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7153PSY > 4. Older adults > Flashcards

4. Older adults Flashcards

1
Q

considerations with older adults

A

medication effects, cognitive changes
grief/loss/emotional issues
change in role
fear of dementia
attitudes to ageing- own, client, society
life experience
impact on decision making capacity
elder abuse
palliative care

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2
Q

cognition across lifespan

A

changes in performance on tests of general ability, but except for speeded tests (20+ years), declines occur relatively late (50s or 60s)
learning continues
age effects more apparent when facing novel tasks, especially 75+ years
little decline in complicated activities in everyday life

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3
Q

main cognitive changes in older adults

A

processing speed
forming associations
multi tasking/divided attention

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4
Q

biological explanations age-related memory decline

A

lose only about 2% of brain weight and volume each decade of life
loss in myelination and reduction in connection among neurons (slowing), decrease in certain neurotransmitters (dopamine), reduced blood flow
main effects on prefrontal region of cortex-attention and maintaining memories/thoughts in consciousness (WM)

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5
Q

social cognitive explanation age-related memory decline

A

negative age stereotypes
worry about underlying cause of memory slips (dementia?)
reduced routine and habit
increased overload of old memories

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6
Q

reinforcement of memory performance

A

positive reinforcement helps to increase future performance

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7
Q

how a negative stereotype affects memory

A

expectations of poorer memory
decreased use of active strategies
poorer recall

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8
Q

minimising memory changes

A

change expectations
adopt good learning strategies
positive and confident attitude about memory

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9
Q

in normal ageing

A

decline in episodic memory, source memory, working memory
NOT in semantic, implicit, procedural or naturalistic prospective memory
Neural changes: subtle changes in prefrontal cortex and hippocampus (memory decline)

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10
Q

in Alzheimer’s dementia

A

deficits in episodic memory are early features and severe, semantic memory also affected
Neural: neuropathology in entorhinal cortex and hippocampus (episodic memory) and then spreads to other cortical regions (semantic memory)

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11
Q

dementia syndrome

A

not a disease
pattern of symptoms that can be caused by many different illnesses
syndrome involving progressive decline in memory and other intellectual abilities
acquired, persistent, multiple impairments to cognition

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12
Q

dementia criteria

A

cognitive/behavioural impairments: new learning and memory, reasoning and handling of complex tasks, poor judgement, visuospatial abilities, language, changes in personality/behaviour

cognitive or behavioural symptoms that:
interfere with function at work or usual activities
represent a decline from previous levels
are not due to delirium or psychiatric disorder

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13
Q

dementia due to alzheimers

A

most common cause of dementia
insidious onset and gradual decline in cognition often beginning with memory lapses

other symptoms:
persistent and frequent memory difficulties, especially of recent events
vagueness in everyday conversation
apparent loss of enthusiasm for previously enjoyed activities
laking longer to do routine tasks
forgetting well known people or places
inability to process questions and instructions
deterioration of social skills
emotional unpredictability

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14
Q

anxiety and depression in older age

A

most significant reported symptom is cognitive changes
protective: greater perceived social support, regular physical exercise, higher level of education

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15
Q

risk factors for depression in later life

A

disability, newly diagnosed medical illness, poor health status, poor self-perceived health, prior depression and bereavement

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16
Q

risk factors for anxiety in later life

A

poor self rated general health status
physical or sexual abuse in childhood
more common than depression, similar risk factors

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17
Q

techniques to promote emotional wellbeing in older adults

A

physical activity
relaxation
sensory stimulation
music and arts
social
reflection
education and skills training
technology
quality of life approaches
carer interventions
interventions delivered by mental health professionals

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18
Q

CBT with older adults

A

structured, collaborative, creative- socratic dialogue, guided discovery, collaborative empiricism
more effective in older adults than working age adults
preferred compared to medication

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19
Q

CBT for depression

A

help person recognise any negative, self focused, self critical thinking and work with them to change these patterns to more realistic and problem solving thinking
behavioural- increase activities that are pleasurable/sense of achievement

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20
Q

CBT for anxiety

A

cognitive- help person recognise thoughts focused on threats and dangers, and change them to more realistic and problem solving
behavioural- relaxation, desensitisation, face up to things being avoided

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21
Q

biopsychosocial model

A

Impact of diagnosed and undiagnosed medical conditions
past trauma
past coping strategies
transitions
societal difficulties
chronicity
attitudes to mental health
leverage wisdom
modify questioning- rather than how mood is different to usual, can ask how would they like to feel

22
Q

reminiscence therapy

A

thinking and talking about past experience in your life
thought to help by:
focusing on former successful coping experiences
reinforces sense of continuity
find meaning and coherence in one’s life
resolve unresolved conflicts
greater effects on community dwelling older adults compared to those in nursing homes/residential care

23
Q

simple reminiscence

A

encourages social connections and shared memories
engage client in pleasurable discussion to develop connection/engagement
person talking to them would usually share some of their experiences or common memories too
topics might include growing up, schooling, marriage, children

