Understanding Personality Disorders in Older Adults

 
Personality disorders in
Older Adults
 
Tier 1
 
What is personality?
 
The 
word ‘personality’ refers to the collection of characteristics or
traits that we have developed as we have grown up and which
make each of us an individual. These include the ways that we:
think
feel
behave
 
I
ndividuals with Personality disorders/
complex emotional needs
 
 
Personality disorder refers to pervasive disturbances within a person’s personality
and behaviour, which can make it difficult for them to live with 
them
selves
and/or other people an
d negatively 
impacts on their social functioning and
relationships.
 
Personality disorders can have a significant impact the ability to respond to life
stresses.
 
People with a personality disorder can feel stigmatised because of this diagnosis
and some prefer the use of the term having complex emotional needs instead
 
Prevalence of personality disorders
 
 
Older adults are less likely to attract a diagnosis of
“personality disorder”
​ so exact prevalence is unknown
 
Prevalence could be around  10% of an older community
population
 
 
 
Types of Personality disorders
 
P
ersonality disorders tend to fall into three groups, according to their
emotional 'flavour':
 
Cluster A: 'Odd or Eccentric’  - 
seem to remain stable as one gets
older
 
Cluster B: 'Dramatic, Emotional, or Erratic’- 
tend to decrease as one
gets older
 
Cluster C: 'Anxious and Fearful’- 
seem to remain stable as one gets
older
 
 
Personality changes causes
 
Recent personality changes can be due to the following reasons so ensure
the following reasons are investigated
Medical or organic cause
Cerebrovascular event
Infection (i.e.,meningitis)
Head Trauma
Brain tumour
Dementia
Prescribed Medications
 Steroids
Mental illness
Depression/Mania
Illegal drugs and/or alcohol
 
Reasons for presentations
 
Reasons for presentation in later life with personality disorder could be
due to the following reasons:
 
The person may lose a significant other who has contained or
compensated for the personality disorder
A move to long term care
Loss of a stabilising situation
Increased use of alcohol and prescription drugs
Retriggering of trauma
Bereavement and losses including loss of jobs/ roles
Difficulty in adapting to ageing
 
Challenges
 
for the older adult
 
Challenges faced by older adults with personality disorder includes
Worse physical functioning
Greater use of medications including opioids, benzodiazepines
More unstable/brief relationships and poor social network
M
ore likely to have other mental health difficulties, like depression
and anxiety
Increased chances of being discharged to a residential placement and
ongoing challenges with forming relationships with carers
Less responsive to treatment 
for
 
any of their other 
mental illnesses
Older adults with Personality Disorder make up 44% of completed
suicides
 
Challenges for the caring teams
 
Challenges faced by the 
teams caring for older adults with personality
disorder include:
Staff receive a lot more calls from this cohort
They may repeatedly ask for prescription medication
They may have frequent attendances to A&E departments
The increased 
expression of psychological distress in the form of
physical health symptoms (somatization)
 and demands for care from
staff/family can lead to team frustration and longer hospital
admissions
They create splitting among the team members 
(
when staff disagree
amongst themselves about the best way to support the person )
 
Core components of support
 
Core components of support for older adults with personality disorders
Establish and understand the importance of the therapeutic
relationship
Treat the older adults comorbidities (e.g. anxiety, depression)
Establish good links with other professionals – 
Have joined up care
between   community and inpatient services
Involve significant others where possible
Use supportive cognitive psychotherapy which may help the older
adult to acknowledge some of these issues and work on them
Training and providing support to carers in helping them understand
ways of managing and offering support
 
 
 
Core components of support
 
Ensure the care team uses a systemic approach that fosters
Consistency
Containment
Empowerment
Compassion
 
References
 
Personality disorders in later life: epidemiology, presentation and
management   Ayesha Bangash  BJPsych Advances (2020), vol. 26,
219–220 doi: 10.1192/bja.2020.19
Late-onset personality disorder: a condition still steeped in ignorance
Peter Tyrer & Robert Howard  BJPsych Advances (2020), vol. 26, 219–
220 doi: 10.1192/bja.2020.19
Slide Note
Embed
Share

Personality disorders in older adults refer to pervasive disturbances in personality and behavior that impact social functioning. Prevalence is around 10% in older community populations, with three main types of disorders categorized by emotional traits. Recent personality changes may indicate underlying medical or mental health issues. Presentations in later life can be triggered by loss, changes in living situations, substance use, trauma, and difficulties with aging.


