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Mental health in older people - Naomi Gallant


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I was privileged to be able to speak as part of a Lent series at St. Paul's and St. Peter's church, Great Missenden about Mental Health and Human Flourishing in aging.In summary I highlighted 3 key areas where mental ill-health can become a problem in aging: dementia, delirium and depression

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Mental health in older people - Naomi Gallant

  1. 1. Mental health in older people @naomi_gallant
  2. 2. Naomi Gallant -
  3. 3. The 3Ds Dementia Delirium Depression Naomi Gallant -
  4. 4. The 3D Quiz - Definitions Progressive loss of brain cells… a terminal condition: An acute or sudden onset: A change in mood lasting at least 2 weeks: Naomi Gallant - Dementia Delirium Depression
  5. 5. The 3D quiz - Duration Years (usually 8-20): Hours to months, dependant on speed of diagnosis: At least 6 weeks, can last months to years if untreated: Naomi Gallant - Dementia Delirium Depression
  6. 6. The 3D Quiz: Thinking Fluctuates… distorted thinking, incoherent speech: May be indecisive, highlight failures/hopelessness: Gradual loss of cognition: Naomi Gallant - Dementia Delirium Depression
  7. 7. The 3D Quiz: Mental status testing Capable of giving correct answers: Attempt to answer, not aware of mistakes: Testing may vary dependant on fluctuating cognition: Naomi Gallant - Dementia Delirium Depression
  8. 8. The 3D Quiz: Memory Recent and past memory impairment: Generally intact, highlights negativity: Recent and immediate memory impairment: Naomi Gallant - Dementia Delirium Depression
  9. 9. The 3D Quiz: Sleep-wake cycle Disturbed, usually early morning awakening: Disturbed, sleep-wake cycle often reversed: May awaken often at night, may wander: Naomi Gallant - Dementia Delirium Depression
  10. 10. The 3D Quiz: Hallucinations/delusions Can be present. Usually guilty and negative to self: Can be present, may misperceive: Often frightening or paranoid: Naomi Gallant - Dementia Delirium Depression
  11. 11. The 3D Quiz: Diagnosis Usually diagnosed approx. 3 years after symptom onset: Diagnosis based on rapid onset of fluctuating symptoms: May notice symptoms before the person does: Naomi Gallant - Dementia Delirium Depression
  12. 12. The 3D Quiz: Care approaches Early recognition is key… find cause and treat quickly: Identify symptoms early. Help person to follow treatment plan and offer hope: Maintain and enhance abilities the remain: Naomi Gallant - Dementia Delirium Depression
  13. 13. The 3D Quiz: Prognosis Treatable and reversible if caught early: Treatable and reversible: Progression can be slow but not reversible: Naomi Gallant - Dementia Delirium Depression
  14. 14. The 3D Quiz: Treatment Treat cause: Antidepressants, ECT, cognitive therapy: ..slow the progression. Symptomatic treatment with environmental and staff approaches: Naomi Gallant - Dementia Delirium Depression
  15. 15. Dementia: some stats • Dementia is non-discriminatory • 1/3 older people will end their lives with dementia • 2 million people by 2051 • There is no cure • Dementia costs the UK £26.3billion a year • 670 000 people in the UK act as primary, unpaid carers for people with dementia. Naomi Gallant -
  16. 16. • Alzheimer’s • Vascular • Lewy Body • Frontal • Frontotemporal • +100 more Naomi Gallant -
  17. 17. 3 key principles (Dr Jennifer Bute) There is always a reason behind the behaviour Normal human responses to: Confusion Loss of control Fear/anxiety Tiredness Expressing needs (pain, hunger, toilet) Sadness Naomi Gallant -
  18. 18. When facts are forgotten, feelings remain “My yesterdays are disappearing, and my tomorrows are uncertain, so what do I live for? I live for each day. I live in the moment… I will forget today, but that doesn’t mean that today doesn’t matter.” ― Lisa Genova, Still Alice Naomi Gallant -
  19. 19. Familiar patterns of behaviour continue Naomi Gallant -
  20. 20. Faith in Dementia Romans 8 v 35, 37-39 – Nothing can separate us from God’s love. Psalm 139 v 7-10 – We cannot go anywhere to escape God. Romans 9 v 14 – 16 – Every day we are alive is an opportunity for mercy. Naomi Gallant -
  21. 21. Beyond words… • Make the most of every moment – feelings will continue • Never forget the person behind the diagnosis or behaviour • Explore the senses Naomi Gallant -