What is Mental Health - Case Study Example

Topic: Mental Health Introduction This essay presents a critical evaluation of mental well being. It describes two definitions of mental health and mental illness, which are two critical aspects that can aid in understanding mental well being. The patient described in the paper was an elderly man who had led a lifestyle that contributed to the occurrence of dementia. Mr. Wilson is the pseudo name that has been given to the patient for confidential reasons in accordance with Nursing and Midwifery Council Code of Conduct (NMC, 2008). The paper presents an overview of the patient’s behavior and the mental challenges that he was facing. It also relates theory with the characteristics that were observed in the patient, leading to the deduction that the case was that of severe dementia that was associated with previous substance abuse and Alzheimer’s disease. Alzheimer’s is a condition that is associated with aging, having an on set age of 65 years. Palliative care has been identified as significant intervention for an aging person suffering from dementia, which in this situation is a terminal mental disorder especially considering the fact that the patient is suffering from Alzheimer’s disease. The paper also explains the various practices that a nurse would engage in to help the patient to cope with mental challenges and to help family members to understand and deal with the patient. Mental Health Mental health is the condition of having a properly functioning state of mind. The cognitive ability of a mentally healthy person allows him/her to undertake the day to day tasks in the right way (Norman and Ryrie, 2004). Barker (2003) supports this definition by stating that it is the manner in which people think and their awareness of the surrounding, as well as all their involvements in coping with life encounters. There can be good or bad mental health. The day to day lives of people involve engagement in social activities where an individual interacts with other people to accomplish social satisfaction. A person needs to feel wanted in the society to be satisfied. Katherine (2000) argued that a person with good mental health is capable of balancing the social and psychological engagements and is emotionally satisfied. For example, when a person is happy with the manner that other people take him/her to be, or when he/she accomplishes success in identifying a solution to a problem, such a person is able to balance the social and psychological aspects of the day to day life. More over, a person who is capable of overcoming traumatizing occurrences is able to accomplish emotional well being and is in good mental health (Caves, 2003). Bad mental health on the other hand occurs when a person is unable to accomplish a balance in the social and psychological aspects of life (Katherine, 2000). For example, although an individual may not be mentally ill, he/she might be suppressing emotions as a way of coping with stress. However, such emotions may continue affecting the individual even when they are not explicit. When a person is unable to find a solution to a particular problem in life, for example failure to get employment to solve family problems, such an individual has bad mental health because he/she has been unable to accomplish a balance in the social and psychological aspects of life. When people live in isolation, they lack the social contact although they may be emotionally satisfied (Barker, 2003). Mental Illness Mental illness on the other hand is an occurrence that lowers the cognitive ability and changes the behaviour of an individual, leading to a deviation from the normal mental functions (Hattie et al. 2004). (Hhorwitz and Scheid, 2009) argue that mental illness is a psychological disorder that causes suffering due to inability to use the mind to manage one’s day to day life. According to Rogers and Pilgrim (2005), a distinction between mental health and illness is apparent, considering the length of the deviation from the normal mental functions as well as how severe the signs of deviation are. This means that a mentally healthy person may have short lived deviations such as depression, but for a mentally ill person, the depression may take long, and may be severe, for example to the extent of crying or sleeping for a period of 3 weeks (Mendez, 2006). The Bioscience perspective focuses on biological aspects of mental health, describing mentally healthy person as that whose nerve cells and chemicals such as the neural transmitters in the brain are functioning properly. When the nerve cells fail to communicate with each other in the right way, mental illness occurs. Illness may also result from brain injury, heredity, drug and substance use and injury during birth among other biological causes (Hhorwitz and Scheid, 2009). The psychosocial perspective focuses on the social aspects that affect the psychological behaviour of an individual. For example, severe problems due to lack of basic necessities may affect an individual psychologically leading to mental illness. Psychological factors might involve traumatic incidents; sorrowful experiences such as death of a loved one or desertion among others (Hattie et al. 2004). The mental continuum theory focuses on mental well-being as a continuum. In this case, there are different levels of mental health that an individual can attain the desired capabilities of coping with the day to day engagements and challenges. The levels are not constant as long as a person is active in life. At a particular time a person may be sorrowful but this condition may change for the better even without taking medication. Such a condition can be considered as a common health issue (Wrycraft, 2009). Communication Skills The patient that was identified during the clinical placement exhibited characteristics that indicated that she was suffering from mental illness. Most of his mental functions were affected or lost completely. For example, the reasoning capabilities had been lost. Wilson could not reason on the use of the toilet despite having the ability to walk, stand and sit. He wetted the bed and also defecated on his clothes. Explaining to him the need of waking up and walking to the toilet seemed not to rouse any interest to do so. He looked like a person in a dream though not asleep. Sometimes he would experience a sudden change of mood that would lead to wailing and hysterical crying. During such frenzies, he could not be comforted by anyone. It looked as if he had developed inexplicable phobia for women. Apart from diminished reasoning capabilities, Wilson’s memory was completely lost such that he could not remember the slightest event that occurred in the last few minutes. He could not remember members of his immediate