Aging and Mental Health Current Challenges in Long Term Care

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Aging and Mental Health Current Challenges in Long Term Care Stephanie Saur & Christina Pacheco Acute Care Behavioural Consultants Alzheimer

It affects how we think, feel, and act. It also helps determine how we handle stress, relate to others, and make choices.

1 Aging and Mental Health Current Challenges in Long Term Care Stephanie Saur & Christina Pacheco Acute Care Behavioural Consultants Alzheimer Society Peel What is Mental Health? Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, and act. It also helps determine how we handle stress, relate to others, and make choices. It is more than the absence of a mental illness Mental health and physical health are interconnected and seniors often report physical symptoms, rather than symptoms of poor mental health 1

Mental Disorder A mental disorder causes major changes in a person s thinking, emotional state and behaviour, and

2 What are Mental Health Problems A mental health problem is a broad term It includes both mental disorders and symptoms of mental disorders that may not be severe enough to lead to a diagnosis of a mental disorder What is a Mental Disorder A mental disorder causes major changes in a person s thinking, emotional state and behaviour, and disrupts the person s ability to work and carry out their usual personal relationships. -Mental Health First Aid,

3 Mental Health Continuum Activity Mental Health In LTC Currently, 20% of those aged 65 and older are living with a mental illness (MacCourt, 2005).* It has been reported that 80%-90% of nursing home residents live with some form of mental illness and/or cognitive impairment (Rovner et al., 1990; Drance, 2005).* Growing clinical experience and research indicates that many of the mental health issues of late life can be improved and functional decline can be slowed down if symptoms are promptly assessed and treated* Like people of any age, older people deserve appropriate care and treatment 3

their community Social Health Seniors with small social networks are more vulnerable to poor social health Socially

4 Social Health Refers to an individual s ability to positively interact with others A socially healthy senior can: Form secure and meaningful relationships with others Socialize and make friends Give and receive emotional support Engage in their community Social Health Seniors with small social networks are more vulnerable to poor social health Socially unhealthy seniors can become anxious and/or depressed Socially isolated seniors may become more at risk for mental health disorders and suicide 4

5 How disabling are Mental Health Problems? How disabling are Mental Health Problems? Gingivitis Mild asthma Low back pain, uncomplicated diabetes Mild depression, epilepsy Mild/moderate panic disorder Anorexia, mild/moderate obsessive compulsive disorder, non-invasive breast cancer Moderate depression, severe asthma, complete hearing loss, chronic hepatitis B Infection Severe vision loss, operable small cell lung cancer Severe post-traumatic stress disorder, paraplegia Severe depression, brain injury with permanent impairments Severe schizophrenia, quadriplegia, end-stage Parkinson s disease, severe dementia 5

6 Stigma and Mental Health Stigma refers to the negative attitudes (prejudice) and negative behaviour (discrimination) towards individuals with mental health disorders Stigma is associated with the mistaken perceptions of the individuals with a mental illness Personally weak or to blame for their illness Dangerous or likely to become violent Unpredictable or difficult to interact with Unlikely to recover even with treatment 6

seniors based solely on their age Seniors with mental health problems also

7 Imagine if we treated everyone like we treat people with mental illness Stigma and Ageism Ageism is defined as the stereotypes and prejudices applied to seniors based solely on their age Seniors with mental health problems also face the stigma of ageism Seniors symptoms are often attributed to just getting old 7

Refers to a number of symptoms that must be present during most of the day, nearly every day for at least two

8 Mental Health Disorders in Long Term Care Major Depressive Disorder Anxiety Psychosis Mental Health and Dementia Signs and Symptoms Strategies and Resources What is a Major Depressive Disorder? Refers to a number of symptoms that must be present during most of the day, nearly every day for at least two weeks A major depressive episode is characterized by either: A depressed mood and/or loss of interest or enjoyment in nearly all activities 8

Signs and Symptoms of Depression Sadness or feelings of despair Unexplained or aggravated aches and pains Loss of interest in socializing or hobbies Weight loss or loss of appetite Feelings of

