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N2270 > 9 - Aging & Mental Health > Flashcards

9 - Aging & Mental Health Flashcards

1
Q

Landscape of Mental Health and Aging

A
  • By the year 2050 one in six persons will be 65+ years of age (UN)
  • health needs change across the lifespan…e.g. 25 vs. 65 this also extends to the older adult e.g. 65 vs. 85
  • Mental health and well-being are as important in older age as in other times of life (MHCC)
  • Ratio of older to ‘working’ age group a potential concern
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2
Q

Background

A
  • Older adults face health, support, and environmental barriers that limit their ability to achieve the best mental health and care outcomes
  • there is insufficient data on risk level or how many are experiencing mental health concerns/ conditions
  • future research on mental health care is needed
  • many older adults living on their own say they have a need for mental health care
  • many 65 and older have reported feeling social isolated
  • Delays in diagnosis increase as people age
  • 1/4 of older adults screened positive for depression
  • very few older adults access health services for mood or anxiety disorders
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3
Q

Is Aging Linear?

A
  • Some individuals age prematurely due to complex, multiple, and chronic health problems or socio-economic circumstances
  • aging is loosely associated with a person’s age in years”
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4
Q

What SDOH’s affect Mental Health of older people?

A
  • stigma against mental illnesses
  • mental health care disparity
  • flawed criminal justice system
  • homelessness
  • aging-related social determinants: ageism, workforce shortage, and social isolation/loneliness
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5
Q

What is Ageism?

A

Ageism: stereotypes, prejudices and attitudes and behaviour against the older adults

  • this view of aging can be internalized by older individuals and enacted
  • Ageism causes inequalities and has detrimental effects on the
    individual, community and society
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6
Q

Effects of Stigma

A
  • Stigma against mental disorders is greater in later life
  • Mental illness stigma can lead delay seeking care
    ex. Depression, delirum or dementia (3ds) - do not seek care b/c of stereotypes
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7
Q

Why is Accessing Care Difficult?

A
  • The geriatric mental health workforce is small (even in high-resourced countries)
  • the number of psychiatrists trained in geriatric psychiatry has not increased
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8
Q

What is the Impact of Loneliness?

A
  • Cognitive impairment
  • Physical attributes/health
  • behavoiurs
  • Loneliness is more common in people with severe mental disorders (ie. schizophrenia)

Loneliness is associated with:
- Alcohol and drug abuse, suicidality, poor nutrition, sedentary lifestyle, inadequate sleep, and worsening physical functioning

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9
Q

What strategies can reduce negative MH outcomes?

A

1) Wisdom
- Wisdom is associated with positive outcomes, including better overall physical and mental health, happiness, and lower levels of depression and loneliness

  • Intergenerational activities (grandparents’ help in raising grandchildren) have been found to benefit both the generations biologically, cognitively and psychosocially

2) Resilience
- Resilience is associated with better health and functioning as well as greater longevity in all age groups, but especially in older adults

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10
Q

What is the importance of having a meaning of life in terms of MH?

A
  • there is a link between purpose in life and better physical, psychosocial and over all health outcomes, including social engagement, in older adult populations
  • Meaning in life may can be a protective factor against suicide
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11
Q

What is Life review therapy?

A
  • an individual or group story-telling intervention with a focus on integrating life stories through different phases in life
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12
Q

What are the most common mental illnesses?

A
  • mood and anxiety disorders are most common?

Mental Illness: Persistent feelings of sadness, hopelessness, and/or loss of interest or pleasure in previously enjoyable activities for 2 weeks or more

  • For older adults, depression includes cognitive and physical changes, memory problems, disturbed sleep, decreased energy or excessive tiredness, decreased appetite, and thoughts of suicide
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13
Q

Depression

A

Depression in older adults is associated with:
- physical disorders and frailty

  • mild cognitive impairment
  • social determinants of health (e.g. major role transitions, bereavement, loneliness and social isolation)
  • exposure to poly-pharmacy
  • heightened risk for suicide
  • brain aging
  • dementia & suicide risk
  • Late-life depression can cause caregiver burden for family members
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14
Q

Insomnia

A

Insomnia
- a symptomatic manifestation of major depression
- also a risk factor for incident and recurrent depressive episodes

  • Persistent insomnia (insomnia disorder) heightens the risk for chronic relapsing and requires independent clinical attention to optimize outcomes
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15
Q

6 Ways to Prevent Depression

A

1) Monitor your mood daily

2) Develop a daily routine

3) Connect with others daily

4) Small acts of kindness

5) Actively look for 5 positive or pleasurable events each day

6) Schedule a pleasurable or joyful activity every day – whether you want to or not

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16
Q

Mood and anxiety disorders

A
  • suicide rates are alarmingly high for older men
  • People 65 and older have the highest rate of hospitalizations for anxiety disorders
17
Q

Substance Misuse

A
  • Substance use disorders are often overlooked as causes of problems for older adults
  • elders, 65+ have higher levels of illicit drug use and prescription drug misuse than other age cohorts
  • 15-30% of people with major late-life depression have an alcohol use problem
  • Older adults are more vulnerable to effects of alcohol on cognition, emotions, and balance
  • Substance misuse can result in acute and longer-term cognitive impairment, depression, or anxiety and may contribute to: FALLS
  • Prescribed medications (e.g. chronic pain or sleep difficulties) can also cause substance dependence and complications similar to those of alcohol misuse
18
Q

Treatment for Substance Use

A
  • Most valuable long-term intervention: Group support for abuse and addiction is the
  • Groups such as Alcoholics or Narcotics Anonymous can help older adults with a substance use disorder by reducing isolation, shame and stigma
  • team-based collaborative care models provide an evidence-based and scalable way for health system to implement prevention and personalized care
  • telemedicine and integration of peer-support specialists, counsellors, and community health workers bridge the gap created by the lack of MH professionals
19
Q

Persistent Psychotic Disorders

A
  • includes Schizophrenia and delusional disorders
  • While the overall prevalence of older adults affected by such disorders is low (1 – 2%), the individuals affected require significant support
  • Predictors of sustained remission include greater social support, being (or having been) married, higher level of cognitive/personality reserve, and early initiation of treatment
  • Patients with very chronic illness, severe symptoms including disorganized thinking and behaviour, resistance to treatment, and brain abnormalities are at higher risk of poor prognosis
  • the clinical course of schizophrenia is stable
  • there is often improvement in psychotic symptoms with age
  • more hospitalizations in elders with schizophrenia are due to physical rather ad psychological problems
20
Q

MH Promotion and Prevention Strategies for Healthy Aging

A
  • Measures to reduce financial insecurity and income inequality
  • Programs to ensure safe and accessible housing, public buildings and transport
  • Social support for older adults and their carers
  • Support for healthy behaviours
  • Health and social programs targeted at vulnerable groups
21
Q

MH Promotion Strategies

A

1) Prompt Recognition and Treatment
- of MH conditions and neurological and substance use conditions

2) Integrated Care
- that is community-based and focused on long-term care of adults living with MH conditions

3) Mix of mental health interventions
- interventions alongside supports that address health, personal care, and social needs of individuals

4) Positive agin should be promoted
- resilience, wisdom, and prosocial behaviours must be highlighted and promoted

N2270 (12 decks)

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