[Psychosocial and caring issues with a bipolar disorder senior inpatient during a manic episode]

This case analysis focuses on a male elderly inpatient with bipolar disorder during an acute manic episode. During the case's 3-week hospitalization, we used a participant observation approach to provide individualized nursing care. Our nursing assessment focused on linking this case's manic symptoms and psychosocial issues. Based on a content analysis of our nursing process record and the five psychosocial issues of elderly bipolar disorder reported by Reiser et al (2008), five major themes were presented. These themes included indulging the memory of youth-hood (cohort beliefs); presenting his old but still strong physical function (physical health); making an attempt to learn and showing the ability (socio-cultural context); providing working expert service and ability (transition in role investments); and playing a positive role as a warm-heartedness senior person (intergenerational relationship). This case's manic symptoms and psychosocial issues showed that he wished to perform as a young man to compensate for his ageing physical state and psychological loss, which revealed he want to maintain his social value. In view of the nursing intervention for this case during the acute manic state, we needed to pay attention to preventing the patient from physical overexertion and falls. We further needed to remind him to drink sufficient water, eat food, and take adequate rest. When the acute symptoms were in remission, we tried to empathize with and understand his psychosocial issues and self-concept and to help him integrate his illness and life experience to accomplish the elderly development task.