Geriatrics and Depression - Free Essay Example

When a person reaches the age of 65, their chances of getting dementia doubles every five years (Buettner, Fitzsimmons, Dudley, 2010; Mansah et al., 2014). Once a person has an altered mental state, like dementia, they often exhibit agitation, passivity, and depression (Buettner, Fitzsimmons, Dudley, 2010; Mansah et al., 2014). Since these interactions affect ones cognition, personality, and daily activities, the quality of life seen is often decreased, making engagement and perception of life also lessening (Buettner, Fitzsimmons, Dudley, 2010; Mansah et al., 2014). As a person gets older, multiple factors can lead to a decline in the quality of life including loss of partners, siblings, or friends and even control of their everyday life events (Babatsikou et al., 2017; Kawamura, Niiyama, Niiyama, 2009; Prosser, Townsend, Staiger, 2008). Age is an inevitable thing that brings health problems along with physical and emotional changes (Adam, Shahar, Ramli, 2016; Gopi Preetha, 2016; Kawamura, Niiyama, Niiyama, 2009; Wang, Ying Chair, Mi Ling Wong, Li, 2016). Depressive symptoms in the elderly population will continue to rise as the baby boomer population reaches the geriatric stage of their life (Adam, Shahar, Ramli, 2016; Babatsikou et al., 2017; Wang et al., 2016). Unfortunately, most nurses admit to not knowing enough about geriatrics and that they would rather work with the patients who had easy and quick-to-apply interventions rather than the ones who had more time-consuming ones (Bleijenberg et al., 2016). A study done by Bleijenberg et al. (2016) shows that there is room for nurse to improve when it comes to how they divide their care and what quality they put into it. Significance to Nursing Depression is seen in 77% of older people with dementia, yet it often goes unrecognized even with its effects on the quality of life (Buettner, Fitzsimmons, Dudley, 2010; Mellor et al., 2008). Since some nurses feel like depression symptoms take longer to treat, appropriate medical attention is not achieved for these residents (Buettner, Fitzsimmons, Dudley, 2010; Mellor et al., 2008). However, caregivers often feel like they lack proper skills needed to recognize and help residents with depressive symptoms, so many feel like educational programs on the different types interventions would be beneficial, interesting, and used daily (Buettner, Fitzsimmons, Dudley, 2010; Mansah et al., 2014; Mellor et al., 2008). Education provided to nurses and care givers is one way to improve care to patients (Mansah et al., 2014). When nurses were provided with educational material and assessment tools, completed training programs, and implemented reflection techniques, they felt like the care they provided to each patient was improved (Bleijenberg et al., 2016; Mansah et al., 2014; Mellor et al., 2008). When a nurse implements their skills, they were able to increase the care and communication they provide to the nursing home residents, gain knowledge about care, and accomplish a sense of self-efficacy (Mansah et al., 2014; Mellor et al., 2008). With the geriatric population rising and nurses being the advocates for residents, an open mind and new innovative types of care need to be looked at to create an individualized treatment plan for residents (Buettner, Fitzsimmons, Dudley, 2010; Justine Hamid, 2010; Mansah et al., 2014). Oftentimes, pharmacologic interventions are the first, if not only, line of defense used in patients with an altered mental state (Buettner, Fitzsimmons, Dudley, 2010), but they typically lead to medication intolerance, increased fall risk, and daytime confusion (Wang et al., 2016). There are multiple structures therapeutic interventions that nurses can lead and implement to impact the geriatric populations quality of life (Adam, Shahar, Ramli, 2016; Buettner, Fitzsimmons, Dudley, 2010; Justine Hamid, 2010; Sampoornam et al., 2016). Since every person is different though, it is important to remember to keep interventions individualized to the patient/resident. The purpose of this paper is to com pare how structured versus nonstructural interventions affect the quality of life in geriatric nursing home residents. Review of Literature Structured therapeutic interventions that nurses can apply