In this final installment of our 2011 Annual Report series, we are pleased to share the voice of those who are too often overlooked—the family caregiver. This video features Mignonne, daughter of 82-year-old Roberto; she speaks candidly about her father’s delirium and the impact it had on both of their lives.

http://youtu.be/GGxupk_6TAw

Delirium is a sudden, fluctuating, and usually reversible state of mental confusion that affects up to 50 percent of hospitalized older adults. People with delirium may present as disoriented and have memory problems. As a result, they are often misdiagnosed with dementia, depression, or psychosis.

Mignonne articulates her father’s delirium well:

“I kept saying, ‘Dad, stop playing,’ because my dad is a joker. I said, ‘Your mom didn’t leave you fifty million dollars.’ Then he said, ‘Your mom is dead and my mom is alive.’ I said, ‘Dad, your wife is still alive. My mom is your wife. She’s still alive. Your mother is no longer here.’ He said, ‘No, no, no.’ That’s when I realized he’s really confused. But I really didn’t understand the extent of his confusion. I kept trying to put it off, thinking it was because of the fall or he doesn’t remember because he’s a little old. I guess I was in denial about my dad’s mental state.”

With the appropriate assessment and care plan, delirium can be treated. Fortunately, that’s what happened with Roberto, thanks to the experience and training of Pam Cacchione, Ph, RN, BC, an Advanced Practice Nurse at the Living Independently For Elders (LIFE) program and Director of the Hartford Center of Geriatric Nursing Excellence at the University of Pennsylvania, and nursing student, Ashley King, MSN, RN.

Drawing on their geropyschiatric background, Cacchione and King determined that Roberto was delirious, got him the appropriate treatment, and were ultimately able to have him move into supportive housing.

“My dad got so much support from the nurses and social workers at LIFE,” says Mignonne. “If it had not been for them I wouldn’t have known what to do with him. He probably would have ended up staying in the nursing home permanently.”

Roberto’s story speaks volumes about the importance of geropsych training for health care professionals and the work of nurses. Nurses represent the largest group of health professionals caring for older adults, but most nurses lack knowledge and skills regarding mental health issues in older adults. To address this, the John A. Hartford Foundation funded the Geropsychiatric Nursing Collaborative (GPNC) in 2008 with a grant of $1 million. The aim of this initiative was to improve the education of nurses at every level in the care of older adults suffering from depression, dementia, and other mental health disorders.

To accomplish this goal, GPNC established and disseminated a core set of geropsychiatric nursing competencies for all levels of nursing education. The three leaders of the GPNC—Cornelia Beck, PhD, RN, Louise Hearn Chair in Dementia and Long-term Care and Professor, College of Medicine and College of Nursing, University of Arkansas for Medical Sciences; Kathleen C. Buckwalter, PhD, RN, Professor Emerita, University of Iowa; and Lois K. Evans, PhD, RN, van Ameringen Professor in Nursing Excellence, University of Pennsylvania School of Nursing—together with the GPNC team, including Dr. Cacchoine and Pamela Dudzik, and a host of geropsych and nurse experts—created these core competencies.

A comprehensive set of gero mental health curricular materials can be found on the Portal of Geriatric Online Education (POGOe). POGOe is a free public repository of geriatric educational materials in various e-learning formats, including lectures, exercises, virtual patients, case-based discussions, and simulations. The GPNC materials can be accessed by typing “geropsych” into the search box.

Here’s a video to help access the free, evidence-based materials that you can use in your classroom to better educate students, like Ashley King, to provide high quality, geropsych care to our aging society. And to help those who are really doing the heavy lifting, caregivers like Mignonne.