Older Persons Mental Health Flashcards
What are some of the assessment challenges when assessing an older person for depression?
- Difficult to distinguish between depression and dementia
- Diagnostic overshadowing
- Ageism
- Cultural issues
Should we assess older people for the risk of suicide? Why?
Yes, older aged people may be vulnerable to suicide, particularly where there is an increase in the complexity of lifelong stressors. Significant issues may enhance feelings of loss: losing or having lost a life partner; bereavement and becoming socially isolated; or other risks which can include cognitive decline or impairment
Dementia
Onset: Chronic
Course: Slow, progressive cognitive failure; symptoms may be worse in evening (sundowning)
Duration: Months to years
Signs & Symptoms:
- Conscious
- Behaviour tends to be worse in the evening
- Aimless wandering or searching
- Mood may be flattened or labile
Delirium
Onset: Rapid onset, usually hours or days
Course: Short, diurnal fluctuations in symptoms
Duration: Hours to days
Signs and symptoms:
- Clouding of consciousness
- Sleep disturbance
- Restless and uneasy
- Emotional lability and distress
onset, course, duration and signs and symptoms
Depression
Onset: Often abrupt and may coincide with life events such as death of a loved one
Course: Diurnal fluctuations, worse in the morning
Duration: Six weeks to years
Signs and symptoms:
- Conscious
- Sleep-wake disturbance
- Selective disorientation
- Sad, feeling hopelessness and helplessness
What are some of the risk factors for delirium? Why are older people more at risk?
- Are acutely unwell or have a chronic illness
- Are acutely unwell or have a chronic illness
- Have a pre-existing diagnosis of dementia or depression
- Are 70 years of age or older
- Have sensory impairment such as poor eyesight
- Are taking multiple medications
- Are in drug withdrawal, including from alcohol
-Elderly are more at risk of a delirium, as they are more at risk of the risk factors that can lead to delirium
Sun downing
Unsettled presentation and worsening neuropsychiatric symptoms of people with dementia in the afternoon and early evening
Agnosia
Inability to recognise familiar objects, people, sounds, or smells, even when the underlying senses are intact
Apraxia
A neurological disorder that causes difficulty with motor planning, making it hard to perform voluntary movements
Aphasia
Inability (or impaired ability) to understand or produce speech
What are the clinical features of dementia?
A decline in cognitive abilities like memory, thinking, and reasoning, leading to difficulties in daily life.
Early signs often include memory loss, especially for recent events, difficulties with language, concentration, and decision-making.
Later stages: involve disorientation, behavioural changes, and physical problems.
What are some of the common medical conditions frequently associated with depression?
Cardiovascular disease, cancer, diabetes, respiratory diseases, stroke.