Initiating a personalized exercise program for each resident based on needs and abilities. As time passes and a person ages, the perception of the quality of life tends to decrease (Buettner, Fitzsimmons, Dudley, 2010; Justine Hamid, 2010) and the presence of insomnia increases (Sampoornam et al., 2016). Exercise has been shown to have positive effects on an older persons perception on the quality of life, while also decreasing fall incidents that can lead to morbidity and mortality (Babatsikou et al., 2017; Buettner, Fitzsimmons, Dudley, 2010; Sampoornam et al., 2016; Wang et al., 2016). Some studies done show a positive correlation between exercise and the perception of quality of life, sleeping patterns, and the meaning of life experiences (Adam, Shahar, Ramli, 2016; Buettner, Fitzsimmons, Dudley, 2010; Justine Hamid, 2010; Sampoornam et al., 2016). Changes in the central nervous system from age can cause a person to lose balance, muscle strength, and mobility all together (Adam, Shahar, Ramli, 2016). There are many types of exercise training techniques that can be implemented to improve the overall quality of life and slow the physical limitations down. Some of these implementations include, but are not limited to, walking (Sampoornam et al., 2016), cardiorespiratory endurance, strength and balance training, flexibility (Justine Hamid, 2010), cross training (Buettner, Fitzsimmons, Dudley, 2010), resistance training, Tai Chi, and dancing (Adam, Shahar, Ramli, 2016). Dancing was implemented in a study done by Adam, Shahar, and Ramli (2016) that allowed the residents to be themselves, have fun, and enjoy the exercise while they were partaking in it. Providing animal interaction opportunities or ability for residents to have pets. Companion animals can help minimize the feeling of loneliness and assist with transition of the normal aging processes by providing a companion, being someone the older person can to talk to and have physical contact with, and being a topic that can be brought up with a stranger (Kawamura, Niiyama, Niiyama, 2009; Prosser, Townsend, Staiger, 2008). By animals increasing social interactions, a positive effect occurs and decreases agitated and depressive behaviors (Kawamura, Niiyama, Niiyama, 2009; Moretti et al., 2011; Prosser, Townsend, Staiger, 2008; Thodberg et al., 2016). Pets also allow the older patient with something to touch and since older patients have a more positive response to touch rather than communication, animals can be a perfect addition to those who have lost loved ones (Prosser, Townsend, Staiger, 2008). In a study done by Moretti et al. (2011), pet therapy was able to decrease symptoms associated with depression by 50% and increased the quality of life measured in long-term care facility residents. During the post-intervention interview in the study done by Prosser, Townsend, and Staiger (2008), many residents wanted the companion program to continue because they enjoyed contact with the animals, they had more social interactions, and it brought variety to their lives. Participants often found pleasure knowing the animals were coming and felt like it provided them with a positive experience at the nursing home (Kawamura, Niiyama, Niiyama, 2009; Moretti et al., 2011; Prosser, Townsend, Staiger, 2008). Using pets as therapy for elder nursing home residents is often implemented when the animals are brought in by a volunteer, but nurses can help encourage protocols to be developed that motivate animal therapy as a common occurrence (Kawamura, Niiyama, Niiyama, 2009; Prosser, Townsend , Staiger, 2008; Thodberg et al., 2016). Offering music and singing programs that residents can be involved in. Music and singing therapy can be used to manage the effects aging has on health maintenance, daily functioning, and the quality of life (Gopi Preetha, 2016; Wang et al., 2016). Through the use of music and singing, depressive symptoms can be decreased and the meaning of quality of life can be more significant to residents (Gopi Preetha, 2016; Wang et al., 2016). Since music interventions are safe, easy, and generally effective at decreasing depressive symptoms, along with increasing the quality of sleep, music could be a simple implementation to add to a nursing home residents daily activities (Gopi Preetha, 