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Older Adults

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					   Polio Support Group

         March 31, 2011
         Donna Bowyer
Canadian Mental Health Association
                 Mental Health
• The capacity of individuals to interact with each
  other and their environments in ways that enhance
  or promote
   –   Their sense of well-being
   –   Their sense of control and choice in their life
   –   Optimal use of their mental abilities
   –   Achievement of their own goals, and
   –   Their quality of life.
                          Canadian Mental Health Association, Supporting Seniors’ Mental Health
                                                     through Home Care, Toronto (2002)


                 Canadian Mental Health Association in Saskatchewan
                Older Adults
• It is estimated that approximately 95% of
  older persons at a given point in time live in
  community rather than in institutions.
• Of those living in the community, approx.
  31% (mostly women) live alone.



            Canadian Mental Health Association in Saskatchewan
                Older Adults
• Mental disorders are the leading risk factors
  for institutionalization.
• Keeping older adults in the community ,
  where they prefer to be , means more
  treatment in the community to stave off
  costly institutionalizations.


            Canadian Mental Health Association in Saskatchewan
    Promoting Senior‟s Mental Health

•   Dignity
•   Independence
•   Participation
•   Fairness
•   Security



             Canadian Mental Health Association in Saskatchewan
   Framework for Seniors Mental Health

• Frame work includes
  – Personal factors
  – External factors
  *Four boxes represent personal factors that affect
    an individual‟s mental health
  * The four circles represent external determinants
    of health that contribute to an individual‟s
    mental health
            Canadian Mental Health Association in Saskatchewan
Canadian Mental Health Association in Saskatchewan
Canadian Mental Health Association in Saskatchewan
  Being an Effective Communicator
• Use familiar words and a conversational, personal tone.
• Proceed logically, with the most important ideas first, and
  linked from one paragraph to the next
• Use action verbs and active construction, not passive
• Favour short words and short sentences
• Present ideas with illustrations or diagrams if this makes
  them easier to understand
• Highlight main ideas and important information with
  headings

                Canadian Mental Health Association in Saskatchewan
               Skills for Care
•   Being an Effective Communicator
•   Involving Person in Decision-Making
•   Being an Effective Advocate
•   Peer Advocacy




             Canadian Mental Health Association in Saskatchewan
       Issues Affecting Senior's
•   Social isolation
•   Functional Decline
•   Substance Abuse
•   Elder Abuse
•   Family Caregiver Stress and Burnout
•   Changing Life Situation
•   Depression
             Canadian Mental Health Association in Saskatchewan
                Social Isolation
• Encourage more social activities
• Discuss the situation and possible solutions the others
  involved
• Try to make the person feel needed in valued
• Help to be informed about activities in the community
• Look for ways to improve access to transportation
• Proved the senior with info supports & services
• Arrange to have someone accompany the person when
  attending a new activity.

                Canadian Mental Health Association in Saskatchewan
           Social Isolation
• Loneliness                Social Isolation
• Depression                Social Isolation
• Anxiety                   Social Isolation


     The Chicken or the Egg

          Canadian Mental Health Association in Saskatchewan
                   Depression
• Depression can result from psychosocial
  factors such as death of a spouse, reduced
  income, change in physical health or other
  losses




            Canadian Mental Health Association in Saskatchewan
                   Depression
• Depression is not a normal part of aging any
  more that in any other age group.

• Depression is less likely to be treated in
  older adults than younger adults



            Canadian Mental Health Association in Saskatchewan
                      Depression
• Depression severity is the only
  psychological or medical variable that was
  significantly associated with all four
  outcomes
     •   Quality of life
     •   Physical functioning,
     •   Mental functioning
     •   Disability

               Canadian Mental Health Association in Saskatchewan
                     Depression

• As depression severity increases, quality of life
  and physical and mental functioning declines,
  while disability increases.

• Depression has a “devastating impact” on both
  emotional and physical functioning in older adults


              Canadian Mental Health Association in Saskatchewan
        Disease and Depression
•   9-27% of diabetes patients
•   22-50% of stoke patients
•   18-39% of cancer patients
•   50% of Parkinson‟s patients
•   15-25% of people that have suffered Heart
    attacks

             Canadian Mental Health Association in Saskatchewan
             Social Isolation
• How do we reach people that have become
  socially isolated whether conscious of
  unconsciously.
     • Home Care
     • Meals on Wheels




            Canadian Mental Health Association in Saskatchewan
               Comfort Line
• Not a help line
• Not a crisis line
• A phone number that anyone can call to
  chat about anything to a volunteer
• You do not have to be in or develop a crisis
  to call someone.


