Loading...

Messages

Proposals

Stuck in your homework and missing deadline? Get urgent help in $10/Page with 24 hours deadline

Get Urgent Writing Help In Your Essays, Assignments, Homeworks, Dissertation, Thesis Or Coursework & Achieve A+ Grades.

Privacy Guaranteed - 100% Plagiarism Free Writing - Free Turnitin Report - Professional And Experienced Writers - 24/7 Online Support

Therapy with Older Adults

08/08/2020 Client: srauf1975 Deadline: 7 Days

I NEED A RESPONSE TO THIS ASSIGNMENT


3 REFERENCES


ZERO PLAGIARISM






Therapy with Older Adults


The client in this case study is a 69-year-old, widowed, African American man. He is self-referred to the clinic to get help with his anxiety and depression. After listening to the clients concerns and getting his background information, I would give him the diagnosis of major depressive disorder (MDD). The complete diagnosis with coding would be major depressive disorder, recurrent episode, severe, without psychotic features, with anxious distress, and melancholic features (Association, 2013). According to the DSM IV, in order to be diagnosed with MDD there must be five or more symptoms from the list of criteria, it should represent change from the individuals usual behaviors and be present over at least a two week time period (2013).


The client is experiencing at least eight symptoms, making the MDD severe, from the listed criteria that have negatively impacted important areas of his life and are not directly correlated with a substance or medical condition. His history does not indicate that any of the symptoms he is currently experiencing can be classified as a mixed episode, manic or hypomanic episodes, and he is not showing signs of schizophrenia or any psychotic features (Substance Abuse and Mental Health Services Administration, 2016). This is also recurrent; the client has had episodes of depression and anxiety in his past. He reports that he feels depressed at least most of the day which is also noticed by his son, he has lost interest in activities that used to bring him pleasure like volunteering at the nursing home and being with his family, the client is experiencing insomnia which is exhibited by him stating that it is hard to fall asleep at night, he is experiencing psychomotor changes exhibited by feeling like he is moving in slow motion, he says that he feels tired all the time, during the assessment it is noted that he is showing signs of guilt and rumination, he states that he has been having trouble concentrating while reading, and he also very preoccupied with the anticipated death of his father and previously his own death when he was diagnosed with prostate cancer (Substance Abuse and Mental Health Services Administration, 2016). The symptoms that he is experiencing fit the criteria for the diagnosis to be specified as anxious distress and melancholic features.


Diagnosing and identifying the severity of MDD accurately and in a timely manner is imperative to initiate treatment. There are several physical exams and diagnostic tools that are routinely used to rule out other medical conditions, confirm a diagnosis of MDD, and identify the severity. Physical exam that focuses on the neurological and endocrine systems should be done to rule out any medical causes for the depression that the client is experiencing, and blood tests to check for anemia, thyroid function tests, levels of calcium, hormones, and vitamins should also be completed low levels of these can cause depressive symptoms (Giannelli, 2020). Diagnostic tools include the Patient Health Questionnaire-2 (PHQ-2), Patient Health Questionnaire-9 (PHQ-9), the Beck Depression Inventory (BDI), and the Geriatric Depression Scale (GDS) (Ng & et al., 2016). The PHQ-2 is a two-question tool that can be used in a busy primary care setting. The PHQ-9 is usually more readily used as the results are easily interpreted and understood, it is easy to administer, and highly accurate (Costa & et al., 2016). The BDI cover affective, cognitive, and somatic aspects of major depression, it is typically used in the outpatient setting it is also highly sensitive to accurately identifying MDD (Ng & et al., 2016). And finally the GDS has been proven to be reliable when screening and identifying major depressive disorder specifically in the elderly population, it is rather lengthy which would make it difficult to use in a busy office setting (Ng & et al., 2016). I would use the PHQ-9 for this client, I am familiar with this assessment and find it useful in detecting depressive symptoms.


Differential diagnosis to consider would be persistent depressive disorder, adjustment disorder with depressed mode, and sadness. The has been experiencing these symptoms over a long period of time, feels hopeless, and is having trouble concentrating (Association, 2013). Psychoeducation should be provided to the client and his family, it should include depression signs and symptoms, the side effects of the pharmacological intervention, and information about the different treatment options to give the client the opportunity to be actively involved in his treatment (Guatam & et al., 2017).