2016; Wang et al., 2016). Music that has tranquilizing effects have been thought to calm the body and suppress the sympathetic nervous system and turn on the parasympathetic nervous system (Wang et al., 2016). In addition, music also lets the mind focus on something other than thoughts, which allows the mind to relax (Gopi Preetha, 2016) and can even initiate sleep (Wang et al., 2016). When music is blended with different tones, restoration of emotions, physical relaxation, and spiritual wellbeing is met (Gopi Preetha, 2016). Implementing different massage and relaxation techniques that residents can partake in. There are many types of massage and relaxation techniques that can be used on nursing home residents daily (Adam, Shahar, Ramli, 2016; Keerthi, Malathi, and Nidagundi, 2018). In a study done by Keerthi, Malathi, and Nidagundi (2018), the use of footbath on joint pain was tested. A foot bath was given to the residents in the experiment twice a week and the effects were tested based on the amount of joint pain the residents felt afterward (Keerthi, Malathi, and Nidagundi, 2018). The footbath is able to cause blood vessels to dilate, which then increases the blood flow to other parts of the body (Keerthi, Malathi, and Nidagundi, 2018). When the dilation occurs, the blood movement causes the muscles to relax and release tension which leads to pain being relieved (Keerthi, Malathi, and Nidagundi, 2018). Relaxation therapy is another technique that has been used for a while to treat stress and anxiety (Adam, Shahar, Ramli, 2016). This type of therapy has been used to restore harmony in the body, reduce physical and mental tension, decreasing depressive symptoms, and creating an overall positive outlook (Adam, Shahar, Ramli, 2016). There are many different types of relaxation techniques that can be used, but some of the most common ones are breathing, meditation, and progressive muscular relaxation (Adam, Shahar, Ramli, 2016). Perception on the quality of life for nursing home residents The depression rates decreased in geriatric residents. In a study done by Buettner, Fitzsimmons, and Dudley (2010), agitation, passivity, and depression were all measured at the start and after two weeks of exercise treatments for each patient. This measurement showed that agitation in patients with depression was lowered after the individualized treatments were performed and went hand in hand with changes in passivity (Buettner, Fitzsimmons, Dudley, 2010). Contrary, Justine and Hamid (2010) found that participants had an improvement in their life satisfaction, but there was no change when it came to their levels of depression. Dancing however was shown to have a positive outlook for residents with depression and anxiety (Adam, Shahar, Ramli, 2016). This exercise not only implements movement, it also incorporated music, which allows muscles to be worked, stress to be released, and fun to be had (Adam, Shahar, Ramli, 2016). Since music is so easy to implement and use, it is a simple thing to add to an exercise routine (Adam, Shahar, Ramli, 2016; Gopi Preetha, 2016; Wang et al., 2016). Music therapy is able to allow relaxation of the mind and body to occur, which in turn has a positive effect on mood and feelings (Gopi Preetha, 2016). Ensure that residents obtain a more consistent sleeping pattern. When quality of sleep is measured after walking exercise is implemented, a decrease in chronic insomnia was seen and sleeping habits were improved (Sampoornam et al., 2016). Sleeping disorders are common as age increases as falling asleep becomes harder and waking up early happens more often (Sampoornam et al., 2016). Circadian rhythm problems have been thought to go hand in hand with cognitive issues (Sampoornam et al., 2016). If cognitive issues are able to be assessed and put in check, sleeping problems could be resolved also. Slow the onset of dementia for nursing home or long-term care facility residents. Since dementia is a progressive brain disease, reversal of this disease is not likely, but some interventions were able to slow the onset down or minimize symptoms (Thodberg et al., 2016). When residents affected with dementia are able to engage in animal interactions, improvement in cognitive functions, motivation, and emotions was seen (Moretti et al., 