            Canadian Mental Health Association in Saskatchewan
          Functional Decline
• Encourage Physical activities – number of
  benefits including greater independence,
  better mental health, improved quality of
  life, less stress, improved self-esteem, and
  simply having fun.



            Canadian Mental Health Association in Saskatchewan
           Substance Abuse
• As people get older their ability to absorb
  and dispose of alcohol and other drugs
  changes.
• Lack of understanding of prescription
  medications can also contribute to substance
  abuse
• Be aware of the potential for substance
  abuse by the caregiver
            Canadian Mental Health Association in Saskatchewan
                Elder Abuse
• Includes physical, sexual, emotional,
  financial and neglect.
• Can come from family, friends, family and
  professional caregivers,
• Be aware of what to look for and report to
  person that can take action


           Canadian Mental Health Association in Saskatchewan
  Family Caregiver Stress and Burnout

• Link the family caregiver with day care,
  respite or other supports available.
• Write out lists so they don‟t have to
  remember
• Help them be realistic about what they can
  do
• Help them learn strategies to cope with
  stress
           Canadian Mental Health Association in Saskatchewan
      Changing Life Situation
• Allow them to reminisce. Listen and share
  their experiences with them
• Assist or have a volunteer assist them in
  coordinating or gaining the knowledge
  needed.
• If you feel there is need for other formal
  care provides (e.g.,counselors, grief
  therapist) encourage them to make contact.
           Canadian Mental Health Association in Saskatchewan
        Post Polio Depression
• Sense of Betrayal of your own body
     Turning anger inward
• people that recovered to the point the they
  lead life where people don‟t know they had
  polio or could live a mobile life.



            Canadian Mental Health Association in Saskatchewan
                       Changes
• Debilitating fatigue or unrelenting pain can
  cause change in ability to function and be
  independent
• Loss of faith in recovery can lead to mild
  depression
• Exercise for depression??????
• Dramatic change in future goals
            Canadian Mental Health Association in Saskatchewan
           Polio Depression
• Not necessarily triggered by normal stresses
• Can hit during a holiday – fatigue, crash
• Confinement of housebound during
  recovery from an event.




            Canadian Mental Health Association in Saskatchewan
                Other Factors
•   Anxiety
•   Isolation
•   Fear of the future
•   Uncooperative family




             Canadian Mental Health Association in Saskatchewan
                Life Changes
• Sheet of paper and Divide into 12 pieces
  – 4 things you enjoy doing
  – 4 things that are important to you
  – 4 people you enjoy spending time with




            Canadian Mental Health Association in Saskatchewan
         Financial Insecurity
• Make person aware of types of financial
  “scams” that exist
• Contact the individual on the care giving
  team to discuss situation
• Watch for signs of depression
• Discuss if you have that type of relationship


            Canadian Mental Health Association in Saskatchewan
                  Depression
• For some seniors, depression is often
  confused with dementia.
• Depression should be assessed.
• Treatment may take the form of medication,
  and.or therapy and is often very effective



           Canadian Mental Health Association in Saskatchewan
          Depression - Signs
1. A sad mood
2. Ongoing pessimism about the past, present
  and future
3. Loss of interest in other activities (e.g.,
  social life hobbies, leisure
4. Lack of energy
5. Irritability
            Canadian Mental Health Association in Saskatchewan
          Depression - Signs
6. Difficulty in making decisions
7. Loss of weight/decreased appetite
8. Disturbed sleep pattern
9. Depressive dreams
10 Thougths of Suicide



            Canadian Mental Health Association in Saskatchewan
                   Depression
1. Try to determine if there are supports in the
  community that can help the senior
2. Contact the individual on the caregiving
  team that can take action
3. Don‟t ignore the warning signs
4. Take all comments about death or suicide
  seriously
            Canadian Mental Health Association in Saskatchewan
                   Depression
5. Pep talks don‟t work. Urging the person to
  „cheer-up‟ isn‟t helpful. Instead, support
  them in their search for appropriate help
6. Listen to the person without criticizing or
  feeling responsible for the person‟s
  unhappiness. Be supportive and
  understanding without feeling guilty – you
  didn‟t cause the depression
            Canadian Mental Health Association in Saskatchewan
      Stigma of Mental Illness

• Between 60 – 65% of all people with
  diagnosable mental illness do not seek
  treatment.