There are different treatment options for management of depression which includes antidepressants, electroconvulsive therapy (ECT) and psychosocial interventions (Gautam & et al., 2017). The success of any of these treatment options requires compliance and cooperation from the client. All antidepressants have been proven to be effective, but they all work differently depending on the client. Selective serotonin reuptake inhibitors (SSRIs) are typically the first line of antidepressants used, they are relatively safe and have less severe side effects (Gautam & et al., 2017). The client has been prescribed three different SSRI’s and two NSRI’s over the years which he reports as having little or no effect. The client denies suicidal ideations his safety is not in immediate danger currently. However, the immediate initiation of an antidepressant is warranted in this situation. I would start him out with a low dose of Trazodone at bedtime and taper up, it has been shown to cause drowsiness in some individuals which can aid in treating the client’s insomnia as well as his depression (Jaffer & et al., 2017).


“Cognitive behavioral therapy (CBT) and interpersonal therapy are the psychotherapeutic approaches that have the best documented efficacy in the literature for management of depression” (Gautam & et al., 2017). As the PMHNP I would recommend using IPT to treat the client’s depression. The goal of this treatment is immediate symptom relief, improved relationships with his family, and to give the client tools and tips that he can use when stressors arise after treatment (Wheeler, 2014). IPT is structured and time limited acute treatment, usually 12-16 weeks of treatment is recommended (Cuijpers et al., 2016). Depression is common in the elderly, but it is not a normal part of aging, recognizing the symptoms of depression in older adults can sometimes be difficult but treatment of this disorder is imperative (Wheeler, 2014).


References


Association, A. P. (2013). Diagnostic and statistical manual of mental disorders, 5th edition: Dsm-5 (5th ed.). Washington, DC: Author.


Cuijpers, P., Donker, T., Weissman, M. M., Ravitz, P., & Cristea, I. A. (2016). Interpersonal psychotherapy for mental health problems: A comprehensive meta-analysis. American Journal of Psychiatry, 173(7), 680–687. https://doi.org/10.1176/appi.ajp.2015.15091141


Giannelli, F. R. (2020). Major depressive disorder : Journal of the american academy of pas. LWW. https://journals.lww.com/jaapa/Citation/2020/04000/Major_depressive_disorder.2.aspx


Gautam, S., Jain, A., Gautam, M., Vahia, V. N., & Grover, S. (2017). Clinical Practice Guidelines for the management of Depression. Indian journal of psychiatry59(Suppl 1), S34–S50. https://doi.org/10.4103/0019-5545.196973


Jaffer, K. Y., Chang, T., Vanle, B., Dang, J., Steiner, A. J., Loera, N., Abdelmesseh, M., Danovitch, I., & Ishak, W. W. (2017). Trazodone for Insomnia: A Systematic Review. Innovations in clinical neuroscience14(7-8), 24–34.


Ng, C. W., How, C. H., & Ng, Y. P. (2016). Major depression in primary care: making the diagnosis. Singapore medical journal57(11), 591–597. https://doi.org/10.11622/smedj.2016174


Substance Abuse and Mental Health Services Administration. (2016). DSM-5 Changes: Implications for Child Serious Emotional Disturbance [Table 9, DSM-IV to DSM-5 Major Depressive Episode/Disorder Comparison]. https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t5/


Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.

Homework is Completed By:

Writer Writer Name Amount Client Comments & Rating
Instant Homework Helper

ONLINE

Instant Homework Helper

$36

She helped me in last minute in a very reasonable price. She is a lifesaver, I got A+ grade in my homework, I will surely hire her again for my next assignments, Thumbs Up!

Order & Get This Solution Within 3 Hours in $25/Page

Custom Original Solution And Get A+ Grades

  • 100% Plagiarism Free
  • Proper APA/MLA/Harvard Referencing
  • Delivery in 3 Hours After Placing Order
  • Free Turnitin Report
  • Unlimited Revisions
  • Privacy Guaranteed

Order & Get This Solution Within 6 Hours in $20/Page

Custom Original Solution And Get A+ Grades

  • 100% Plagiarism Free
  • Proper APA/MLA/Harvard Referencing
  • Delivery in 6 Hours After Placing Order
  • Free Turnitin Report
  • Unlimited Revisions
  • Privacy Guaranteed

Order & Get This Solution Within 12 Hours in $15/Page

Custom Original Solution And Get A+ Grades

  • 100% Plagiarism Free
  • Proper APA/MLA/Harvard Referencing
  • Delivery in 12 Hours After Placing Order
  • Free Turnitin Report
  • Unlimited Revisions
  • Privacy Guaranteed

6 writers have sent their proposals to do this homework:

Academic Master
Online Assignment Help
Top Essay Tutor
Top Grade Tutor
Engineering Guru
Assignment Hub
Writer Writer Name Offer Chat
Academic Master

ONLINE

Academic Master

I have super grip on essays, case studies, reports and discussion posts. I am working on this forum from last 6 years with full amount of satisfaction of my clients.

