1. Identify seven characteristics of mental health

1. 1. Identify seven characteristics of mental health Define the following term: mental health the normal functioning of emotional and intellectual abilities.

2. 1. Identify seven characteristics of mental health • These are the characteristics of a person who is mentally healthy: • Gets along with others • Adapts to change • Cares for self and others • Gives and accepts love • Deals with situations that cause anxiety, disappointment, and frustration • Takes responsibility for decisions, feelings, and actions • Controls and fulfills desires and impulses appropriately

3. 2. Identify four causes of mental illness Define the following terms: mental illness a disease that affects a person’s ability to function at a normal level in the family, home, or community. situation response a temporary condition that has symptoms like those of mental illness; possible causes include a personal crisis, temporary physical changes in the brain, side effects from medications, interactions among medications, and severe change in the environment.

4. 2. Identify four causes of mental illness The following conditions may cause or worsen mental illness: Physical factors such as illness, disability, aging, substance abuse, or chemical imbalance Environmental factors such as weak family relationships or traumatic childhood experiences Heredity or family influence Stress, including coping abilities

5. 3. Distinguish between fact and fallacy concerning mental illness • Define the following term: • fallacy • a false belief.

6. 3. Distinguish between fact and fallacy concerning mental illness REMEMBER: Mental illness is a disease like any other physical illness. People who are mentally ill cannot simply choose to be well.

7. 3. Distinguish between fact and fallacy concerning mental illness REMEMBER: Mental illness and intellectual disability are not the same. Intellectual disability is a developmental disability that causes below-average mental functioning. It is not a type of mental illness. One common point, however, is that residents with both conditions will need emotional support in addition to care and treatment.

8. 4. Explain the connection between mental and physical wellness REMEMBER: Being mentally healthy can reduce stress and prevent some physical diseases. The reverse of this statement is also true. Mentally ill residents may experience high levels of stress that can affect their physical health.

9. 4. Explain the connection between mental and physical wellness Think about this question: What stress-reducing techniques do you find effective in your own life?

10. 5. List guidelines for communicating with mentally ill residents NAs should remember these guidelines for communicating with residents who are mentally ill: Do not talk to adults as if they were children. Use simple, clear statements and normal tone of voice. Communicate respect and concern. Sit or stand at a normal distance. Use posture that says you are listening (body language). Be honest and direct. Avoid arguments. Maintain eye contact. Listen carefully.

11. 6. Identify and define common defense mechanisms Define the following term: defense mechanisms unconscious behaviors used to release tension or cope with stress.

12. 6. Identify and define common defense mechanisms NAs should be familiar with these defense mechanisms: Denial Projection Displacement Rationalization Repression Regression

13. 7. Describe the symptoms of anxiety, depression, and schizophrenia Define the following terms: anxiety uneasiness or fear, often about a situation or condition. phobias an intense form of anxiety or fear. claustrophobia the fear of being in a confined space. panic disorder a disorder in which a person has repeated episodes of intense fear that something bad will occur.

14. 7. Describe the symptoms of anxiety, depression, and schizophrenia Define the following terms: obsessive-compulsive disorder (OCD) an anxiety disorder characterized by obsessive behavior or thoughts. post-traumatic stress disorder an anxiety disorder caused by a traumatic experience. apathy a lack of interest in activities. major depressive disorder a type of depression that causes withdrawal, lack of energy, and loss of interest in activities, as well as other symptoms; also called major depression.

15. 7. Describe the symptoms of anxiety, depression, and schizophrenia Define the following terms: bipolar disorder a type of depression that causes a person to swing from periods of deep depression to periods of extreme activity; also called manic-depressive illness. schizophrenia a form of mental illness that affects a person’s ability to think, communicate, make decisions, and understand reality. paranoid schizophrenia a form of mental illness characterized by hallucinations and delusions.

16. Transparency 20-1: Mental Diagnosis 1

17. Transparency 20-2: Mental Diagnosis 2

18. Transparency 20-3: Mental Diagnosis 3

19. 8. Explain how mental illness is treated Define the following term: psychotherapy a method of treating mental illness that involves talking about one’s problems with mental health professionals.

20. 8. Explain how mental illness is treated Mental illness can be treated. The following are common treatments: Medication Psychotherapy

21. 8. Explain how mental illness is treated REMEMBER: Residents with mental illness have the right to participate in the planning of their care.

22. Transparency 20-4: NA’s Role in Caring for the Mentally Ill Observe residents carefully for changes. Document and report. Support the resident and family. Encourage residents to do as much for themselves as possible.

23. 9. Explain the nursing assistant’s role in caring for residents who are mentally ill Home Care Focus A stable home environment is important in managing many forms of mental illness. An HHA may be assigned to provide the following services: Food shopping, meal planning, and preparation Housecleaning and laundry Assistance with ADLs and personal care Caring for children and other family members.

24. 9. Explain the nursing assistant’s role in caring for residents who are mentally ill Home Care Focus REMEMBER: By assisting the family with meeting their basic needs, the HHA helps the recovery process.

25. 10. Identify important observations that should be made and reported NAs should observe and report the following in residents with mental illness: Changes in ability Positive or negative mood changes (withdrawal) Behavior changes Comments about hurting self or others (including jokes) Real or imagined physical symptoms Events, situations, or people that provoke certain reactions

26. 11. List the signs of substance abuse Define the following term: substance abuse the repeated use of legal or illegal drugs, cigarettes, or alcohol in a way that is harmful to oneself or others.

