DiscoverCounselor Toolbox PodcastMental Health and the Elderly 12 Key Points
Mental Health and the Elderly 12 Key Points

Mental Health and the Elderly 12 Key Points

Update: 2019-09-08
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421 -Mental Health & the Elderly

12 Key Points


Podcast is part of A La Carte Course:

https://www.allceus.com/member/cart/index/product/id/112/c/


Dr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC

Executive Director, AllCEUs.com

Podcast Host: Counselor Toolbox & Case Management Toolbox

Objectives

– Review 12 key issues that either differ or often go overlooked in people over 65

Psychosocial Adjustment to Aging

– There are multiple psychosocial aspects to aging

– Integrity vs. Despair

– Loss of physical functioning

– Death of friends

– Changes in social relationships

– Frequent mental distress (FMD) may interfere with major life activities, such as eating well, maintaining a household, working, or sustaining personal relationships.

– Older adults with FMD were more likely to engage in behaviors that can contribute to poor health, such as smoking, not getting recommend amounts of exercise, or eating a diet with few fruits and vegetables (11)

Emotional Health

– Mood issues are not a consequence of normal aging

– Depression

– Situational (grief, life transitions)

– Vascular

– Bidirectional association between depression and cardiovascular diseases

– Elderly men have the highest rate of suicide of any age group

– When untreated, depression reduces life expectancy, worsens medical illnesses, enhances health care costs and is the primary cause of suicide among older people

– Both exercise and dietary interventions can promote mental health

– Almost half of older adults who are diagnosed with a major depression also meet the criteria for anxiety


Cognitive Decline

– It is often partly preventable

– Slowing or some loss of other cognitive functions takes place, most notably in:

– Information processing

– Selective attention

– Problem-solving ability

– Prevention and early intervention should focus on

– Encouraging different problem solving tasks (hobbies, puzzles etc.)

– Maintaining physical activity to improve blood flow

– Maintaining a good sleep routine (including addressing bladder issues)

Cognitive Health

– Dementia Risk Factors

– Smoking

– Alcohol use

– Hypertension

– Diabetes

– TBI from falls

– Dementia Interventions

– Physical activity

– Control of blood pressure

– Not smoking

– Social engagement

– Depression prevention/intervention

– Diabetes management

Chronic Health Conditions

– Medications

– Pain

– Increased injury risk

– Parkinson’s Disease

– Frailty Syndrome is a geriatric syndrome characterized by the clinical presentation of identifiable physical alterations such as loss of muscle mass and strength, energy and exercise tolerance, and decreased physiological reserve

– Malnutrition

– Lack of Exercise

– Depression

– Horticulture Therapy shows great potential in enhancing mental health, cognitive functioning and physical health in the elderly


Medication

– Age-related physiological changes that can impact drug effects include the following:

– absorption: increasing gastric pH, decreasing absorptive surface

– distribution: decreasing total body water, lean body mass, and serum albumin

– metabolism: decreasing hepatic mass and blood flow

– excretion: decreasing renal blood flow, glomerular filtration rate, and tubular secretion.

– Some of the most common medicines likely to have adverse effects include anticoagulants, antibiotics, diuretics, hypoglycemic agents, benzodiazepines, opioids, NSAIDs


Sexuality

– Hormonal changes and other physiological changes associated with aging affect sexual interest.

– Erectile dysfunction is a problem in men increasing with age.

– Diabetes, cardiovascular, cancerous, and chronic respiratory diseases and also some medications can reduce sexual capacity and desire

– The most common causes for male erectile dysfunction are vascular diseases.

– Age is not a barrier to sexually transmitted diseases.

– In women lack of emotional wellbeing and a sense of intimacy during sexual intercourse can lead to reduced sexual interest

Malnutrition

– The causes of malnutrition can stem from other health problems

– Seniors suffering from dementia may forget to eat

– Depression

– Alcoholism

– Dietary restrictions

– Reduced social contact

– Limited income

– Reduced mobility

– Dental problems

Sleep

– Sleep needs do not decrease with age.

– Short and long sleep duration groups had increased prevalence of mental health issues by 66% and 26%

– Poor quality insufficient sleep is associated with poorer physical function and cardiovascular issues

– With ageing less slow wave sleep (deep sleep) is expected, along with more awakenings, and a tendency toward earlier sleep times.


Sleep

– Causes of Sleep Problems

– Bladder control

– Neurological conditions

– Lung diseases (asthma, COPD)

– Chronic pain

– Sleep apnea

– Anemia

– GERD

– Rapid eye movement sleep behavior disorder often represents the earliest sign of a Lewy Body Dementia.

– In REM-SBD people act out vivid, often unpleasant dreams with vocal sounds and sudden, often violent arm and leg movements during REM sleep.


Social

– Social support serves major functions, including

– Emotional support

– Informational support (e.g. advice and guidance)

– Instrumental support (e.g. providing rides or assisting with housekeeping)

– Adequate social support is associated with reduced risk of mental illness, physical illness, and mortality

– Retirement Blues

Social

– Technology based interventions to reduce social isolation had a moderate, but short-term impact on reducing isolation.

– Social support interventions should focus on

– Connecting to the outside world

– Gaining social support

– Engaging in meaningful activities

– Boosting self-confidence

Life Satisfaction

– Life satisfaction is the self-evaluation of one’s life as a whole, and is influenced by socioeconomic, health, and environmental factors

– Life dissatisfaction is associated with obesity and risky health behaviors such as smoking, physical inactivity, and heavy drinking (all which increase risk of dementia)

Cultural Differences Impacting Treatment

– Different conceptualization of the problem

– Different idea of appropriate interventions

– Suspiciousness of strangers or “white coat syndrome”

– Different expressions of distress

– Limited resources


Treatment Principles


– Therapeutic interventions to encourage autonomy include

– Daily living skills

– Improving safety at home

– Provision of practical support and information including social and legal rights.

Summary

– Older people with mental illnesses (particularly depression or dementia) may take longer to respond to treatment

– Interactions between medication and comorbid physical illnesses (and their treatment) are also common.

– It is important to address coexistent physical and mental health issues

– Social engagement, physical activity, control of diabetes and hypertension, prevention of depression and developing a sense of life satisfaction are all associated with positive health outcomes and reduced risk of depression and dementia

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Mental Health and the Elderly 12 Key Points

Mental Health and the Elderly 12 Key Points

Charles Snipes