$185 Chat With Writer
Online Assignment Help

ONLINE

Online Assignment Help

I am an elite class Ph.D. writer who can deliver you a supreme level of content within your given deadline. I will give you plagiarism free content within your given timeline.

$180 Chat With Writer
Top Essay Tutor

ONLINE

Top Essay Tutor

I feel, I would be the best choice for this project, I have more than 10 years of working experience in writing essys, reports, case studies and dissertations. Give me your work and get relax

$175 Chat With Writer
Top Grade Tutor

ONLINE

Top Grade Tutor

I can provide you with a guarantee of plagiarism free work. I am producing quality content for my clients including ARTICLE WRITING, ESSAY WRITING, RESEARCH PAPERS, BUSINESS PLAN, TECHNICAL WRITING, MATLAB, THESIS & DISSERTATIONS.

$200 Chat With Writer
Engineering Guru

ONLINE

Engineering Guru

Hello, I have more than 10 years of writing experience. I can manage essays, summaries, reports and analysis works in very short period of time. I produce plagiarism free content for my clients, will send you FREE TURNITIN Reports as well. Thank you.

$205 Chat With Writer
Assignment Hub

ONLINE

Assignment Hub

I feel, I am the best option for you to fulfill this project with 100% perfection. I am working on this forum since 2014 and I have served more than 1200 clients with a full amount of satisfaction.

$180 Chat With Writer

Let our expert academic writers to help you in achieving a+ grades in your homework, assignment, quiz or exam.

Similar Homework Questions

Corporate social responsibility - Dr jeremy freeman neurologist - Compare and contrast utilitarianism deontology and virtue ethics - Dq - Australian steel section properties - Primary consumer marine food chain - Aaa configuration cisco switch - 8 page paper due tomorrow - Tv guide melbourne tonight - Road safety ottawa charter - Path goal leadership theory could be best described as a - Financial Statement Analysis - Can t anybody here play this game pdf - Assignment - Paper - Rolling stones unplugged bootleg - Explaining dissociation to a child - Indra nooyi leadership style ppt - What is the world's saddest candy worksheet answers - Forum: Week 2 Discussion - 2 Individual Questions - What does i am the mustard seed mean - Supply chain management simulation pearson answers - Emily eyefinger duncan ball - Write a prescription - Meaning of unmisted by love or dislike - Slaughterhouse five quotes about death - Good samaritan act first aid - Bevan brennan education queensland - Bmw isetta club australia - Similar minds personality disorder test - Legion of mary praesidium names - Digital electronics lab manual - Cengage board of directors - BUS 322 Week 3 Assignment 1 What Makes ____ the Best Place to Work and Why? - Digital logic design exam - Sandro salsano net worth - Health informatics 6th edition pdf - Wuthering heights chapter 1 questions and answers - Corporate IT Security Audit Compliance - Sequential fuel injection diagram - Coding practicum outpatient book evaluation and management - Help 2 - Consular electronic application center - Dynon hdx installation manual - Nursing - 32 bit multiplication in 8086 assembly language program - Kite runner Essay - Pilchard cake dog treat recipe - Caen car park braunton - 5 layer density tower - Basis point value calculation caiib - A ship sailing parallel to shore sights - The call by jessie pope essay - Chemical Neurotransmission - Mechanistic vs organic organizational structure - Organizational behavior of google company - Wuthering heights key quotes - 2009 english paper 2 - High tech campus 9 - Literature for composition 11th edition pdf free - In malachi, god denounces his people by raising the question of - The california sutter health approach - Bidomak the tonic bottle - Discussion - Density of nylon 66 30 gf - Who embalmed emmett till - Maintenance scope of work template - Mtv swot analysis - Metro station design thesis - MKTG201 Week 2 Discussion - Direct and inverse variation practice worksheet answers - Shoe size vs height - 50 conductor cable color code - Efficiency of dc shunt motor - Inequality - Diploma of security and risk management - Member railwayspensions co uk - Altered tails barnhart clinic - Specification writer job description - American Revaluation - Topic 3 DQ1 Patophysiology - 4 concepts of nursing theory - Philosophy - Anthm - Of paramount significance in the tabernacle was the - Light stick chemical reaction - Student information system sequence diagram - Sometimes in april youtube - Ash wednesday story for preschoolers - Chemistry placement exam practice - In what financial activities does a corporate treasurer engage - Higher psychology past papers - Visual Opinion Paper - General Chemistry II - Fundamentals of supply chain management dr dawei lu - Living things and non living things drawing - How secure is my password net - Franchising decisions in retailing ppt - 20 kiora avenue mosman nsw 2088