Debbie Ohl, RN, M.Msc., PhD - HCMarketplace.com

CHAPTER 2
The causative factors can be:
•• Physiological: deregulated systems
– Chemical
– Hormonal
– Circadian rhythm
•• Psychological•
– Loss of valued objects
– Exit events
– Negative distortions of life experiences
– Automatic negative thinking
•• Psychosocial
– Weak support system
– Poor health
Occurrence of mood disturbances
Mood is short lived, lasting seconds to hours. It is sometimes precipitated by thoughts or
circumstances. Mood disturbances can be characterized by the following:
•• Pathological•emotions. These are involuntary outbursts that are not congruent
with mood. The person does not know why they are laughing or crying. It can
occur with multiple sclerosis, strokes, etc. The care planning strategies need to be
built around how the disturbance impacts the resident and those around them.
•• Catastrophic•reactions. These are the outcomes of task failure created by cognitive
compromise. When the person cannot translate or understand, they may
become frustrated and confused, resulting in acting-out behaviors such as combativeness
and care refusal. Catastrophic reactions need to be anticipated and
circumstances for occurrences minimized when possible.
Occurrence of depression
1.• Reactive•syndromes•or•adjustment•disorders.•
– Most common in the elderly. Results from certain personality traits that cause a
person to be vulnerable to particular environmental stressors.
12 MDS 3.0 Care Plans Made Easy
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