Chronic anxiety can complicate many illnesses such as hypertension, heart disease, chronic obstructive pulmonary disease, diabetes and may interfere with ADL’s, and cause cognitive decline and impairment, especially in the elderly.
Anxiety and pain perceptions in a population over the age of 65 showed that anxiety significantly elevated acute pain perception.
Some of the risk factors for anxiety are, excessive worrying, restlessness, irritability, sleep disturbances, fatigue and impaired concentration.
Older adults with chronic medical conditions are at a much higher risk for development of anxiety disorders when compared to those with-out chronic illnesses.
Drugs that can cause or worsen anxiety are, caffeine, theophylline, pseudoephedrine, and baclofen.
Instruments available to assess anxiety are, the Stat-Trait-Anxiety Inventory(STAI) and the Hospital-Anxiety-Inventory.
Interventions are, giving instructions to painful procedures, and in self management of pain, relaxation, breathing techniques, distraction, and cognitive restructuring can decrease anxiety.
Some medical conditions can cause or exacerbate anxiety in the elderly, such as hypoglycemia, hyper thyroidism, cardiac arrhythmia, hypertension and COPD.
The death of a spouse significantly increases the incidence of anxiety in older adults, catastrophic events in early life, poor subjective health, lack of an adequate support network, loneliness, and perceived vulnerability are also contributing factors for developing anxiety in the elderly.
Some medications to treat anxiety are, benzodiazepines, which have many side-effects, and serotonin norepinephrine re-uptake inhibitors (SNRi’s), and the selective serotonin re-uptake inhibitors (SSRI’s). The first line of treatments are the SSRI’s, because they have fewer side-effects.
Reference
Mauk, K. (2010). Gerontological Nursing Competencies for Care (2nd ed.). Sudbury, MA: Jones and Bartlett Publishers.
NOTE: This blog post reflects the work of a registered nurse with minor editing by Shirley Comer RN and was completed as a class assignment. The content of this blog is for informational purposes only. Before beginning or changing a treatment or lifestyle regime you should consult your primary health care provider.
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