9 Signs and Symptoms of Depression Sadness or feelings of despair Unexplained or aggravated aches and pains Loss of interest in socializing or hobbies Weight loss or loss of appetite Feelings of hopelessness or helplessness Lack of motivation and energy Sleep disturbances (difficulty falling asleep or staying asleep, oversleeping, or daytime sleepiness) Loss of self-worth (worries about being a burden, feelings of worthlessness or selfloathing) Slowed movement or speech Increased use of alcohol or other drugs Fixation on death; thoughts of suicide Memory problems Neglecting personal care (skipping meals, forgetting meds, neglecting personal hygiene) Anxiety Disorders Anxiety is a state of worry or unease. It is a normal feeling that everybody experiences at some time, and can range from unpleasant to intolerable and even uncontrollable Anxiety Disorders differ from normal anxiety as they are: More severe or intense Long-lasting Interferes with the person s ability to function Happens when a person is not in a state of danger Sometimes, anxiety disorders are triggered by a specific event or stressful life experience. 9

Signs and Symptoms of Anxiety Psychological Symptoms Physical Symptoms Excessive inappropriate worry Fear of impending doom or

down Irritability Insomnia, and/or vivid dreams Specific phobias Chest pain, heart palpitations, and rapid heart rate

Nausea, vomiting, and Diarrhea Muscle aches and pains Tenseness and restlessness Psychosis Causes a senior to lose some touch with

10 Signs and Symptoms of Anxiety Psychological Symptoms Physical Symptoms Excessive inappropriate worry Fear of impending doom or danger Fear of dying or going mad Fear of falling Trouble concentrating and maintaining focus Thoughts seem to speed up or slow down Irritability Insomnia, and/or vivid dreams Specific phobias Chest pain, heart palpitations, and rapid heart rate Hyperventilation or shortness of breath Dizziness, headache, vertigo Tingling or numbness of the skin Choking sensation, dry mouth Nausea, vomiting, and Diarrhea Muscle aches and pains Tenseness and restlessness Psychosis Causes a senior to lose some touch with reality May be expressed chronically or in episodes Significantly changes the way a senior feels, thinks and acts Seriously disrupts a seniors life 10

Signs and Symptoms of Psychosis Positive Symptoms: thoughts, feelings or behaviours that are not normally present but which have been added or distorted as a result of the mental health problem

Symptoms: changes that diminish functioning They are thoughts, feelings or behaviours that are normally present but which are lost or reduced as a result of a mental heath problem Includes: cognitive

11 Signs and Symptoms of Psychosis Positive Symptoms: thoughts, feelings or behaviours that are not normally present but which have been added or distorted as a result of the mental health problem Delusions: fixed false beliefs that are not open to change Hallucinations: impaired sensory perception (senior sees, hears, smells, tastes or feels something that his not actual there) Negative Symptoms: changes that diminish functioning They are thoughts, feelings or behaviours that are normally present but which are lost or reduced as a result of a mental heath problem Includes: cognitive impairment, disorganized behaviours, blunted emotions, social withdrawal and loss of drive A significant loss of intellectual abilities and memory capacity severe enough to interfere with social and/or occupational functioning It is a set of symptoms that includes impairment of: Attention Orientation Memory Judgement Language Motor and spatial skills Ability to function What is Dementia? 11

12 ABC of Brain Function 12

Dementia and Mental Health The relationship between all forms of dementia, mild cognitive impairment (MCI) and mental health problems is complex.

13 Dementia and Mental Health The relationship between all forms of dementia, mild cognitive impairment (MCI) and mental health problems is complex. Some symptoms of dementia and depression for instance- including withdrawal from social activities and general apathy- are very similar This can sometimes lead to misdiagnosis. Two conditions can be present concurrently, which can also complicate identification. Mental health in later life is shaped by the experiences lived through to this point, the social, economic and physical environments in which people live and is influenced by pressure points and experiences such as retirement, bereavement or a deterioration of physical health Strategies to Support Assess the risk of safety, harm and physical deterioration Assess the immediate and long term risks Evaluate the situation before taking a course of action Validate and listen non-judgmentally It takes real concentration and open-mindedness to hear another individuals perspective It means being flexible with your own thinking and being willing to shift from your point of view to hear another's sense of reality 13

health problem Support and encourage the individual to access that support Encourage activities that instill

14 Strategies to Support Facilitating access to information and professional resources Help the individual identify the most appropriate professional person/service that can assist them with their particular mental health problem Support and encourage the individual to access that support Encourage activities that instill a sense of purpose Foster a sense of belonging through strengthening cultural, spiritual and religious connections 14

15 References Thank You 15

Mental Health 101. Workshop Agreement

Mental Health 101. Workshop Agreement Mental Health 101 June 9, 2017 Workshop Agreement Take ownership of your own learning Ask questions Feel free to share safe environment Request an example Be mindful of the different learning styles of