• Stigma disproportionately affects children
  and older adults to a greater extent than
  adults

            Canadian Mental Health Association in Saskatchewan
 Depression & Suicide in Older Adults

• The most serious consequence of depression
  in later life – especially untreated or
  inadequately treated depression is suicide or
  somatic illness
• Persons 65 + have highest suicide rate of
  any age group
• Suicide rate of individuals age 85+ is the
  highest (21suicides per 100,000)
            Canadian Mental Health Association in Saskatchewan
Depression and Suicide in Older Adults

• Using a “psychological autopsy” it has been
  determined that 60-75% of suicides have
  diagnosable depression

• Thought of death may be developmentally
  expected in older adults, suicidal thoughts
  are not.

            Canadian Mental Health Association in Saskatchewan
 Depression & Suicide in Older Adults

• Studies have shown that older adults had
  seen their physician within a short interval
  of completing suicide, yet few were
  receiving mental health treatment.




            Canadian Mental Health Association in Saskatchewan
    Depression in Older Adults

• Depression can also lead to increased
  mortality from other diseases, such as heart
  disease and possibly cancer.




            Canadian Mental Health Association in Saskatchewan
 Myths about dealing with Grief
1.   Don‟t feel bad
2.   Replace the loss
3.   Grieve alone
4.   Just give it time
5.   Be strong for others
6.   Keep busy

              Canadian Mental Health Association in Saskatchewan
 While there are no stages of grief..

• There are common responses which are
  normal
• Their occurrence and duration is different
  for everyone.




            Canadian Mental Health Association in Saskatchewan
         Common Responses
• Reduced Concentration
  – Preoccupation with emotions of loss
  – Inability to concentrate
  – Common to almost all grievers




            Canadian Mental Health Association in Saskatchewan
            Common Response
• A sense of numbness
  –   Usually first reaction after notification
  –   Physical, emotional or both
  –   Mislabelled as denial
  –   Rarely lasts more than several hours




               Canadian Mental Health Association in Saskatchewan
          Common Response
• Disrupted sleep patterns
  – Not being able to sleep
  – Sleeping too much
  – both




            Canadian Mental Health Association in Saskatchewan
          Common Response
• Changed Eating Habits
  – Little or no appetite
  – Eat non-stop
  – Both




             Canadian Mental Health Association in Saskatchewan
          Common Response
• Roller Coaster of Emotional Energy
  – Emotional highs and lows
  – Grievers often feel emotionally and physically
    drained




            Canadian Mental Health Association in Saskatchewan
          Common Response
• Academy Award Recovery
  – “I‟m fine”
  – How many have experienced the death of a
    lover one in the past 5 years
  – How many of you still experience pain,
    isolation and loneliness as a result of the loss?



             Canadian Mental Health Association in Saskatchewan
         Mental Health Lens
• Without mental health there is no health
• When developing any policy or program
  look through the mental health lens to make
  sure that not only our physical health issues
  are dealt with but also our mental health



            Canadian Mental Health Association in Saskatchewan
           My Generation
• http://www.youtube.com/watch?v=zqfFrCU
  rEbY
• http://www.youtube.com/watch?v=VKBqk
  Dxkv30&feature=related
• http://www.youtube.com/watch?v=ZZhsxh
  G5e-o


          Canadian Mental Health Association in Saskatchewan
Canadian Mental Health Association in Saskatchewan
Stopping the Stigma: What Can
           You Do?

 • Ask yourself if what you hear about
   mental health is...
 Stereotyping people with mental illnesses
 Trivializes /belittles the person or the illness
 Offends the person by insulting him/her
 Patronizes the person by treating them as if they
         Canadian good as other Saskatchewan
   were not asMental Health Association in people
Canadian Mental Health Association in Saskatchewan
Canadian Mental Health Association in Saskatchewan

				
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