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MENTAL HEALTH & Disease in Elderly

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MENTAL HEALTH & Disease in Elderly MENTAL HEALTH & Disease in Elderly Module 4 Unit 1: History of Mental Health & Management LEARNING OBJECTIVES • Upon completion of the course, the learner is expected to be able to: • Analyze the factors that determine health and individual behavior in health • Discuss theories and models concerning health promotion interventions in mental health • Apply screening tools for mental health disease (depression and dementia) in the elderly • Recognize the key symptoms and signs of mental health disease in the elderly • Demonstrate communication techniques and individualized care strategies Case Study (for self-reflection) picture from pixsabay.com Mr. Jones is a 75 -Have you met years old and he has people like Mr. Jones been living in a before? hospice since his wife died five years -What do you think ago. are his most important needs and challenges? • There is no "official" definition of mental health. Cultural differences, subjective assessments, and competing professional theories all affect how "mental health" is defined. In general, most experts agree that "mental health" and "mental illness" are not opposites. In other words, the absence of a recognized mental disorder is not necessarily an indicator of mental health Definition by WHO Introduction picturefrompixsaby.com • “Mental health is a concept that refers to a human individual's emotional and psychological well-being˶ • Before you read the content of the course press the button with the learning objectives to learn more • Mental health definition is։ "A state of emotional and psychological well-being in which an individual is able to use his or her cognitive and emotional capabilities, function in society, and meet the ordinary demands of everyday life." HISTORY OF MENTAL HEALTH • By the end of the 17th century and into the Enlightenment, madness was increasingly seen as an organic physical phenomenon, no longer involving the soul or moral responsibility. The mentally ill were typically viewed as insensitive wild animals. Harsh treatment and restraint in chains was seen as therapeutic, helping suppress the animal passions. • The turn of the 20th century saw the development of psychoanalysis, which came to the fore later. Kraepelin's classification gained popularity, including the separation of mood disorders from what would later be termed schizophrenia • Asylum superintendents sought to improve the image and medical status of their profession. Asylum "inmates" were increasingly referred to as "patients" and asylums renamed as hospitals. Referring to people as having a "mental illness" dates from this period in the early 20th century INTERACTIVE THERAPIES AND METHODS OF IMPLEMENTATION • The twenty first century Psychiatrist moves freely from an understanding of the normal or abnormal mind/brain to thinking about disruption in neural circuits and neurochemistry • Although the Psychotherapies do not use medications to effect change, they do cause biological changes in the brain/mind that are just as real as physical as those produced by medications. 8 INTERACTIVE THERAPIES AND METHODS OF IMPLEMENTATION • Increasingly, Psychotherapists and other Neuroscientists recognize that Psychotherapies capitalized on the fact of brain plasticity and produce long term changes at the neural level. They do so by training the brain to form new connections 9 Different types of illness • Bulimia Nervosa • Predominantly Compulsive Acts (Obsession Rituals) • Agoraphobia • Anxious (Avoidant) Personality Disorder • Personality Disorders • Attention Deficit Hyperactivity Disorder (ADHD) • Bipolar Disorder • Eating Disorders • Social Phobia • Psychosis – Schizophrenia • Dementia • Depression • Mood Disorders –Bipolar Disorder • Personality Disorders Case Study picture from pixsabay.com Mr. Jones is often -Do you think these are complaining that he is not common issues? given enough food although in fact his food is always left -What do you think are untouched by his bedside. the reasons for his He is also often seen crying behavior? during the night and not -What risk factors wishing to get out of bed next morning predispose for such symptoms? Activity 1. Health promotion interventions 1. The definition of ‘mental health’ is likely to be affected by: a. Subjective estimations and assessment results b. Cultural factors c. Both a and b 2. According to contemporary Psychiatric approaches, mental health disorders are attributed to: a. Brain abnormalities b. Neural disruptions c. Abuse of medicine 3. Modern Psychotherapy aims at: a. Training the brain to form new neural connections b. Mitigating brain damage c. Preventing mental health illnesses 4. The 3 D’s of mental health disorders refer to: a. Deficit