NURS6640 Therapy with Older Adults Discussion HW
NURS6640 Therapy with Older Adults Discussion HW
Clients who are older have often times been dealing with their mental health disorder their entire lives, whiles other disorders may be brought on through the aging process or the trauma of losing a lifelong partner. Treatment can be challenging for both the client and the therapist. For this Discussion, you will focus on therapeutic approaches for an older adult presented in a case study.
- Assess clients presenting with depression
- Analyze therapeutic approaches for treating clients presenting with depression NURS6640 Therapy with Older Adults Discussion HW
- Evaluate outcomes for clients presenting with depression
- Download and review the Week 10: Case Study from this week’s Learning Resources.
- Review this week’s Learning Resources and reflect on the insights they provide.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click Submit, you cannot delete or edit your own posts, and cannot post anonymously. Please check your post carefully before clicking Submit!
BY DAY 3
Post a treatment plan for the older adult client in the Week 10: Case Study found in this week’s Learning Resources. Be sure to address the following in your post:
- Which diagnosis should be considered?
- What is the DSM-V Coding for the diagnosis you are considering?
- What is your rationale for the diagnosis? Be sure and link the client’s signs and symptoms to the DSM-V diagnostic criteria to support your diagnosis.
- What tests or tools should be considered to help identify the correct diagnosis?
- What differential diagnosis should be considered?
- What Treatment Strategy would you recommend?
- What treatment would you prescribe and what is the rationale?
- Diagnostic Tests
- What standard guidelines would you use to treat or assess this patient?
- Clinical Note: Is depression a normal part of aging?
Support your approach with evidence-based literature.
NURS 6640: Psychotherapy with Individuals
Week 10: Case Study
IDENTIFICATION: The patient is a 69-year-old, widowed African American male who is the father of one adult child andgrandfather of six grandchildren. The patient is self-referred to a psychiatric outpatient clinic.
CHIEF COMPLAINT: “I need help with depression and anxiety.
HISTORY OF CHIEF COMPLAINT: The patient reports thathis father is dying, and he has been experiencing worsening ofdepression and anxiety symptoms over the past few months. Heis seeking a psychiatric evaluation at hisson’s advice. Thepatient does not enjoy being with his family.
He has difficulty falling asleep, but then spendsthe day lying on the couch and reports feeling like he is “movingin slow motion.” He reports feeling tired all the time. He hasalso stopped going to his volunteer job at the nursing home.
He responded to the practitioner’s question of “whydepressed now?” by saying that with the imminent death of hisfather, he is losing his main support.In addition to his father’s illness, the patient was diagnosedand treated for prostate cancer this year. He receivedpsychotherapy at that time which focused on his anxiety aboutthe diagnosis, hisdenial of its severity, hiswish to “not knowwhat he knew,” and, ultimately, end-of-life issues.
PAST PSYCHIATRIC HISTORY: The patient was neverhospitalized for psychiatric reasons. He has no history ofsuicidal thoughts, gestures, or attempts.The patient described either a partial or negative responsefrom several medications hehad been prescribed from his primary care provider (PCP) over the course of a several years,including Effexor, Prozac, Zoloft Lexapro and Duloxetine.
He is currently prescribed Lorazeapm1 mg BID by hisPCP which hehas been taking for several years.
MEDICAL HISTORY: GERD, HTN and hyperlipidemia. History of prostate cancer.
HISTORY OF DRUG OR ALCOHOL ABUSE: The patientdenies history of drug and alcohol abuse.
FAMILY PSYCHIATRIC HISTORY: Patient reports that hismother had depression. He is an only child and does not recall anyemotional difficulties in grandparents or other relatives.
Perinatal: No known perinatal complications.
TRAUMA/ABUSE HISTORY: Denies
Mental Status Examination
Appearance: Well-groomed, appropriately dressed, olderGentleman who is obese
Behavior and psychomotor activity: Good eye contact,pleasant, cooperative. Slightly unsteady gait uses walker.
Consciousness:Alert and able to answerall questionsappropriately.
Orientation:Oriented to person,place, time, andsituation.
Memory: Intact. Good recent andremote memory.
Concentration and attention:Appears to have goodconcentration during theinterview but reportsthat hehas recently hadtrouble concentratingwhile reading.
Visuospatial ability: Not formally assessed.
Abstract thought:Within normal limits,appropriate use ofmetaphors.
Intellectual functioning:Patient has Masters degree
Speech and language: Normal rate and rhythm.
Perceptions: No abnormalitiespresent.
Thought processes:Goal directed, butevidence of guilt andrumination consistentwith depressivesymptomatology.
Thought content:Patient is highly anxiousand expresses thoughtsof sadness, frustration.He is preoccupied withthoughts about theanticipated loss of his father.
Mood: Depressed and anxious.
Affect: Congruent with mood.
Impulse control: Good.
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