family, and in one occasion his son felt that it was the father’s strategy to deny him inheritance. The hospital personnel had a hard time explaining to the son about the effects of dementia. It was amazing to find a man forgetting members of a family that according to close relatives who knew him before the mental illness, he adored. Sometimes the wife claimed that the patient had taken poisoned alcohol, although she remembered that he was an occasional substance abuser. Memory loss was a major problem and the patient could not figure out how events occurred or even the manner in which they affected him. Deterioration of memory affected his feeding habits since he could not recall if he fed or not. He could complain of hunger and being neglected by relatives while they were understood by the hospital staff to be caring and concerned about his health. They visited him three times a day and therefore it was difficult for them to understand why he felt neglected and unwanted. Personal Concept of Mental Health Wilson’s personality changed to the extent that people began abhorring him. Personality is a term that represents the typical patterns of personal judgment, mind-set and actions that generate uniqueness in an individual. It emanates from the individual and remains relatively consistent in his entire life. Principally, personality involves efforts by an individual to capture the attributes that make him/her what he actually is (Hhorwitz and Scheid, 2009). Such attributes were lost in the patient and he seemed not to care about the surrounding. He had lost his unconscious mind, which is a significant factor that controls behaviour. According to Sigmund Freud in his works on psychoanalysis, the unconscious mind holds feelings, attitude, desires as well as recollections that are far from consciousness (Rogers and Pilgrim, 2005). It generates feelings of embarrassment, disagreement and nervousness among other objectionable aspects. It consistently influences behaviour as well as human experience though the victim remains unaware regarding the fundamental influences. Wilson’s condition was a severe case of dementia, which is itself not an illness but a combination of symptoms that could be associated with age as well as the patient’s lifestyle. He was approaching 82 years and even though he had a stable family, substance abuse deteriorated his condition. He had used illicit drugs and alcohol since his youth and had not stopped until the time that he developed the symptoms. It was therefore a combination of Alzheimer’s disease that is associated with old age as well as deteriorating mental health due to drug use. However, it was not clearly established which of the two had a greater impact on the patient since according to Hhorwitz and Scheid (2009), Alzheimer’s disease has equal potential as drug abuse to cause symptoms of dementia. Alzheimer’s disease is a degenerative terminal illness that mainly affects the aging population with the onset age being 65 years (Corey, 2002). The disease was discovered in 1906 by Alois Alzheimer and no medication has been found to treat it up to date. Patients usually loose the capacity to store new memories at the early stages of disease. As it progresses, the patient begins getting confused, short-tempered and may even be aggressive with sudden changes in mood. Communication breakdown and complete loss of memory occurs and the patient tends to withdraw from participation in the normal interactions with people as their mind declines. There is usually a slow diminishing of the body functions that culminates in death. According to Hattie et al. (2004), an Alzheimer’s patient can survive up to 7 years after diagnosis. However, the number of years the sufferer lives is dependent on the quality of palliative care offered. Awareness of Personal Strengths and Weaknesses One major weakness encountered in the clinical placement was determining the exact cause of dementia. This limited the level of intervention since dealing with the illness depended on the knowledge of its aetiology. However, Wilson’s background as regards his previous lifestyle and the available literature were the core strengths for predicting the causative factors of dementia. Corey (2002) observes that Alzheimer’s disease is worsened by prolonged substance abuse in the previous years before diagnosis. Alcohol and drugs can influence the occurrence of dementia even in youthful stages. Substance abuse may cause brain damage among users leading to the occurrence of symptoms such as learning difficulties, memory loss and psychological well-being, which are similar to the signs observed among sufferers of Alzheimer’s disease in its early stages of development. Some drugs such as opium have been found to influence the pre-mature aging of the brain leading to early signs of Alzheimer’s disease. Heroine and methadone are also associated with the accumulation of a protein that leads to brain damage (Katherine, 2000). Wilson, having been a victim of drug and alcohol abuse was exposed to Alzheimer’s disease especially at his advanced age. Even though he had stopped substance abuse, their long term effect had already had an impact on his brain and could not be cured. Dementia can not be regarded as normal aging since it does not affect every person who has attained the age of 65. Tyrer and Steinberg (2003) observe that there is a high degree of heritability of Alzheimer’s disease ranging from 58% to 78%. However, there were minimal chances of Wilson’s case being hereditary since according to a reliable family member, no case had been witnessed in the lineage. The role of different health and social care professionals in mental health promotion The dementia patient needs to be constantly monitored to establish whether the prescribed medications are effective and to find out any side effects that may have occurred as a result of the prescriptions. It is important to offer the necessary cognitive enhancement skills and social interactions to help the patient to cope with sudden mood swings as well as to eliminate feelings of segregation (Norman and Ryrie, 2004). Ensuring that the patient has sufficient rest and sleep improves the effectiveness of medication. Health complications can be prevented through ensuring that the patient is fed on a balanced diet with adequate fluids as well as ensuring that he is comfortable all the time. Sufficient hydration is significant for a patient suffering from dementia. It is also necessary to ensure that the patient does not suffer from pain through provision of pain killers whenever necessary (Tyrer and Steinberg, 2003). In case of aggressiveness, the patient should not be restrained physically or pharmacologically. Rather, a calm approach should be used to calm him down. Even though