Uploaded on Jul 18, 2024 | 0 Views


Download Presentation

Please find below an Image/Link to download the presentation.

The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author. Download presentation by click this link. If you encounter any issues during the download, it is possible that the publisher has removed the file from their server.

E N D

Presentation Transcript


  1. Personality disorders in Older Adults Tier 1

  2. What is personality? The word personality refers to the collection of characteristics or traits that we have developed as we have grown up and which make each of us an individual. These include the ways that we: think feel behave

  3. Individuals with Personality disorders/ complex emotional needs Personality disorder refers to pervasive disturbances within a person s personality and behaviour, which can make it difficult for them to live with themselves and/or other people and negatively impacts on their social functioning and relationships. Personality disorders can have a significant impact the ability to respond to life stresses. People with a personality disorder can feel stigmatised because of this diagnosis and some prefer the use of the term having complex emotional needs instead

  4. Prevalence of personality disorders Older adults are less likely to attract a diagnosis of personality disorder so exact prevalence is unknown Prevalence could be around 10% of an older community population

  5. Types of Personality disorders Personality disorders tend to fall into three groups, according to their emotional 'flavour': Cluster A: 'Odd or Eccentric - seem to remain stable as one gets older Cluster B: 'Dramatic, Emotional, or Erratic - tend to decrease as one gets older Cluster C: 'Anxious and Fearful - seem to remain stable as one gets older

  6. Personality changes causes Recent personality changes can be due to the following reasons so ensure the following reasons are investigated Medical or organic cause Cerebrovascular event Infection (i.e.,meningitis) Head Trauma Brain tumour Dementia Prescribed Medications Steroids Mental illness Depression/Mania Illegal drugs and/or alcohol

  7. Reasons for presentations Reasons for presentation in later life with personality disorder could be due to the following reasons: The person may lose a significant other who has contained or compensated for the personality disorder A move to long term care Loss of a stabilising situation Increased use of alcohol and prescription drugs Retriggering of trauma Bereavement and losses including loss of jobs/ roles Difficulty in adapting to ageing

  8. Challenges for the older adult Challenges faced by older adults with personality disorder includes Worse physical functioning Greater use of medications including opioids, benzodiazepines More unstable/brief relationships and poor social network More likely to have other mental health difficulties, like depression and anxiety Increased chances of being discharged to a residential placement and ongoing challenges with forming relationships with carers Less responsive to treatment for any of their other mental illnesses Older adults with Personality Disorder make up 44% of completed suicides

  9. Challenges for the caring teams Challenges faced by the teams caring for older adults with personality disorder include: Staff receive a lot more calls from this cohort They may repeatedly ask for prescription medication They may have frequent attendances to A&E departments The increased expression of psychological distress in the form of physical health symptoms (somatization) and demands for care from staff/family can lead to team frustration and longer hospital admissions They create splitting among the team members (when staff disagree amongst themselves about the best way to support the person )

  10. Core components of support Core components of support for older adults with personality disorders Establish and understand the importance of the therapeutic relationship Treat the older adults comorbidities (e.g. anxiety, depression) Establish good links with other professionals Have joined up care between community and inpatient services Involve significant others where possible Use supportive cognitive psychotherapy which may help the older adult to acknowledge some of these issues and work on them Training and providing support to carers in helping them understand ways of managing and offering support

  11. Core components of support Ensure the care team uses a systemic approach that fosters Consistency Containment Empowerment Compassion

  12. References Personality disorders in later life: epidemiology, presentation and management Ayesha Bangash BJPsych Advances (2020), vol. 26, 219 220 doi: 10.1192/bja.2020.19 Late-onset personality disorder: a condition still steeped in ignorance Peter Tyrer & Robert Howard BJPsych Advances (2020), vol. 26, 219 220 doi: 10.1192/bja.2020.19

More Related Content

giItT1WQy@!-/#giItT1WQy@!-/#giItT1WQy@!-/#giItT1WQy@!-/#