Research Project: Nurses & Elderly Mental Health

This research project investigates the role of nurses in managing the mental health problems of older patients within the NHS in the UK. The study utilizes an exploratory research design, incorporating both primary and secondary data collection methods. Secondary data was gathered from various sources, including journal articles, books, and online resources. Primary data was collected through a survey of senior management at NHS facilities. Thematic analysis was employed to analyze the qualitative data. The findings highlight the challenges nurses face in this area, emphasizing the importance of their role in educating families, implementing health promotion interventions, and identifying improvements in patient conditions. The research concludes with recommendations for improving nursing training, developing care and recovery plans, and enhancing communication strategies. Areas for further research are also suggested, including exploring nurses' roles in genetic counseling and the use of new technologies in patient care.

RESEARCH PROJECT
ROLE OF NURSES IN MANAGING MENTAL
HEALTH PROBLEMS OF OLDER PATIENTS IN
NHS UK

TABLE OF CONTENTS
CHAPTER 1 - INTRODUCTION AND BACKGROUND............................................................4
Task 1 formulating research specification...................................................................................4
CHAPTER 2- DETAILED LITERATURE REVIEW....................................................................6
CHAPTER 3 - METHODOLOGY..................................................................................................8
Task 2 implementing research project.........................................................................................9
CHAPTER 4- RESULTS OF RESEARCH..................................................................................21
Task 3 evaluating research outcomes........................................................................................21
CHAPTER 5- CONCLUSION AND RECOMMENDATIONS...................................................27
Task 4 presenting the research outcomes..................................................................................29
CHAPTER 6- REVIEW OF METHODOLOGY..........................................................................29
CHAPTER 7- PERSONAL REFLECTIONS...............................................................................31
CONCLUSION..............................................................................................................................32
REFERENCES..............................................................................................................................33

EXECUTIVE SUMMARY
Caring treatment and quality services lies at the heart of the nurse’s role and functions. It
plays significant role in assessing the goals and objectives that were formulated for the sake of
patients and service users. The current research report is about the role of nurses in managing
mental health problems of older patients in NHS. The importance of their role has been assessed
with respect to their roles, duties, responsibilities and challenges that come through their way in
order to achieve the organizational outcome. The whole research report focuses on nurses who
are providing their care and services at NHS, UK.
The topic has been chosen by researcher because role of nurses in managing the mental
health of old age people is very crucial in their recovery and quick care. But, still effective
outcomes of the role of nurses with respect to increasing mental patients who are older in age are
not discovered yet by other researcher. Along with this research also identifies different
challenges that are attained by nurses as a part of their role in health care units.
For attaining all these objectives researcher has followed a specific and appropriate
research methodology. In which study has used exploratory research has been used. For
obtaining useful information research has followed effective primary and secondary data
collection method. Literature view of various historical studies provided a clear insight relevant
to the subject. In order to attain whole objectives researcher has exercised probability sampling
method for selecting sample from NHS. Along with this study has focused on qualitative
research techniques for analysing collected information.

CHAPTER 1 - INTRODUCTION AND BACKGROUND
Care of elderly people has been considered as the best when concern and treatment are
provided at their own homes. Ageing has been identified as the sure aspect which leads to
develop various problems with it. It is same with the elderly people who encountered health
status which demand intensive management. From the time patient is admitted to the hospital, till
the subsequent discharge always remains a challenge. In that case, delivering package of quality
care and treatment always remain a critical aspect (Anstey, 2008). Therefore, nurses plays
significant role that plays their part and parcel in looking after patients and work on delivering
them quick care and treatment for soon recovery. In this regard, mental health problem has also
been encountered. It develops from number of various health issues which are majorly affecting
the health conditions of elderly people (Valente, 2005). In similar regards, there is need to find
out the various roles and responsibilities of nurses in managing mental health problems of elderly
people. The report has been prepared with the intention to assess the roles that are part of nursing
care and treatment. The given research study is on understanding the role of nurses in managing
mental health problems of older patients in NHS UK. Research Project has been covered in four
sections. First section covers the Proposal which depict the outline of research to be undertaken.
Second section is prepared by formulating research specification and using agreed procedures.
Evaluation of research is made in section three. Lastly, section four consists of outcome of whole
study undertaken.
Task 1 formulating research specification
a) Identify and clarity the factors that will help you to choose an appropriate project topic
There is a presence of many factors that is likely to help in choosing any given research
topic. The choice is dependent on how widespread is the issue which would be studied by
researcher. The widespread nature of any topic aids the researcher in choosing the topic area.
The presence of sufficient literature studies done on a particular topic may also help the
researcher in making the choice (5 Important Factors to Consider When Choosing Your
Dissertation Research Topics, 2015). In the same manner, the interest of researcher also plays a
key role towards topic selection. Having prior knowledge on the topic may assist the researcher
towards providing for a quality work. In this respect, the topic that has been selected for the
present study is on understanding the role of nurses in managing mental health problems of older