24
Q

life review

A

encourages an understanding of one’s life and identity
more structured
cover a different part of their life each session
childhood, adolescence, working life etc.
help client appreciate common themes in life, sense of who they are
life book or digital story

25
Q

life review therapy

A

encourages a recollection of problem solving success
ask specific questions to prime positive representation of self
self efficacy
greater effects than simple reminiscence, especially on depression

26
Q

addressing hearing loss

A

minimise background noise
look at client when speaking
speak slowly and distinctly
don’t shout or over articulate
lower pitch of voice
sit close
written summaries for follow up material
auditory amplifiers

27
Q

addressing vision loss

A

increase lighting, reduce glare, do not use glossy print materials
large print
time to refocus
reading glasses available
arrange furiture so pathways are clear

28
Q

addressing mobility changes

A

office accessibility and toiler accessibility
sit at same level
do not assume they need help- ask first

29
Q

dementia not preventable

A

can reduce risk factors (delay, prevent onset)
risk factors for one form of dementia may be same as another, prevention can target more than one type

30
Q

modifiable risk factors for dementia

A

40% modifiable
early life (<45): les education
midlife (45-65): hearing loss, TBI, hypertenson, alcohhol >21 units per week, obesity
Later life (>65): smoking, depression, social isolation, physical inactivity, air pollution, diabetes

31
Q

cognitive stimulation

A

typically group: reality orientation, reminiscence, music/art, validation
greater benefit when sessions occur mroe than weekly and for mild dementia
improve ADLs, quality of life, mood, comm, soc interaction, decrease in challenging behaviours

32
Q

cognitive rehabilitation

A

goal attainment- 3 goals developed (e.g. learning to use mobile phone)

32
Q

cognitive training

A

no adverse effects

33
Q

methods that work in dementia

A

procedural memory training
dual cognitive support
spaced retrieval
errorless learning important

34
Q

spaced retrieval

A

errorless learning approach
small amount of important information for very long periods
repeated at progressively lengthened intervals, active retrieval of important information
error made, feedback provided, interval shortened
minimal congitive effort, spontaneously used

35
Q

preclinical/prodromal alzheimer’s disease

A

disease modifying treatments and cognitive interventions most effect early as possible in disease process

36
Q

MCI

A

Subjective cognitive concerns and objective impairment on tests
still functionally independent, no dementia
common, increases with age
15% develop dementia within 2 years, triple risk of developing within 2-5 years

37
Q

LATCH

A

group cognitive interventions for MCI and healthy older adults
6 week 2H group, 3M booster
middle-older aged participants
6-12 px
psychoed + therapy (CBT), info about memory and memory strategies, skills in everyday use of strategies
understanding memory
prepare for remembering: identifying, reducing risk factors, promote self confidence, concentration
reduce memory load: do tasks imemediately, external aids
internal strategies: spaced retrieval, association, implementation intentions
practice

38
Q

group therapy

A

modelling acceptance, courage and optimism
group dynamic reinforces learning
peer credibility
expectancy-modification important for some participants

39
Q

LATCH behaviour change technqiues

A
40
Q

BCTs

A

85 active agent of intervention which work via 26 different mechanisms of actions (MoAs)

41
Q

BCTs linked to MoA beliefs about capabilities

A

demonstration of the behaviour
instruction on how to perform behaviour
behavioural practice/rehearsal
graded tasks
problem solving

42
Q

BCTs linked to MoA behavioural regulation (skills for changing behaviour)

A

self monitoring
facilitate performance of behaviour

42
Q

BCTs linked or MoA goals- individuals want to achieve

A

Goal setting
review behaviour goals
review outcome goals

43
Q

process for prospective memory

A

quick brainstorm highlighting the different types of prospective memory tasks (things that can be done straight away, things that need to be done in a little while, date attached, can be done anytime)
framework that illustrates the problems in the context of a memory model
this guides best type of strategy required for each problem
helping people choose optimal strategy for success

44
Q

prospective memory model

A

formation
retention
reinstantiation
execution
difficulties at any step may mean we don’t remember our delayed intention at the right time
tasks often ‘forgotten’ because absorbed in another activity, hard to recognise cues to shift

45
Q

propsective memory complex as it requires

A

deciding what need or want to do (forming an intention)
holding onto your intention while doing something else
recalling what you wanted to do, when the right moment arrives (recognising the cues that it is the right moment)
actually doing the task you planned

46
Q

strategies for prospective memory

A

notes
diaries, calendars
do it now
alarms
implementation intention

47
Q

implementation intention

A

make a specific and detailed plan about when, where and how your intention will happen, and visualise what is happening before, during and after you do the task
1. helps create stronger intention to begin with
2. helps create more cues

48
Q

OPTIMISE

A

Online learning 6 modules
8 week period
booster at 3MO
Compensatory strategies rather than restorative (brain training) approach
psychoeducation (models of memory, age-related changes in memory)
practical skill building
opportunity to share experiences of memory changes amongst peers
personalised
most significantly increased strategy use, daily improvements, reduced memory concerns, confidence/self efficacy, sharing and shame-busting

7153PSY (11 decks)

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