Nurses in the Prevention and Control of Indiscriminate Use of Neuropsychopharmaceuticals in the Elderly

PRAIA Raquel de Souza^1*, RIBEIRO Euler Esteves², MAIA-RIBEIRO Ednéa Aguiar³, ARAÚJO Arthenize Riame Praia, G. C.⁴, ONETI Ciro Felix⁵, NETA Inez Siqueira Santiago⁶, MUNIZ Orleilso Ximenes⁷, BORGES Helyanthus Frank da Silva⁸, FREITAS Alexandre Gama⁹, NASCIMENTO João Batista do¹⁰, AZEVEDO Midian Barbosa¹¹, CUNHA Fabrícia da Silva¹¹, SOUSA Warllison Gomes de¹²

¹Coordinator of the Biosafety Nucleus of CBMAM (Amazon Military Fire Department), Health Officer - Nurse, Master in Gerontology-UFSM
²PhD in Gerontology from PUC-RS; Rector of FUnATI (Open University Foundation for the Elderly)
³Co-advisor of the Saúde em Casa FUnATI/UEA Project, Physician, PhD in Physical Activity and Sport Sciences
⁴Nurse from Universidade Paulista (UNIP/AM), former member of the Saúde em Casa Project UNATI/UEA, Nursing Technician at EBSERH/HUGV-AM
⁵Master in Science Education in the Amazon by UEA, Nurse by EEM/UFAM, Research Assistant at FUNATI
⁶Nurse by EEM/UFAM, Research Assistant at FUnATI/UEA
⁷Colonel QOBM, General Commander CBMAM, Spec. in Public Safety
⁸Colonel QOBM, General Deputy Commander of CBMAM, Spec. in Public Safety
⁹Colonel QOBM, Chief of General Staff (CHEMG) of CBMAM, Spec. in Public Safety
¹⁰TC, director of DS at CBMAM, Specialist in Public Security by UNINA and graduated in Mathematics by UEA
¹¹3^rd Sgt QCPBM, Member of the CBMAM Biosafety Nucleus, Esp. in Public Safety
¹²Corporal QPBM, Member of the Office of the General Commander of CBMAM, Specialist in Public Security; Member of the CBMAM Biosafety Center

*Correspondence to: Dr. PRAIA Raquel de Souza. Open University for the Elderly (UnATI/UEA). Av. Brazil, s/n. compensates.

Copyright © 2023 Dr. PRAIA Raquel de Souza, et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Introduction
For human survival, it is essential to eat well and this is an activity that is related to environmental, physiological and even psychological. The educational habits acquired throughout the life and that began in the childhood of this special elderly person or any Other someone else, are continually reinforced by the fact that eating is a routine activity. Clarify the eating behavior of a person is fundamental for understanding their personal dynamics [1].

It is natural for the human body to undergo physiological changes with the over time, as aging is a natural process and the ideal is that it occurs with quality and actively. unfortunately that neither is always achieved and some elderly people start to face serious limitations in various aspects of your health and performance of activities 2. This also applies to nutritional issues and raises concerns among the nursing professionals who assist them. investigations arise based on clinical knowledge and critical thinking to try to unravel possible causes for these issues, since the changes in the nutritional status of the elderly are an inseparable element of the process normal aging [2].

It is increasingly common to find elderly patients with of mental disorders, it is necessary to develop a strategy comprehensive holistic care and with the participation of the entire team multidisciplinary. Depression and dementia are disorders often found in this segment of the population and are capable of causing great damage that subtract much from the autonomy and independence of the elderly, which directly affects their good nutrition [3].

The importance of food for the health of the elderly and the amount of nutrients and cholesterol need to be well balanced to avoid the initiation or potentiation of any process pathological. More and more dietary supplements are gaining prominence and being used in the daily use of the elderly, which requires attention and care on the part of nursing, which needs to guide well the patient about products that make a lot of promises [4].

Pharmacological treatments in the elderly presente peculiarities that must be known, because this population faces the occurrence of changes in response, drug interactions and greater susceptibility to side effects. There are changes in pharmacokinetics and pharmacodynamics providing interactions each increasingly serious and frequent among drugs and this largely due to the usual multimorbidity and polypharmacy that affect this age group. These events contribute to an increase in iatrogenic events, lower adherence to treatment and more side effects and/or adverse effects [5].

Methods
This research consists of a bibliographic review, in which information relevant to the subject was gathered and discussed regarding its applicability in the setting of care for the elderly. The information was summarized and are presented in the form of topics in this article.

Goals
1. Know more about the nutritional conditions of elderly individuals who have limitations in their lives related to psychiatric disorders at varying intensities.
2. Contribute to the generation of health research and literature about the beware of this category of patient. Disseminate up-to-date information and relevant data on the nutritional status of these patients.