patients in NHS UK.
 Suitability of the topic: The selection of the topic is required to consider the factor known
as suitability. The selection of proper subject is essential to make the study suitable in the
eye of readers. For the current study, the researchers must take in account the proper use
of selection of factors that are actually valid for selecting topic. The rationale behind
taking this factor to show the effectiveness of selected topic has been justified
 Interesting subject: The topic should be interesting which makes the study appropriate.
According to the current research study, the efforts are infused to investigate the
understanding of the role of nurses in managing mental health problems of older patients
in NHS UK.
 Element for apt literature review: This is another element which proves useful in
selection of research project. Adequate literature was available on the subject matter
concerning the current topic of understanding the role of nurses in managing mental
health problems of older patients in NHS UK.
b) Purpose for your research
The purpose behind choosing the topic is that around a fifth of population that is present
in UK is over the age of 60 years. In this regard the old people tend to suffer from mental health
issues that are normal part of ageing (Mental health problems with the elderly, 2015). The
studies have further found that the majority of elderly do not have mental illness but a minority
of them suffers from the problem (Mental Health Statistics: Older People, 2014). The elderly
may suffer from dementia, experience emotional and psychological stress, loneliness as well as
isolation or loss of a loved one (Depression in Older Adults and the Elderly, 2015). The problem
is that these issues are never incorporated in the medical or health care system. The purpose of
the study is thus to understand the role of nurses in managing mental health problems of older
patients in NHS UK. It is only when there has been an identification of proper role to be played
by nursing staff then proper job related documents are can be given by the nursing staff present
in NHS UK.
Aims
To understand the role of nurses in managing mental health problems of older patients in NHS
UK
Objectives

 To assess the mental health issues suffered by older patients in NHS UK.
 To assess the importance of nurses in managing mental health problems of older patients
in NHS UK.
 To recommend strategies that can be taken by nurses for managing mental health
problems of older patients.
CHAPTER 2- DETAILED LITERATURE REVIEW
c) Preliminary literature review which should include a critique of the key sources identified
A study carried out by Hert and et.al, (2009) on old people with severe mental illness
position concluded that patients suffering from schizophrenia, depression or bipolar disorder,
have other issues in form of worse physical health and reduced life expectancy. Hence, the need
is to make sure that the nurses have a key role to play in this respect. The study recommended
initiating cooperation and carrying out a shared care by diverse healthcare professionals. This
will not only increase the awareness of doctors, nurses and patients about varied mental issues
but also aid the nurses in providing proper care (Hert and et.al, 2009).
A research conducted by a Brown and et.al., (2003) on older patients suffering from
depression concluded that home care nurses face difficulty in assessing symptoms of depression
in elderly patients admitted in care homes. The research was carried out with an aim to
investigate the ability of health care nurses to correctly identify the presence of depressive
symptoms among old people. It has been found in the research that nurses play very critical role
in treating elderly patients with major and minor depression issues. The inability of home health
nurses to correctly identify the psychiatric disorders act as a potential barrier in treating old
patients. Thus the study recommends that employing nurses with skills and geriatric experience
can accurately diagnose symptoms of depression mental disorders in old home care patients
(Brown and et.al. 2003).
The research paper done by Gask and et.al., (2012), features a conceptual care model for
improving access to mental health care patients in United Kingdom. The paper outlined the
importance of quality of care services for healthcare agencies like NHS to effectively treat
patients suffering from depression and other mental disorders. It also highlights the issues of
limited care access to patients as well as efficacy of improved interventions in healthcare models.
Both the factors are critical in treating patients who suffer from severe mental disorders. Poor

