Mental Health in Older Adults: Key Insights and Strategies

 
Mental Health In Older
Adults: Lunch and Learn
 
Hosted by:                  
The Center for Volunteer Caregiving
Presented by:             
Robert H. Pollock MSW, LCSW
 
Objectives of Presentation
 
Review of the human life cycle stages
Definition of Mental Illness, Personality Disorder
Older Adult Facts
Elder Abuse
Elder Competency
Risk Factors for Mental Illness, and Symptoms of Mental Illness
Mental Health Goals / Interventions – Individual & Community
Integrated Care Model
Attitudes Towards the Elderly
 
The Human Life Cycle Stages
 
Pre-birth
Birth
Infancy (0-3)
Early Childhood (3-6)
Middle Childhood (6-8)
Late Childhood (9-11)
Adolescence (12-20)
Early Adulthood (20-35)
Midlife (35-50)
 
 
The Human Life Cycle Stages-
continued
 
Mature Adulthood (50-80)
Late Adulthood (80+)
Death and Dying
 
One Definition of Mental Illness
 
A mental illness is a condition that affects a person’s thinking, feeling or
mood.  Such conditions may affect someone’s ability to relate to others
and function each day.  Each person will have different experiences, even
people with the same diagnosis.
 
One Definition of a Personality Disorder
 
A personality disorder is a type of mental disorder in which you have a rigid
and unhealthy pattern of thinking, functioning and behaving.  A person
with a personality disorder has trouble perceiving and relating to situations
and people.  Personality disorders usually begin in the teenage years or
early adulthood, and usually persist throughout life.
 
Older Adults: Facts
 
Older adults are more likely than any other age group to have complex
health conditions, substance use disorders and cognitive impairments
Loss is common: loss of – spouse, friends, physical functioning,
independence, purpose
Purpose affects overall health, including mental  health, physical health
and substance use
Healthcare providers and older adults  often mistake depression for a
natural response to aging.  This can lead providers to not screen for or treat
depression
Older adults do not seek help
Older adults go to see their Primary Care Physician, to get all of their
medications and help for their physical illnesses
 
Elder Abuse
 
Physical abuse
Sexual abuse
Domestic violence
Psychological abuse
Financial abuse
Neglect
Self-neglect
Elder abuse is a serious problem, with an estimated 8-10% of older adults
experiencing abuse
Only 27% of hospital emergency departments have elder abuse protocalls
 
Pediatrics and Eldercare
 
As some adults age, they may begin to rely more on spouses, adult
children, grandchildren and other loved ones for assistance with daily living
activities and navigating the health care system
Unlike the pediatric population, where parents legally and functionally act
as caregiver and decision maker for their child, caregiver relationships for
older adults are much less straightforward and obvious
In conditions like dementia, capacities are slowly lost and there is often not
a clear point at which older adults require surrogate decision-makers
Advance Directives are very important
Wills and Living Wills are very important
 
Some Basics About Geriatrics
 
Changes of the brain
Changes of the body
Changes of many levels of functioning
Changes of tolerance in medication, alcohol, foods
 
Causes and Risk Factors for Senior
Mental Illness
 
Physical disability
Long-term illness (e.g., heart disease, cancer)
Dementia-causing illness (e.g., Alzheimer’s disease)
Physical illnesses that can affect thought, memory, and emotion (e.g.,
thyroid or adrenal disease)
Change of environment, like moving into assisted living
Illness or loss of a loved one
Medication interactions
Alcohol or substance use
Poor diet or malnutrition
 
10 Symptoms of Mental Illness
 
1. Sad or depressed mood lasting longer than two weeks
2. Social withdrawal; loss of interest in things that used to be enjoyable
3. Unexplained fatigue, energy loss, or sleep changes
4. Confusion, disorientation, problems with concentration or decision-
making
5. Increase or decrease in appetite; changes in weight
6. Memory loss, especially recent or short-term memory problems
7. Feelings of worthlessness, inappropriate guilt, helplessness; thoughts of
suicide
8. Physical symptoms that can’t otherwise be explained: aches,
constipation, etc.
 