Results
1. Nutrition as a basis for a healthy life

The basal metabolic rate is the amount of energy that the body requires to carry out its life-sustaining activities, such as circulation, maintaining temperature, breathing and heart rate.

The cells, tissues and organs of the human body only carry out functions necessary to maintain life if they receive their daily contribution of energy, which is obtained through food rich in nutrients. It is essential to have guarantees of food security for the elderly in their family environment, especially if he has special needs in the psychosomatic scope, that is: to ensure that he enjoys a style healthy lifestyle based on the consumption of healthy foods and nutrients in adequate amount. The issue of food may have still a very marked symbolic meaning, depending on the origins ethnic origins or traditions of the individual and many celebrations, festivals, traditions, religious ceremonies and events place a high value on the presence or correlation with some specific type of food [6].

Nurse Florence Nightingale considered the role of the nurse in what she called the science and art of eating, this guaranteed the category of nursing a role that has been perfected and within the branches of nutrition and diet therapy. Maintaining a relationship trust with the client, the nursing professional, as well as the physician and the nutritionist, will be able to develop an adequate counseling in nutritional therapy to allow the patient to prevent or control of certain conditions, such as type I diabetes mellitus. And some pathologies require a special diet with certain restrictions, or even different forms from offering nutrition to the body, which can be achieved, for example, with a nasogastric tube [6].

2. Good nutrition undermined by the impact of a mental disorder

The demographic transition phase that Brazil is going through has contributed to the fact that it is an increasingly frequent reality to find elderly people with mental disorders3. Being the majority aware of the extent to which this type of disorder can impair autonomy and the independence of the individual, we correlated this category of weaknesses with the impact that can be caused on the aspect of nutrition of the elderly patient. Depression and dementia are two very common diagnoses commonly found in this public and specialists in gerontology, in a way, fear the great impact that can be experienced by relatives of the elderly person who has these or other psychiatric syndromes [3].

It is known that these clinical conditions can further burden family caregivers and therefore decrease the quality of care received. Elderly people with depressive disorders or dementia have their reduced mobility, your hygiene declines considerably, increases the risk to suffer an act of violence, are more often affected by falls, may have more pressure ulcers, less adherence to treatments pharmacological drugs prescribed for their comorbidities [7].

In addition to all these factors, such geriatric patients are at a higher risk of suffering from food deprivation. As for the functional alterations of the organism, they can, for consequence of the psychiatric disorder, having their aging process harmed. Therefore, more frequent cases such as the presence of cavities and fallen teeth, poor oral hygiene, sarcopenia, anorexia, binge eating feed, etc [2].

One should also be aware of possible interactions medications with certain foods, in addition to the risks of polypharmacy, a very common aspect in this age group. Even research indicates that tricyclic antidepressants are not ideal medications for the elderly, as their adverse effects are very strong.

Conclusion
It is essential to become familiar with the scales and instruments of geriatric assessment available, as such resources direct us following a more competent and accurate investigation into the state nutrition of the elderly. It is also necessary to understand changes in the pathophysiology of the elderly, which are often associated with nutritional deficits in cases where the aging process is not working satisfactorily.

The pathophysiological changes may also, in most cases, be involved in the genesis or accentuation of mental disorders, and these therefore tend to generate or aggravate a case of malnutrition.

Good articulation between health professionals and maintenance of a good relationship with the patient’s family guarantee a greater adherence to nutritional care. This precaution is very important. because it strengthens the body and makes it more resistant against different types problems such as pressure ulcers, low immunity and loss of muscle mass.

Proposal
Team members need to be empowered in health, particularly the nurse, so that there is greater ease to address issues related to the most basic levels of health in elderly population, such as nutrition. And this factor often ends up being complex to evaluate due to the many difficulties that are imposed by the environment in which the elderly live, in addition to their underlying illnesses. currently the malnutrition is becoming an increasingly rare problem in our country, more still persists, and our demographic transition is exposing some of the elderly members to this kind of health problem.

Bibliography

1. Cordás, T. A. & Kachani, A. T. (2010). Nutrição em psiquiatria. Porto Alegre: Artmed.
2. Manso, M. & Biffi, E. (2015). Geriatria Manual da LEPE (Liga de Estudos no Processo de Envelhecimento). São Paulo: Martinari.
3. Osvaldo, P. A. (1999). Idosos atendidos em serviço de emergência de saúde mental: características demográficas e clínicas. Revista Brasileira de psiquiatria.
4. Ruiz, J. S. (2006). Psicofarmácos em geriátria. Madri: Ars Medica.
5. Eliopoulos, C. (2014). Enfermería Gerontológica. 8a Ed. Espanha: Wolters Kluwer Health.
6. Potter, et al. (2013). Fundamentos de enfermagem. 8a Ed. Rio de Janeiro: Elsevier.