2011). Meaningful life experiences are important for residents with dementia and these events can change both passive and agitative behavior (Buettner, Fitzsimmons, Dudley, 2010). Conclusion Summary When a nurse is able to work with other healthcare professionals, the resident, and their families, stronger therapeutic communication skills are gained, interpersonal relationships are improved, knowledge about personal events are shared, and multiple assessment tools are looked at to create an improved and individualized treatment approach (Buettner, Fitzsimmons, Dudley, 2010; Mansah et al., 2014; Mellor et al., 2008). When nurses have the proper knowledge and education needed to help care for residents (Mansah et al., 2014; Mellor et al., 2008), implementations like exercise programs (Adam, Shahar, Ramli, 2016; Justine Hamid, 2010; Sampoornam et al., 2016), animal therapy (Kawamura, Niiyama, Niiyama, 2009; Moretti et al., 2011; Thodberg et al., 2016), music and singing (Gopi Preetha, 2016; Wang et al., 2016), and relaxation techniques (Adam, Shahar, Ramli, 2016; Keerthi, Malathi, and Nidagundi, 2018), can be implemented and individualized for each elder. All of the interven tions talked about previously can be applied into a residents activity schedule based on what their interests are and their physical ability. It would also be beneficial to educate nurses on how to properly implement structured therapeutic interventions and provide nursing homes with the ability to offer those interventions. Areas for Future Research Most study researchers felt like they needed a longer adaptation period during their study so they could have more observations (Buettner, Fitzsimmons, Dudley, 2010; Justine Hamid, 2010; Mansah et al., 2014; Moretti et al., 2011; Sampoornam et al., 2016; Wang et al., 2016). This longer period might allow more time for the positive impact on the quality of life to occur and ensure that the participants are comfortable and familiar with their new interventions (Buettner, Fitzsimmons, Dudley, 2010; Justine Hamid, 2010; Moretti et al., 2011; Sampoornam et al., 2016; Wang et al., 2016). It was also a common that authors thought there needed to be a larger test group with more diversity in a future study done (Buettner, Fitzsimmons, Dudley, 2010; Justine Hamid, 2010; Kawamura, Niiyama, Niiyama, 2009; Keerthi, Malathi, and Nidagundi, 2018; Moretti et al., 2011; Sampoornam et al., 2016). Research can also be done to test the effects on younger children visiting and interacting with nursing home residents. This would provide the resident with someone to talk to that they can teach and do activities with. Gardening and cooking might be other areas that can be looked at. It might be hard for aging residents to partake in activities like this that they once enjoyed, but if modifications could be made to help them adapt to physical changes, these activities might be achievable.

Describing Sizes and Dimensions in Spanish

Here are three common ways to express measurements in Spanish. Deciding which ones to use is largely a matter of personal preference since they are interchangeable in most cases.   1. Medir   This verb, which is conjugated irregularly, generally means to measure. Examples: Mido cinco pies y cinco pulgadas de alto. (I measure 5 feet, 5 inches tall.) Los cientà ­ficos hallaron un fà ³sil que mide dos metros de largo. (The scientists found a fossil that measures two meters long.) 2. Tiene This verb literally means to have. It can be used to directly indicate dimensions. It also is conjugated irregularly. Examples: El centro comercial tiene tres kilà ³metros de largo. (The commercial center is three kilometers long.) Si antes tenà ­a cinco metros de profundidad, ahora tiene dos. (If it was five meters deep before, its now two meters.) 3. Ser de This is the rough equivalent of saying in English that something is a certain size. Note the use of the preposition de, which is not translated to English. This method of describing dimensions is less common than the other two. Examples: El à ¡rea es de 160 metros cuadrados. (The area is 160 square meters.) Las dimensiones del nuevo almacà ©n son de 25 por 70 metros, y la altura es de ocho metros. (The horizontal dimensions of the new warehouse are 25 by 70 meters, and its height is 8 meters.)