 
10 Symptoms Continued
 
9. Changes in appearance or dress, or problems maintaining the home or
yard
10. Trouble handling finances or working with numbers
 
Mental Health Goals / Interventions
 
Healthy adjustment to stage of life
Acceptance of loss – letting go
Explore for and treat “Survivor Guilt”, which is often present when the
elderly person has survived one of their children
Explore for and treat a deep sense of guilt wishing a loved one would die
Involvement in life activities as fully as possible
Reminiscence therapy – discussion of past activities, events, experiences
with another person or group, usually with the aid of tangible prompts such
as photographs, household and other familiar items from the past such as
music, old movies
 
More Interventions
 
Explore spirituality
All preparations for death are completed to a satisfactory level
Acceptance of how a person has lived their life
What is their legacy
What are they proud about in their life
What are they not proud about in their life, and acceptance of this
The bucket list
Do they want to talk about death / the after life?  Do they have an opinion
about this
What is their meaning of life
 
Integrated Care Model
 
One person to act in the role of “Case Manager”
A team approach in which all relevant providers share information about
the elderly person
The team also provides for the caregiver and other important people
(family, friends), so the entire team does not disappear when the elderly
person dies
Making sure nothing is “slipping through the cracks” about the over all care
and well-being of the elderly person
Exercise needs to be included – it is not only healthy for the body, but for
the emotional well-being of every person
 
 
More Interventions
 
Healthy Ideas – 
is a national model with measurable results and
demonstrated benefits for older adults, service providers and community
mental/behavioral health practitioners
Senior Reach – 
is an award winning, innovative collaborative between
Jefferson Center for Mental Health, Seniors’ Resource Center, and Mental
Health Partners, and is having a profound impact in the community and
has proven highly successful in decreasing depression, anxiety, feelings of
hopelessness and social isolation among seniors.  Their mission is to support
the well-being, independence and dignity of older adults by educating the
community, providing care management and mental health services, and
connecting older adults to community resources
 
More Interventions
 
Enhance Wellness – 
Seniors looking for assistance in managing needs such
as physical activity, weight management, mental stimulation, nutrition,
medication management or depression/anxiety have a resource in the
Enhance Wellness program.
 
Attitudes Towards the Elderly
 
America
 – present-day attitudes
about the elderly is very poor,
and treated with little respect
 
Some Cultures Respect Their
Elders
Aging isn’t just a biological
process – it’s also very much a
cultural one
The Elderly
 are treated with high
respect among the Native
American elders, in China,
Greece, Korea, and Romans
 
Something to work Towards
 
Good Mental Health is Ageless
 
Questions?
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Explore the complexities of mental health in older adults, covering topics such as life cycle stages, definitions of mental illness and personality disorders, elder abuse, risk factors, and interventions. Gain an understanding of the unique challenges faced by older adults in seeking help for mental health issues and learn how healthcare providers can better support this population.

  • Mental Health
  • Older Adults
  • Elder Abuse
  • Healthcare Providers
  • Intervention

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  1. Mental Health In Older Adults: Lunch and Learn Hosted by: The Center for Volunteer Caregiving Presented by: Robert H. Pollock MSW, LCSW

  2. Objectives of Presentation Review of the human life cycle stages Definition of Mental Illness, Personality Disorder Older Adult Facts Elder Abuse Elder Competency Risk Factors for Mental Illness, and Symptoms of Mental Illness Mental Health Goals / Interventions Individual & Community Integrated Care Model Attitudes Towards the Elderly

  3. The Human Life Cycle Stages Pre-birth Birth Infancy (0-3) Early Childhood (3-6) Middle Childhood (6-8) Late Childhood (9-11) Adolescence (12-20) Early Adulthood (20-35) Midlife (35-50)

  4. The Human Life Cycle Stages- continued Mature Adulthood (50-80) Late Adulthood (80+) Death and Dying

  5. One Definition of Mental Illness A mental illness is a condition that affects a person s thinking, feeling or mood. Such conditions may affect someone s ability to relate to others and function each day. Each person will have different experiences, even people with the same diagnosis.

  6. One Definition of a Personality Disorder A personality disorder is a type of mental disorder in which you have a rigid and unhealthy pattern of thinking, functioning and behaving. A person with a personality disorder has trouble perceiving and relating to situations and people. Personality disorders usually begin in the teenage years or early adulthood, and usually persist throughout life.