the patient needs continuous support for movements, it is necessary to encourage the maintenance of functional capabilities through ensuring that the patient remains as independent as possible and keeping up mobility. The assistance offered should be planned according to the patient’s needs. For example, movement to the toilet should be programmed to suit the excretory functions to avoid embarrassment. The patient should be encouraged to perform regular exercises that dissipate energy (Kiernan, 2007). This helps to promote blood circulation and sleep. Personal values and beliefs and how they may influence their own attitudes Addressing behavioral challenges is necessary to ensure that the environmental factors accelerating the impact of dementia are dealt with. The patient needs to be reassured of safety to get rid of fear and anxiety. A peaceful environment needs to be maintained to ensure that stimuli for aggression and mood swings are contained. On the other hand, the environment should not be under-stimulating leading to withdrawal and loneliness (Tudor, 1996). The patient should be free from health hazards. Sensory aides should be put in place to enhance cognitive capabilities. The patient should be given an opportunity to meet family members, who should also be informed on the appropriate approach to use when handling the patient (Sugarman & Barry, 2000). Simple words and phrases need to be used whenever communicating with the patient. In this particular case, the patient could not speak but only used signals indicating what he wanted. It is important as a care giver to understand such communication and not to force any other kind of communication that may not be understandable to the patient. Assisting him to feed, dress, tidy up his hair, brush teeth and bathe are among the important day to day activities that are important in maintaining hygiene (Kuebler et al. 2006). Such practices are significant in ensuring that the medications to the patient are effective. The patient needs to feel wanted and appreciated for his actions. It is therefore important to celebrate the residual capacity through offering moments of excitement that raises his spirits even if the happy experiences are forgotten almost immediately. Regular distractions might be appropriate whenever the patient can not control certain impulses such as undressing in the presence of other patients. People can also be instructed to leave when the patient’s emotions are high to avoid aggravating the situation (Sugarman & Barry, 2000). This is especially if the stimulus for emotions is the presence of large crowds of people. Self-esteem generates confidence and it may facilitate recovery in the patient. This can be accomplished through offering him and opportunity to carry out some simple tasks that he is capable of performing. Allowing the patient to help rather than always being helped generates a feeling of importance in the society, which contributes to the recovery process and lessening the symptoms of dementia. The family members and well wishers coming to visit the patient should be taught to respect his feelings to avoid disappointing him. The patient should be corrected through positive actions rather than threatening or harsh language to correct a wrong (Kiernan, 2007). Practical strategies to improve strengths and needs in relation to your skills in IT Wilson should be given an identifier to help the healthcare professionals identify him among other patients. This is important for all the patients to prevent inefficiencies that may emerge from mixing up treatments. Items such as bracelets and tags are the conventional identifiers used to differentiate the patients. However, it might present a major challenge if they remove the tag or refuse any identifier to be used on them. The application of IT is a significant strategy to improve the strengths in data capture (Wainwright and Waring, 2000). “E-Health” is a term that is widely used in the contemporary healthcare system referring to the application of information technology in healthcare to facilitate the delivery of services and also improve effectiveness in data collection, storage and retrieval (Geldof & Unwin, 2005). It is a cost effective means of capturing, researching and disseminating healthcare information to clients. It is used by healthcare professionals to monitor progress of their patients as well as knowledge sharing among the healthcare staff. This strategy needs to be used in capturing and storing information on dementia patients to help in their identification and tracking the progress of recovery (Mendez, 2006). Conclusion Mental health can be described as a situation in which a person’s mind is functioning properly. It can also be described as consciousness of the surrounding as well as the ability to accomplish the day to day involvements and dealing with the day to day encounters. Mental illness can be described as the reduction in cognitive ability. A mentally ill person lacks the capacity to perform the normal mental functions. The patient in this case was suffering from dementia, which was characterized by deteriorating mental functions. These included poor reasoning capability and memory loss. The condition had changed the patient’s personality leading to self hatred and abhorrence in the society. Dementia is a combination of symptoms that indicate mental illness. The patient was approaching an advanced age and had symptoms of Alzheimer’s disease, which was accelerated by the previous lifestyle of the patient. He was a perpetual drug user that is known to cause brain damage. He had constant mood swings and often became aggressive and confused. The patient needs regular monitoring to ensure that he is free from health hazards. He also needs sufficient sleep and rest. Physical or pharmacological restraint should not be applied. Rather, a comforting approach should be used to ensure that aggressiveness is not roused in the patient. Behavioural challenges should also be addressed and also ensuring that the environmental factors accelerating the ailment are eliminated. Harsh interventions in case of a mistake should be avoided. The patient needs encouragement to maintain his self esteem, which can facilitate recovery. Love should be demonstrated to the patient to make him feel worth in the society. He should be allowed to take part in some simple tasks. Generally, dementia is a condition that may culminate in death especially when essential body functions are lost. People’s mental well being is important and the causative factors such as drug abuse and injuries should be avoided. References Barker, P. 2003. 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An Introduction to Mental Health Nursing. Open University Press. McGraw-Hill Education. Read More