interaction with health professionals such as nurses and limited access to care services act as
barriers in treating older patients. The paper also recommends improvements of care services to
effectively treat patients who are diagnosed with mental health problems (Gask and et.al., 2012).
The study carried out by Katon and et. al., (2001), features the development of evidence
based healthcare approach for serving patients with chronic and mental illness. It describes the
importance of care principles that are vital for improving the care services given by the
organized health care organizations. It recommends the reorganization of roles of care
professionals such as specialists, physicians and nurses in order to provide improved healthcare
services to patients suffering from chronic diseases such as depression, diabetes, asthma and
major mental disorders (Katon and et. al., 2001).
The study conducted by Cody, Beck and Svarstad, (2002), highlights that nursing homes
need to apply non pharmacologic interventions while treating problem behavior of care patients.
The article features different internal and external factors that act as barriers to the use of
nonpharmalogical interventions. It highlights the most common cause of mental disorders in
hospitalized elderly people is dementia. The article concludes that there should be effective
communication between physicians, nurses’ directors and monitors in order to fulfill the unmet
needs of patients seeking treatment at hospitals and nursing homes. According to the authors, the
internal and external barriers need to be overcome in order to prevent mental disorders in elderly
patients (Cody, Beck and Svarstad, 2002).
According to a research article by Glover and et.al., (2014), older people with mental
conditions like dementia, delirium and depression are often hospitalized which can further cause
distress and complicate their health problems. General hospitals do not to treat the old people
with psychiatric disorders as they fail to assess their mental health needs effectively. The
research concluded that hospitalized mental patients have several health care needs which need
to be addressed effectively. In order to meet the mental health needs of old patients the care
organizations should restructure the medical, diagnostic and nursing facilities. The study also
evaluated the role of nurses in assessing the care needs of old people by delivering them
comprehensive geriatric assessment.
The study carried out by Cole, (2005), features that 50 percent of elderly patients who are
hospitalized suffer from Delirium. It is a mental disorder that is characterized by memory
impairment, disturbances in consciousness and rapid changes in behavior. Old patients who

suffer from delirium develop dementia at the later stage of life if not treated well. The severity of
the condition increases with prolonged hospital stay and many other factors. The study analyses
the role of nurses in correctly screening the symptoms of delirium in the affected patient. The
study recommends the systematic detection of the condition at an early stage that can be
beneficial for the old patients in initiating the treatment (Cole, 2005).
CHAPTER 3 - METHODOLOGY
d) Chosen methodology with justification
 Research design: Exploratory research design has been chosen for the study as there is a
dearth of literature on this topic. Moreover, the issue is yet to be explored by the
researchers in terms of understanding the role of nurses with respect to handing older
patients suffering from mental problems (Kelly and Lesh, 2012).
 Secondary data collection: The data collection will be done by secondary literature. Here,
newspaper articles, online reference, books as well as journal articles on role of nurses in
managing mental health problems of older patients will be referred. The choice is
justified as secondary collection will assist in judging the importance of nurses as well as
varied kinds of mental problems faced by older patients.
 Primary data collection: Survey session will be carried out on senior management who
work with elder patients in NHS. Week, in this regard, open and close ended question set
will be sent to them. Questions will be asked with respect mental health problems faced
by older patients as well as what role nurses can play in older patient management with
respect to mental health issues. The selection has been justified so as to assist in
analyzing the views of senior management with respect to nurse role in treating older
patients suffering from mental issues. Sample technique will be convenience sampling so
as to ensure towards convenient accessibility and proximity to the researcher.
 Data analysis: Thematic analysis will be used for the study where there would be
identification of themes (Pittenger, 2003). The selected technique has been justified due
to secondary nature of study topic.
e) Develop an action plan
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Deciding
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Task 2 implementing research project
a) Carrying out a literature review (secondary research)
Mental health issues suffered by older patients in NHS UK
According to Moula, Mumu and Flora (2011), mental health is inclusive of various

symptoms and diagnosis. This covers depression, phobias, compulsive disorder, schizophrenia,
eating or personality disorder, etc. As stated by the World Health Organization (WHO), mental
health is not only regarding the absence of mental disorder. They have defined this as the state of
well-being in which every human being recognizes his or her own potential (Moula, Mumu and
Flora, 2011). It is in order to cope with the normal stresses of life so that work can be done
fruitfully and productively by their own. With respect to the older people who are suffering from
mental health issues, there are various problems which are affecting their health. At NHS, older
adults are facing various forms of mental health issues. According to Sartorius (2002), role of
nurses is significant in managing and providing effective care and treatment to the elderly people
suffering from mental ill health (Sartorius, 2002).
As stated by Raue (2011), old age people are mostly found to be suffered from the
depression. It is a fact that this is characterized as a normal disease which grows with the age. It
is also identified as a medical illness which is under-treated and under recognized. The
development of depression is generally seen with the serious illness issues such as Parkinson's
disease, heart issues, stroke, diabetes etc (Raue, 2011). It has been diagnosed that number of
older age people are facing the problem of illness due to social or economic challenges (A
Framework for Mental Health Nurses, 2006). Job of nurse is essentially required to understand
these issues so that they may not take them to further harm. This is essential so that it may not
lead to further worsen the prevailing situation of older people and to the existing health status.
Role of nurses in managing mental health problems of older patients at NHS UK
Major role lies in providing high quality nursing care irrespective of kind of mental
health issue elderly people is facing. It should be stable and consistent for all the older people
irrespective of kind of mental health issue they are suffering from. According to Aparasu et al
(2014), in the field of gerontological dimension of providing nursing, the role of nurses should
focus on quality treatment and care. In UK, the proportion of elderly individuals is growing at a
fast rate. In contrary to same, there arise various problems where handling of older people
becomes unmanageable due to psychological challenges and difficulties (Aparasu et al., 2014).
The role of nurses highly depends on the skills and abilities of the nurses which tends them to
address the issues that are faced by the older people.
According to Dallaire et al (2008), role of nurses is to serves the mental nursing of the
elderly people focus on providing care. Their major work is to promote the psychological and