  7. Older Adults: Facts Older adults are more likely than any other age group to have complex health conditions, substance use disorders and cognitive impairments Loss is common: loss of spouse, friends, physical functioning, independence, purpose Purpose affects overall health, including mental health, physical health and substance use Healthcare providers and older adults often mistake depression for a natural response to aging. This can lead providers to not screen for or treat depression Older adults do not seek help Older adults go to see their Primary Care Physician, to get all of their medications and help for their physical illnesses

  8. Elder Abuse Physical abuse Sexual abuse Domestic violence Psychological abuse Financial abuse Neglect Self-neglect Elder abuse is a serious problem, with an estimated 8-10% of older adults experiencing abuse Only 27% of hospital emergency departments have elder abuse protocalls

  9. Pediatrics and Eldercare As some adults age, they may begin to rely more on spouses, adult children, grandchildren and other loved ones for assistance with daily living activities and navigating the health care system Unlike the pediatric population, where parents legally and functionally act as caregiver and decision maker for their child, caregiver relationships for older adults are much less straightforward and obvious In conditions like dementia, capacities are slowly lost and there is often not a clear point at which older adults require surrogate decision-makers Advance Directives are very important Wills and Living Wills are very important

  10. Some Basics About Geriatrics Changes of the brain Changes of the body Changes of many levels of functioning Changes of tolerance in medication, alcohol, foods

  11. Causes and Risk Factors for Senior Mental Illness Physical disability Long-term illness (e.g., heart disease, cancer) Dementia-causing illness (e.g., Alzheimer s disease) Physical illnesses that can affect thought, memory, and emotion (e.g., thyroid or adrenal disease) Change of environment, like moving into assisted living Illness or loss of a loved one Medication interactions Alcohol or substance use Poor diet or malnutrition

  12. 10 Symptoms of Mental Illness 1. Sad or depressed mood lasting longer than two weeks 2. Social withdrawal; loss of interest in things that used to be enjoyable 3. Unexplained fatigue, energy loss, or sleep changes 4. Confusion, disorientation, problems with concentration or decision- making 5. Increase or decrease in appetite; changes in weight 6. Memory loss, especially recent or short-term memory problems 7. Feelings of worthlessness, inappropriate guilt, helplessness; thoughts of suicide 8. Physical symptoms that can t otherwise be explained: aches, constipation, etc.

  13. 10 Symptoms Continued 9. Changes in appearance or dress, or problems maintaining the home or yard 10. Trouble handling finances or working with numbers

  14. Mental Health Goals / Interventions Healthy adjustment to stage of life Acceptance of loss letting go Explore for and treat Survivor Guilt , which is often present when the elderly person has survived one of their children Explore for and treat a deep sense of guilt wishing a loved one would die Involvement in life activities as fully as possible Reminiscence therapy discussion of past activities, events, experiences with another person or group, usually with the aid of tangible prompts such as photographs, household and other familiar items from the past such as music, old movies

  15. More Interventions Explore spirituality All preparations for death are completed to a satisfactory level Acceptance of how a person has lived their life What is their legacy What are they proud about in their life What are they not proud about in their life, and acceptance of this The bucket list Do they want to talk about death / the after life? Do they have an opinion about this What is their meaning of life

  16. Integrated Care Model One person to act in the role of Case Manager A team approach in which all relevant providers share information about the elderly person The team also provides for the caregiver and other important people (family, friends), so the entire team does not disappear when the elderly person dies Making sure nothing is slipping through the cracks about the over all care and well-being of the elderly person Exercise needs to be included it is not only healthy for the body, but for the emotional well-being of every person

  17. More Interventions Healthy Ideas is a national model with measurable results and demonstrated benefits for older adults, service providers and community mental/behavioral health practitioners Senior Reach is an award winning, innovative collaborative between Jefferson Center for Mental Health, Seniors Resource Center, and Mental Health Partners, and is having a profound impact in the community and has proven highly successful in decreasing depression, anxiety, feelings of hopelessness and social isolation among seniors. Their mission is to support the well-being, independence and dignity of older adults by educating the community, providing care management and mental health services, and connecting older adults to community resources

  18. More Interventions Enhance Wellness Seniors looking for assistance in managing needs such as physical activity, weight management, mental stimulation, nutrition, medication management or depression/anxiety have a resource in the Enhance Wellness program.

  19. Attitudes Towards the Elderly Some Cultures Respect Their Elders America present-day attitudes about the elderly is very poor, and treated with little respect Aging isn t just a biological process it s also very much a cultural one The Elderly are treated with high respect among the Native American elders, in China, Greece, Korea, and Romans

  20. Something to work Towards Good Mental Health is Ageless Questions?

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