from harming yourself?"  1. Ask about their Feelings  "Who or what makes life worth living?"  "Do you feel tired of living?"  4. Express concern and empathy, and link them to their reason  "Have you thought about ending your life?" for living.  "Have you been thinking about suicide?"  "I care about you and your safety."  2. Be direct and clear. Ask if they have a suicide plan  "I want to help you get the support you need."  "Have you thought of specific ways to end your life?"  "Let’s talk to someone who can help.“  "Have you given away your possessions?"  5.Immediate Action  "Have you asked someone to help or join you?"  Contact the nurse, doctors, EMS/9-1-1  "Have you collected pills or started a plan?"  Do NOT leave the person alone  Restrict access to harmful items (medication, weapons, cutlery) Probing for Suicidal Intent  Focus on Safety: Remove any potentially harmful Stay Calm and Show Empathy and items from the Composed: Your calm Validation: Let the client environment, such as demeanor helps the know their feelings are sharp objects, client feel safer and valid and that you care medications, or cords, if more supported. Avoid about their well-being. it’s safe to do so. Keep showing panic or shock, Use phrases like, "I'm the immediate as this may escalate here to support you," or Supporting surroundings as calm and their distress. "Your feelings matter." free from triggers as possible. Clients with Take It Seriously: Always treat suicide discussions as urgent. Report Immediately: Inform your supervisor right away. Stay With the Client: Never leave the client alone. Suicidal Intent Encourage Conversation: Listen actively to show you In Home Care: Stay until Recognize Your Role: Your role is not to diagnose or counsel but care. Focus on listening rather help arrives, whether it's than problem-solving. to provide immediate a nurse, case manager, Avoid dismissive comments like support, ensure safety, or emergency personnel. “Things will work out” or “Look and seek professional on the bright side.” Avoid offering personal solutions help.