Cognitive Behavioral Therapy for Depression in Dementia Patients

Running head: NURSING
Evidence Based Nursing Research
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1NURSING
PART B
Mr. X is an 82 years old retired high school teacher. He was living with his wife. 5 years ago he
diagnosed with initial stage of dementia and depression. Doctors prescribed some basic level
medications and some regular activities. His wife monitored and assessed his disabilities and
treatment. Few months ago his wife died leaving him with high depressed and traumatized state.
After his wife’s death he is experiencing consistent agitation during day time with frequent
breathlessness. They did not have any children. One of his relatives consulted with a home centre
care association to provide regular assessment and support. However, the breathing problem of
Mr. X was deteriorating with frequent agitation and panic attack. After admitting him to a Aged
care home. He refused to talk or move. When any caregiver or nurse is trying to help him, he is
shouting with fury. He has Blood pressure of 130/85, which is quite higher than normal and
BMI of 29 that indicates the Obesity. Mr. X also has mild bronco infection and dust allergies that
trigger his Asthma and breathlessness. He is also suffering from memory loss while having
problem to find direction.
It has been estimated that almost 50% of individuals suffering from dementia are
subjected to increased risk of depression. In patients suffering from dementia, depression is a
prime cause of poor quality of life that profusely worsens the symptoms of dementia. The
ultimate result of such decline in the patient’s condition leads to increased burden on the care
giver. Anxiety has been denoted to be the most common symptom of depression among
dementia patients, which has varied negative symptoms. In relation to the influence of the
depressive conditions, there is a large pool of literature that point out that severity of depression
is directly linked with dementia progress (Yoon et al. 2018). The primary outcomes of
depression and anxiety in dementia are decreased dependence, increased risk of hospital

2NURSING
readmissions, and comorbid physical conditions. Studies have indicated that the frequency of
depressive symptoms might vary from one person to another as a function of the severity of
dementia. For instance, experiences of depression are more common in those dementia patients
who are at the later stages of life (Stewart et al. 2018). In the present case the patient is 82 years
old and thus is at increased risk of suffering depressive symptoms. It was therefore perceived
significant to consider focus on intervention for addressing depression in the patient and enabling
improved quality of life.
Results of clinical trials that have been so far been conducted to assess the efficacy of
anti-anxiety drugs and anti-depressant drugs indicate that the same do not hold much potential to
relieve the individual of depressive symptoms. This background information puts forward the
pressing need of implementing alternative effective treatments for addressing depression and
improving quality of life in dementia patients (Payne 2017). As opined by Stokes (2017) the
primary psychotherapeutic approaches to address depression in older adults are interpersonal
therapy, psychodynamic therapy, supportive counselling and cognitive behavioral therapy
(CBT). Previous research brings to the conclusion that psychotherapy delivered to older adult is
noteworthy since there is promotion of general psychological well being along with
improvement in depression. Most of the psychotherapies have the focus on dysfunctional beliefs
and incorporation of behavioral therapy components so that negative cognitions in patients can
be challenged. Cognitive behavioral therapy (CBT) has been the most widely discussed
therapeutic approach in theory and practice. What lies at the core of CBT is monitoring and
identification of thoughts and behaviors that are the contributory factors to anxiety and
depression. Modifications of CBT can be brought about for targeting patients suffering from
mild to severe dementia in later stages of life. The aim of such an approach is to bring reduction