27. Transparency 20-5: Signs of Substance Abuse Changes in physical appearance (red eyes, dilated pupils, weight loss) Changes in personality (moodiness, strange behavior, disruption of routines, lying) Irritability Odor of cigarettes, liquor, or other substances on breath or clothes Diminished sense of smell Unexplained changes in vital signs Loss of appetite Inability to function normally Need for money Confusion or forgetfulness Blackouts or memory loss Frequent accidents Problems with family or friends

28. 11. List the signs of substance abuse REMEMBER: Illegal drugs are not the only substances that are abused. Over-the-counter and prescription medications can be abused if taken incorrectly or excessively.

29. 11. List the signs of substance abuse Think about this question: What substances commonly found in the home could be abused?

30. 11. List the signs of substance abuse REMEMBER: Residents who do not have doctors’ orders against drinking alcohol and who live in a facility where alcoholic beverages are allowed may drink alcohol if they wish to do so. NAs should not make judgments or gossip.

31. Exam Multiple Choice. Choose the correct answer. A person who is mentally healthy (A) Can control and fulfill impulses appropriately (B) Is unlikely to have relationships with others (C) Cannot deal with stress well (D) Does not take responsibility for decisions Which of the following is a sign or symptom of mental illness? (A) Adapting to change (B) Getting along with others (C) Controlling impulses (D) Regularly being agitated

32. Exam Mental illness can be made worse by (A) Eating a diet heavy in red meat and other animal-based proteins (B) A strong sense of self-respect (C) Taking prescribed medications (D) Substance abuse Which of the following statements is true about mental illness? (A) People with mental illness can control their symptoms. (B) Mental illness is a disease like any physical illness. (C) Mentally healthy persons are unable to control their emotions. (D) Mental illness rarely disrupts a person’s ability to function.

33. Exam One guideline for communicating with mentally ill residents is to (A) Talk to adults like they are children if they do not understand what is being said (B) Maintain eye contact and listen closely (C) Stand really close to residents (D) Argue with residents if what they are saying is not true Which of the following is true of defense mechanisms? (A) They are a type of mental illness. (B) Anyone who uses them is likely to become mentally ill at some point. (C) People who are mentally ill do not use them. (D) They help a person cope with stress.

34. Exam Telling your coworker, “Let’s throw spitballs at our boss,” is an example of which kind of defense mechanism? (A) Displacement (B) Regression (C) Rationalization (D) Projection A coworker gets the promotion that an NA has wanted for a long time. When a friend asks if the NA is upset, he says, “No, not at all.” This is an example of (A) Denial (B) Displacement (C) Regression (D) Projection

35. Exam Signs and symptoms of clinical depression include (A) Apathy (B) Intense hunger (C) Sudden chest pain (D) Breath that smells fruity A ______ is an intense form of anxiety. (A) Phobia (B) Coping mechanism (C) Fallacy (D) Situation response

36. Exam Which of the following is an appropriate way for an NA to care for a mentally ill resident? (A) The NA should do everything for the resident. (B) The NA should administer the resident’s medication. (C) The NA should support the resident and his family and friends. (D) The NA should encourage the resident to stop being mentally ill and just get better. Which of the following statements about observing mentally ill residents is true? (A) An NA does not need to report a comment about suicide as long as it is a joke. (B) An NA needs to report changes in mood. (C) Withdrawal does not need to be reported. (D) Imagined physical symptoms do not need to be reported.

37. Exam The fear of being in a confined space is called (A) Post-traumatic stress disorder (B) Obsessive compulsive disorder (C) Claustrophobia (D) Schizophrenia A brain disorder that affects a person’s ability to think clearly and understand reality is (A) Clinical depression (B) Claustrophobia (C) Bipolar disorder (D) Schizophrenia

38. Exam An anxiety-related disorder that is characterized by repetitive thoughts or behavior is (A) Generalized anxiety disorder (B) Post-traumatic stress disorder (C) Obsessive-compulsive disorder (D) Panic disorder

39. CHAPTER 20 PRACTICE 1. Which of the following is a sign or symptom of mental illness? (A) Adapting to change (B) Getting along with others (C) Controlling impulses (D) Regularly being agitated 2. One guideline for communicating with mentally ill residents is to (A) Talk to adults like they are children if they do not understand what is being said (B) Maintain eye contact and listen closely (C) Stand really close to residents (D) Argue with residents if what they are saying is not true. 3. Which of the following is a common set of treatments for mental illness? (A) Electroconvulsive (shock) therapy and psychosurgery (B) Medication and psychotherapy (C) Psychotherapy and psychosurgery (D) Medication and electroconvulsive (shock) therapy 4. An anxiety-related disorder that is characterized by repetitive thoughts or behavior is (A) Generalized anxiety disorder (B) Post-traumatic stress disorder (C) Obsessive-compulsive disorder (D) Panic disorder

40. CHAPTER 20 PRACTICE 1. Which of the following is a sign or symptom of mental illness? (A) Adapting to change (B) Getting along with others (C) Controlling impulses (D) Regularly being agitated 2. One guideline for communicating with mentally ill residents is to (A) Talk to adults like they are children if they do not understand what is being said (B) Maintain eye contact and listen closely (C) Stand really close to residents (D) Argue with residents if what they are saying is not true. 3. Which of the following is a common set of treatments for mental illness? (A) Electroconvulsive (shock) therapy and psychosurgery (B) Medication and psychotherapy (C) Psychotherapy and psychosurgery (D) Medication and electroconvulsive (shock) therapy 4. An anxiety-related disorder that is characterized by repetitive thoughts or behavior is (A) Generalized anxiety disorder (B) Post-traumatic stress disorder (C) Obsessive-compulsive disorder (D) Panic disorder

41. CHAPTER 20 PRACTICE ANSWERS D-REGULARLY BEING AGITATED B-MAINTAIN EYE CONTACT AND LISTEN CAREFULLY B-MEDICATION AND PSYCHOTHERAPY C-OBSESSIVE-COMPULSIVE DISORDER