Discussion Board Nursing and the Aging Family

Question 1: Week 7 Discussion Question: Chapter 29, Mental Health Disorders

Hypochondriasis is a mental health condition identified as illness anxiety disorder, health phobia, or health anxiety (Eliopoulos, 2019). A hypochondriac person excessively worries that they are or may seriously get ill. Though there are no physical indications that they are ill or medical examinations do not reveal any serious medical condition, they are pretty much disturbed. Older people are particularly prone to hypochondria (Barnett et al., 2019). The severity of this condition usually escalates when a person is under too much time stress and increasing age. Typically, older women are prone to become hypochondriac compared to older men. Individuals might perceive the normal body sensations or minor symptoms as indications of severe illness.

The perception or behavior is accompanied by over obsession with personal health status, frequently booking appointments with the doctor, avoiding places or people for fear of getting sick. In some cases, the hypochondria may be severe, triggering too much anxiety, which can be debilitating, causing problems with relationships or carrying out daily activities due to anxiety and distress (Veazie & Denham, 2021). Hypochondriasis is normally co-occurring with other psychiatric disorders such as anxiety, obsessive-compulsive disorder, substance use, and dependence. 

In treating hypochondriasis, proper diagnosis needs to be done for other associated comorbidities, which should be treated simultaneously. Normally, there is no known drug administered for hypochondriasis (van Dijk et al., 2018). The nurse practitioner may have to prescribe anti-depression or anti-anxiety medication associated with diagnosed mental health conditions.  In older adults, the condition may be due to social stressors and complaints about the discomforts and restrictions of physical decline. The senior hypochondriac patient should be helped acknowledge social stress as a major source of the problem to develop a realistic coping mechanism. The nurse practitioner needs to assess all the underlying factors contributing to hypochondriasis critically. If the nurse practitioner determines that psychotherapeutic intervention is necessary, they may recommend behavior modification and cognitive-behavior therapy with a psychologist.

Question 2: Week 7 Discussion Question: Chapter 29, Mental Health Disorders

Among older people, psychotropic medications have been linked to many adverse outcomes. Older adults tend to react to medication differently than the younger patients, even the healthy older people, since their bodies process and eliminate medication slower (Harrison et al., 2018). Psychotropic medications include anti-anxiety, anti-depressant, anti-psychotics, stimulant, sedative-hypnotics, and mood stabilizers. In older adults, due to reduced metabolism rate, certain psychotropic medications may take longer for their body to clear if the liver or kidney are not functioning well.

For the elderly treated with multiple medications, the probability of the drug-drug interaction increases the risk of side effects or adverse reactions. The improper administration of psychotropic drugs exposes elderly patients to adverse medication reactions leading to deteriorating medical and cognitive status (Brimelow et al., 2019). Wrong drug disposition alters normal aging since this age group is greatly sensitive to adverse side effects, declining their functional level. Some psychotropic side effects include psychomotor retardation, sedation, cognitive impairment, confusion, poor memory, impaired coordination, and falls. Sometimes, dysphoria, irritability, and anxiety develop in elderly patients under these medications.

 In the elderly, anti-psychotic medications can cause serious side effects, such as continuous spasms and muscle contraction, slowness of movement, and irregular, jerky movements (Arnold et al., 2017). Particularly, the APs utilized in the older adults to treat dementia clinical presentation to reduce manifesting aggressive behaviors, agitation, delusions, hallucinations, and sleep deficiency may not be effective and are likely to engender a range of adverse events to which the senior is more susceptible. The APs adverse effects are likely to cause cardiovascular effects in older adults, increasing the risk of high-low blood pressure, irregular heartbeat, QTc interval alteration, and metabolism problems (Arnold et al., 2017). The senior patients may already have several underlying conditions as part of normal aging or medical conditions associated with aging, so these medications only worsen them.