PMH1011 Lecture Notes - Lecture 10: Differential Diagnosis, Mild Cognitive Impairment, Prescription Drug
4 Jul 2018
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1. WEEK 10 – MENTAL HEALTH IN LATER YEARS (CH.11)
Learning Objectives
Appreciate the normal changes that occur in the brain as we age.
Understand the prevalence of depression in the elderly.
Explain the symptoms that differentiate depression in older adults from depression in
other age groups.
Identify the major risk factors for developing depression in old age.
oFor example: bereavement; accrual of medical pathology; medication (CNS) side
effect; vascular changes are part of normal ageing, but a high load can result in
depressive conditions; cognitive disorders such as Alzheimer’s disease; psychosocial
disadvantage/stresses (low economic status; loss of economic independence/ability to
contribute within society); caring for an ill partner.
Understand the assessment and treatment options for depression in the elderly.
Explain the risk factors associated with attempted and completed suicide in older adults.
Appreciate the distinction between normal ageing and the development of dementia.
Understand the prevalence, risk factors and protective factors for the development of
dementia.
Introduction
Care for someone is to actively elevate their interest and wellbeing to a position of
primacy.
HP approach to caring based upon recognition of who this older person is. This
approach is also consistent with biopsychosocial understanding.
Effective HP do not pathologist ageing.
Depression, anxiety, dementia, suicide and myriad other mental illnesses are not the
inevitable consequences of ageing.
Understanding the experiences of the older person is brought into sharp focus with the
problems of delirium.
The ageing process has been described in terms such as ‘wise’, ‘slow’, ‘senile”, ‘ill’,
‘infirm’, ‘forgetful’, ‘frail’ and ‘decrepit.
Senile: A state where the person may exhibit memory loss or unclear cognitive or
mental impairment that is sometimes associated with ageing.
A combination of ageist social values and an increasing tendency to medicalize ageing
sees the ageing process often couched in terms of cognitive decline.
Pervasive ageism among HP in the way the older person is so easily labelled in
pejorative terms like ‘social admission’ and ‘acopia’.
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find more resources at oneclass.com
Social Admission: A label often used to describe a patient who has been admitted to
hospital to address social needs, rather than a biomedical condition; usually negative in
connotation.
Acopia: A label often used to describe someone who has a low level of coping skills or
finds it difficult to cope with life’s experience usually negative connotation.
Normal Signs of Older Age
Physical changes – somatic diseases
oMusculoskeletal
oCardiovascular
oMetabolic
oEndocrine
oGastrointestinal
oSensory deficits
oPain and medication
oBrain (vascular, degenerative)
Psychological Changes
oPersonality
Amplification of character traits
oCognitive, memory
Mental slowing
Transformed memory structure
Summarized experiences
oEmotional Changes
Emotional maturity
Grief and Loss
oSocial Change
Retirement (financial difficulties)
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find more resources at oneclass.com
Decrease in social status (retirement)
Facing somatic and mental dysfunction
Grief (loss of spouse, brothers or sisters, friends)
Social isolation
Moving to nursing/residential home.
Assessing the Older Person
Biopsychosocial Approach
oDispite there being some common themes when caring for the elderly they are
still a heterogeneous group.
It is important to consider all these elements and how they related to the
individual
This will help avoid stigma and discrimination
Culmination of these biopsychological factors= “Knowing the person”
This is often the foundation of all psychological assessment in this
population.
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Week 10 mental health in later years (ch. 11) Appreciate the normal changes that occur in the brain as we age. Understand the prevalence of depression in the elderly. Explain the symptoms that differentiate depression in older adults from depression in other age groups. Identify the major risk factors for developing depression in old age. o. Understand the assessment and treatment options for depression in the elderly. Explain the risk factors associated with attempted and completed suicide in older adults. Appreciate the distinction between normal ageing and the development of dementia. Understand the prevalence, risk factors and protective factors for the development of dementia. Care for someone is to actively elevate their interest and wellbeing to a position of primacy. Hp approach to caring based upon recognition of who this older person is. This approach is also consistent with biopsychosocial understanding. Depression, anxiety, dementia, suicide and myriad other mental illnesses are not the inevitable consequences of ageing.
