Plato's theory about psychodynamic forces is used to develop a holistic model for nursing practice. The dysphoric emotional state of demoralization is conceptualized as an imbalance between Spirit, Appetite, and Reason. Interventions are designed for elderly clients who show objective and subjective signs of demoralization. The objective indicators are measured with the Psychiatric Epidemiological Research Interview (PERI), before and after the implementation of individualized interventions. Results for the 23 subjects who completed the study in an assisted-living environment are suggestive of the effectiveness of basic nursing interventions in remediating the symptoms of demoralization. Plato's model of the psyche is an elegant, yet simple, conceptual tool for understanding the mental health needs of clients.
Get full access to this article
View all access options for this article.
References
1.
Aasen, N. (1987). Interventions to facilitate personal control. Journal of Gerontological Nursing, 13(6), 20-28.
2.
Austin, A. (1989). Becoming immune to loneliness: Helping the elderly fill a void. Journal of Gerontological Nursing, 15(9), 25-28.
3.
Beisecker, A. (1988). Aging and desire for information and input in medical decisions: Patient consumerism in medical encounters. Gerontologist, 28, 311-317.
4.
Berkowitz, M., Waxman, R., & Yaffe, L. (1988). The effects of a resident self-help model on control, social development, and self-esteem among the elderly. Gerontologist, 28, 620-624.
5.
Brooke, V. (1987, July/August). The spiritual well-being of the elderly. Geriatric Nursing, pp. 194-195.
6.
Burris-Bammel, L., & Bammel, G. (1985). Leisure and recreation. In J. E. Birren& K. W. Schaie (Eds.), Handbook of the psychology of aging (pp. 848-863). New York: Van Nostrand Reinhold.
7.
Cornford, F. (1964). The republic of Plato (24th printing). New York: Oxford University Press.
8.
deFiguerio, J., & Frank, J. (1982). Subjective incompetence: The clinical hallmark of demoralization. Comprehensive Psychiatry, 23, 353-363.
9.
Dohrenwend, B. P., Shrout, P. E., Egri, G., & Mendelsohn, F. (1980). Nonspecific psychological distress and other dimensions of psychopathology measures for use in the general population. Archives of General Psychiatry, 37, 1229-1236.
10.
Dossey, B., Keegan, L., Guzzetta, C., & Kolkmeir, L. (Eds.). (1988). Holistic nursing: A handbook for practice. Rockville, MD: Aspen.
11.
Eliopoulos, C. (1990). Caring for the elderly in diverse care settings. Philadelphia: J. B. Lippincott.
12.
Emery, C., & Blumenthal, J. (1990). Perceived change among participants in an exercise program for older adults. Gerontologist, 30, 516-521.
13.
Frank, J. (1973). American psychotherapy in perspective. In persuasion and healing. Baltimore and London: Johns Hopkins University Press.
14.
Frank, J. (1974). Psychotherapy: The restoration of morale. American Journal of Psychiatry, 131, 271-274.
15.
Huss, M., Buckwalter, K., & Stolley, J. (1988). Nursing's impact on life satisfaction. Journal of Gerontological Nursing, 14(5), 31-36.
16.
Klein, D., Gittleman, R., Quithin, F., & Rifkin, A. (1980). Diagnosis of affective disorders: Clinical considerations. In D. Klein& J. Davis (Eds.), Diagnosis and drug treatment of psychotic disorders: Adults and children (2nd ed., pp. 228-251). Baltimore, MD: Williams and Wilkins.
17.
Koenig, H., George, L., & Siegler, I. (1988). The use of religion and other emotion-regulating coping strategies among older adults. Gerontologist, 28, 303-310.
18.
Marin, R. (1990). Differential diagnosis and classification of apathy. American Journal of Psychiatry, 147(1), 22-30.
19.
Nadzam, D. (1986). Depression and demoralization of the aged. Unpublished doctoral dissertation, Case Western Reserve University, Cleveland, OH.
20.
Nelson, P. (1990). Intrinsic/extrinsic religious orientative of the elderly: Relationship to depression and self-esteem. Journal of Gerontological Nursing, 16(3), 29-35.
21.
Ross, H. (1990, November/December). Lesson of life. Geriatric Nursing, pp. 274-275.
22.
Ryden, M., & Knopman, D. (1989). Assess not assume: Measuring the morale of cognitive impaired elderly. Journal of Gerontological Nursing, 15(11), 27-31.
23.
Shrout, P., Dohrenwend, B. P., & Levav, I. (1986). A discriminant rule for screening cases of diverse diagnostic types: Preliminary results. Journal of Consulting and Clinical Psychology, 54, 314-319.
24.
Wells, L., & Singer, C. (1988). Quality of life in institutions for the elderly: Maximizing well-being. Gerontologist, 28.
