Dementia: Major Depressive Disorder and Geriatric Nursing

Module 6.
Depression/Delirium/Dementia
Mary Shelkey, RN, PhD
Editor: Conchita Rader, MA, RN

Staff Development Partners Edition
Instructor Guide

EXPECTED STAFF (Cognitive) COMPETENCIES

1. Describe the prevalence of depression in older adults.

2. Use an assessment instrument for depression in older adults (see Module 5. Cognitive / Mental Status Assessment of Older Adults)

3. Discuss symptoms and treatment strategies for depression in older adults.

4. Describe the prevalence of delirium and dementia in older adults.

5. Discuss the symptoms of delirium and dementia.

6. Discuss the assessment and treatment strategies for delirium and dementia.

7. Contrast criteria for differentiating depression, delirium, and dementia in older adults.

EXPECTED STAFF (Clinical) COMPETENCIES
|Behaviors |How validated |Novice |Advanced |Competent |Proficient |Expert |
| | | |Beginner | | | |
|Accurately assess for depression in an older |Direct observation of use of instrument, | | | | | |
|adult client using a reliable assessment |and review of documented evidence of | | | | | |
|instrument |findings | | | | | |
|Recognize manifestations of depression, |Direct observation of assessment | | | | | |
|delirium, and dementia in older adults | | | | |

Links: [1] Butler, R. N., Lewis, M. I., & Sunderland, T. (1992). Aging and mental health: Positive psychosocial and biomedical approaches. (4th ed.). Columbus, OH: Charles E. Merrill. [2] Anderson, A. J. (2002). Treatment of depression in older adults. International Journal of Psychosocial Rehabilitation, 6, 69-78. [4] Holroyd, S., & Clayton, A. H. (2000). Measuring depression in the elderly: Which scale is best? Medscape General Medicine, 2(4). Retrieved April 30, 2004 from http://www.medscape.com/viewarticle/430554 [5] Izal, M., & Montorio, I [6] Weeks, S. K., McGann, P. E., Michaels, T. K., Penninx, B. W. (2003, Second Quarter). Comparing various short-form geriatric depression scales leads to the GDS-5/15. Journal of Nursing Scholarship, 133-137. [7] Beers, M. H. & Berkow, R. (Eds.) (2000). The merck manual of geriatrics. (3rd Ed.). Whitehouse Station, NJ: Used by permission. [8] Source: Agency for health Care Research and Quality,(AHRQ), Depression in Primary Care (1993), volume 2, 29. [10] Nezu, A. M., & Nezu, C. M, & Perri, M. G. (1989). Problem-solving therapy for depression: theory, research, and clinical guidelines. New York: Wiley. [11] Butler, R. (1974). Successful aging and the role of life review. Journal of the American Geriatric Society, 22, 529-535. [12] Hirschfeld, R. M. (2001). The comorbidity of major depression and anxiety disorders: Recognition and management in primary care. 3(6), 244-254. [15] The Global Deterioration scale for assessment of primary degenerative dementia. American Journal of Psychiatry, 139 1136-1139. 1982. Copyright 1982. The American Psychiatric Association. Reprinted by permission. [17] American Psychiatric Association. (1999, May). Practice guideline for the treatment of patients with delirium. American Psychiatric Association. American Journal of Psychiatry. 156. 1-20. [19] Doody, R. S., Stevens, J. C., Beck, C. et al. (2001, May). Practice parameter: Management of dementia (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology, 8(56). 1154-1166.