The Wild City Of Bangkok - 1778 Words

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I didn’t really feel like getting into the deeper reasons at the time mainly because they knew nothing about Buddhism and they had so many other questions about the wild city of Bangkok, so I just left the explanation at a â€Å"I know, it’s really sad.† What I didn’t further explain to them was that the main reasons for the allowance of these dogs was that it is against the first precept to harm them, as well as the basic idea of karma. Although Buddhism saves and protects many animals, it is also the reason millions of animals are suffering in Thailand as well as causing many ecological problems. As one first starts learning about Buddhism, they will learn that the most fundamental guideline of living a meaningful life is to follow the 5 precepts. Fortunately you don’t have to go too deep into these precepts before you come across the first preceptShow MoreRelatedEssay Why Fly to Bangkok?: Top 10 Attractions to See in Bangkok813 Words   |  4 PagesWhy fly to Bangkok? 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The Empires of Persia free essay sample

1. Why does the book say that Darius was more important as an administrator than as a conqueror? Darius built a new capital at Persepolis Center of a sophisticated bureaucratic state Created the Twenty-three satrapies(governors) Created weights and Measurements One central Coinage (Currency) and standardized taxation He had tolerance: Spies to check every level of govt 2. How did Darius organize his empire politically – how did he govern, what were the levels of government in the empire? Set up an efficient administration of twenty-three satrapies (provinces) Created a fine balance between central and local control( Satraps, Spies Provincial rulers, satraps Constrained by the presence of imperial troops and tax collectors While traveling bureaucrats also monitored their actions 3. What systems did Darius establish to rule such a large empire? 23 Satrapies (provinces) that created a fine balance between central local control Taxes and soldiers Traveling Bureaucrats Centralized Coinage, Unified taxes, (Common weights and measurements) -Postal Systems 4. In what ways did Darius, and his successors, promote communication and commerce throughout the empire? They created the Persian Royal Road stretched for 1600 miles from the Aegean Sea to Iran. -It provided communication w/ large parts of the empire. Used uniform taxes which allowed every Satrap to collect Darius had bureaucrats who monitored their actions Coinage- This was to unify the entire empire Bureaucrats- They monitored the tax collectors Postal Stations 6. How did the Parthians come to control the Persian Empire? Power of Parthian was heavy cavalry Mithradates I established a empire through conquests from 171-155 B.C.E. Parthian government followed the example of Achaemenid administration Conquered Seleuds 7. What was the role of the imperial bureaucrats in Persian society? How did they fit in with the other social classes? Imperial administration called for educated bureaucrats Shared power and influence with warriors and clan leaders(fell under the warrior class) Administrators, tax collectors, record keepers, and translators 8. What agricultural technologies and techniques did the Persians use to produce the large surpluses they needed to feed their huge population of nonfood producers? The Persians came up w/ underground irrig. Canals (Qanats) does not evaporate It makes its way to the crops. Extensive road building -Persian Royal Road -Courier Service 9. The Persian Empires were noted for being part of a trade route critical to the economy of the classical world. What did the rulers do to facilitate trade? They: Used long-distance trade Imported products from India Their lands were fertile Persian elites considered trade to be a profession of lies and deceit Most Persian communities and estates were self-sufficient Local merchants and traders continued to deal with trade along key routes: -Silk Road (East) -Trans-Arabian (West) -Red Sea Maritime Trade (West) -Mediterranean Coastal Trade (Northwest) 10. What were the basic teachings of Zoroastrianism? Why is it considered a highly moralistic religion? How did Zoroastrianism influence other religions? Ahura Mazda super deity with 6 lesser deities There was a cosmic conflict between Ahura Mazda and ANgra Mainyu Heavenly paradise and hellish realm as reward and punishment Saw the material world as a blessing. The moral formula was good words, good thoughts, and good deeds. Influenced the Jewish religion (belief in future reward and punishment); Christianity (concepts of heaven and hell Moral formula Good deeds, Good Words, and Good thoughts Islamic conquerors toppled the Sasanid empire, seventh century C.E. Some Zoroastrians fled to India (Parsis) Most Zoroastrians in Persia converted to Islam Some Zoroastrians still exist in modern-day Iran 11. The authors refer to the Persian Empires as cosmopolitan. What does this mean? In what ways did the rulers promote this cosmopolitanism? Fashion and Art—ethnically diverse  Broad culture  Persian arts, or Iranian arts is one of the richest art heritages in world history and encompasses many disciplines including architecture, painting, weaving, pottery, calligraphy, metalworking and stonemasonry. There is also a very vibrant Iranian modern and contemporary art scene. 12. The authors suggest that classical societies were more complex and more sophisticated than the early societies discussed in part. What evidence do you see of this in the development of the Persian Empires? Classical Civilizations: (1000 BCE 600 CE) Change political centers Improve technology Establish more elaborate philosophical and religious traditions Expand science and math  Methods for territorial expansion; Embraced diverse group of people Integrated aspects of their institutions and traditions  Each civilization operated separately despite contacts with each other Sophisticated internal organization  Roads for better internal trade and travel