of Attention, Depression, Delirium b. Dementia, Depression, Delirium c. Delirium, Disorder of personality, Disorder of behaviour Unit 2: The 3Ds of old age The 3D”s Dementia -Depression -Delirium https://www.y https://www.youtub outube.com/w Dementia Depression Delirium e.com/watch?v=2ik IlSgJ90w&t=146s atch?v=qmMYs VaZ0zo Epidemiology of Dementia • Estimated that 1.3% of the entire UK population, or 7.1% of those aged 65 or over, have dementia. • An estimated number of 19,765 people living with dementia in Northern Ireland. • A clinical syndrome include a variety of underlying pathophysiological processes. Most common • Alzheimer's disease (50-75%) • Vascular dementia (20%), • Dementia with Lewy bodies (5%) • Frontotemporal lobar dementia (5%). • The symptoms make people with dementia more dependent and vulnerable, both socially and in terms of physical and mental health, presenting evolving challenges to society and to our healthcare systems. Symptoms of Dementia https://www.youtube.com/watch?v=qmMYsVaZ0zo picture from pixsabay.com • Or Psychologic Behavioral Neuropsych A group of al non cognitive Symptoms iatric symptoms symptoms Symptoms Neuropsychiatric Symptoms of Dementia picture from pixsabay.comBehavioral and psychological signs and symptoms of dementia: a consensus statement on current knowledge and implications for research and treatment.Finkel SI, Costa e Silva J, Cohen G, Miller S, Sartorius N Int Psychogeriatr. 1996; 8 Suppl 3():497-500. • High Sufferers Disturbed Mood & Motor Alter and their personality level of emotions perception Thoughts activity distress caregivers traits Classification of Dementia DSM-IV-TR and ICD-10 consists that dementia has features like gradual and multiple cognitive deficits (involving memory and at least one additional cognitive domain) not occurring exclusively during delirium and representing a decline from a previous level of functioning (American Psychiatric Association, 1994). Dementia may code as Alzheimer disease, AD) in axis III and specific mental disorders (e.g., mood or psychotic disorder) in axis I American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th Edn. Washington, DC: American Psychiatric Association Disturbances in emotional experience https://www.youtube.com/watch?v=CJ1tEtrPQzg (video early signs of dementia ) Depression frequently masked by dementia, feelings of sadness, unhappiness, and preoccupation with depressing topics, hopeless (strongly associated with suicidal ideation) and loss of self-esteem (Prado-Jean et al., 2010). anhedonia (lost of interest in previous pleasurable stimuli), expression of somatic concerns and anxiety, a subjective unpleasant experience of fear manifested as apprehension, tension, panic, or worry associated with autonomic activation and observable physical and motor manifestations of tension. Apathy LACK of motivation with additional loss or diminished goal- directed behaviors, cognitive activities and emotions (Robert et al., 2009). Elated mood, ranging from hypomania to severe mania, cheerfulness, euphoria that is out of proportion to the circumstances often associated with a heightened emotional tone or emotional reactivity, irritability, hunger, sleepiness, and pain, rapid emotional shifts, within seconds or minutes. Delusions and abnormal thought content Delusional ideas (false believes strongly held, enduring, and irrefutable) The delusions are typically less complex and organized than those observed in non-demented psychotic patients and the usual content of delusional thoughts involves suspiciousness, abandonment, and misidentification (Jeste et al., 2006). Examples include the conviction that: people are coming into the home and hiding/stealing objects, the newspaper is writing for him or the conviction that spouse is an impostor accusation of a conspiracy to abandon or institutionalize; conviction that spouse is unfaithful (Tariot et al., 1995). When associated with severe depression, delusional thoughts can involve guilt, worthless, reference, and persecution. Perceptual disturbances Is difficult to ascertain whether the perceptual disturbance is an illusion or whether the patient is having a perception in the absence of sensory stimuli (hallucination). Visual hallucinations are common in dementia with Lewy bodies (DLB). They are recurrent, and typically consist of well formed images of animals or persons that the patient describes in detail (McKeith et al., 2005). Disturbances in motor function Motor retardation (slowed movements and speech, reduced body tone, and decreased number of spontaneous body movements, whereas motor hyperactivity is characterized by an increased energy level with more frequent movements and/or rapid speech). Agitation- repetitive, purposeless behaviors, social inappropriate activities (tendency to disregard social
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