emotional well being of the older people. By communicating with them, they understand mental
health conditions which patients are going through (Dallaire et al., 2008). Along with this, they
play role of identifying the symptoms and plan strategies to get aware regarding exacerbate
mental health conditions of the patients.
In the similar fashion, Kå mpf (2009) asserted that nursing of mental health work includes
taking care of the clients or elderly people who are victim of issues such as depression, anxiety,
bi polar disorder and schizophrenia. Therefore, it can be said that role of nurse is interesting and
varied (Kå mpf, 2009). In a streamline of various job roles which they are required to do consists
of mental health promotion and prevention, direct nursing care, training and education, specialist
mentoring and psychotherapy, etc.
As stated by Li and McLaughlin (2011), nursing role at NHS have been acquired through
clinical practices which are raised through two levels. These are basic and advanced. They
commence work at basic level where work is carried out through the individuals, families and
communities (Li and McLaughlin, 2011). The activities are comprises of interventions for
assessing mental health of elderly people, and improvement of their disability (Elderly Patients
in Hospital, 2015). Furthermore, interventions are inclusive of health promotions, management
of preventive actions for psychiatric mental well being. Moreover, it takes into account,
administering and monitoring treatments for psycho-biological regimens.
According to views shared by Bali et al (2014), nurses play integral role of bringing
improvement in medicines quality and care. They are inclined and are responsible for monitoring
and administrating medication. This includes practices of self-management of in taking of
medications (Bali et al., 2014). Along with this, they are also responsible for meeting the regular
needs and habits of the old age people.
In the words of D'Onofrio (2007), mental health nursing of old age people are required to
be met through standards at NHS. These are inclusive of specific follow up of both prevention
and interventions up-to elderly people care and treatment level. Understanding the phenomenon
of happening of any kind of uncertain event is required to be effectively assessed (D'Onofrio,
2007). The role of nurse is highly inclined in management and review of risk associated events
while taking care of the old age mental patients.
Along with this, Chatterjee et al (2014) stated that nurses are also responsible for
managing the old age person's reaction, attitude and beliefs. Since nurses are the carers who

spent maximum of time with the patients and old age people. Therefore, they can well work to
demonstrate the Root Cause Analysis and Failure Mode and Effect Analysis (FMEA) in reducing
the impact of the happening of worst situation (Chatterjee et al., 2014).
Nurses who are taking care of elderly people suffering from mental ill health plays role of
maintaining and developing a therapeutic and collaborative relationship with the patients. Hence,
as a part of their job role, it becomes imperative for them to have interacting time with them
where they grasp the way in which they can share from them their psychological pain and
respect. They serve those older age people by planning the realistic assessment schedule. There
is need for them to make use of clinical reasoning where they can work to determine the care
priority along with two chief aspects namely, reporting and documenting.
As specified above and correlated with the views shared by Van Mierlo et al (2015),
nurses spent maximum time with patients. Therefore, they can effectively provide information
and communicate the risk associated with the treatment plan with the management of the
organization (Van Mierlo et al., 2015). The information are inclusive of related risk and
protective factors, mental status of old age people, current triggers that activate the feeling of
distress in them etc.
In a streamline, as specified by Ayalon et al (2010), mental nursing care has been
required to consider the most vital aspect of providing care with respect to human rights as well.
It must be effectively taken care that none of the action of the nurse may not cause harm to old
age people. It should be in relation to both psychological and physical harm as well. All the
respective provisions of care must ensure maximization of human freedom and liberty (Ayalon et
al., 2010). These are required to be maintaining at-most. The duty of nurse should ensure
responsibilities that should not compromise with the safety of the individual or older patient.
Strategies that can be taken by nurses for managing mental health problems of older patients
Taking care of patients who are facing the issues regarding old age and mental ill health
are required to be assisted through care and treatments. However, with the number of increase in
people who are rising with the dilemma of poor mental status calls for a need of strategic
planning. Care strategies can be planned with respect to improvise the quality care and treatment.
As stated in the words of Chalise (2014), in light of developing the ways in which nurses are
required to monitor the functions of older people. There have been authors who studied that
maintaining the daily routine of human being suffering from ill health is one way to maintain the