Quiz #2 Flashcards
(28 cards)
mental health
- About 20% of older adults have a mental health issue
- Depression, dementia, anxiety, delusional disorders are most common
- Women tend to have higher rates of mental illness
- Decline often results from disease processes or inability to cope with stress related to change in physical health, death of a partner, social isolation, etc.
- Mental health disorders are often undiagnosed or misdiagnosed
depression
- Depression affects 2-5% of older persons
- Higher rates for women and LTC residents
- Triggered by multiple concurrent personal crises/losses, lack of social support, living alone, drug interactions, chronic pain, disability, physical illness, dementia, fear of falling, strain of caring for a frail spouse, diagnosis of a terminal illness
- Depression amplifies functional disabilities, interferes with treatment and rehabilitation, and contributes to decline in physical and cognitive functioning
symptoms of depression
- Loss of energy
- Decreased interest and pleasure in usual activities
- Pain and somatic complaints
- Decreased interest and pleasure in usual activities
- Complaints of memory problems
Overlooked by health professionals/difficult to detect due to:
- Older adults reluctant to admit to psychological difficulties/symptoms; more likely to communicate physical symptoms
- Several symptoms of depression (sleep issues, fatigue/low energy) also naturally occur in older adulthood - misattributed to normal aging
- Myth that its normal for older adults to feel some amount of depression
suicide
Males 85 and older are most at risk
Rates are rising as longevity increases
delirium
- worsening or change in a person’s mental state that happens suddenly, usually over one to two days, fluctuations are common
- Those with dementia can have delirium too, making cognition worse or causing the person to not be their usual self; therefore important to get a baseline from family/friends/carers
hyperactive delirium
restlessness, agitation, resistive/aggressive, hallucinations/delusions
hypoactive delirium
withdrawn, lethargic, drowsy, unfocused (often missed due to the patient being “well behaved”)
mixed delirium
Combination of hyperactive and hypoactive; switch between the two
symptoms of delirium
- Be easily distracted
- Be less aware of where they are or what time it is (disorientation)
- Suddenly not be able to do something as well as normal (functional decline) (eg. walking or eating)
- Unable to speak clearly or follow a conversation
- Sudden mood swings
- Hallucinations (seeing or hearing things, often frightening)
- Have delusions or become paranoid
risk factors for delirium
Hospitalization
Pain
Infection or other medical condition
Poor nutrition
Constipation or urinary retention
Dehydration
Low levels of blood oxygen (anemia)
A change in medication
Abnormal metabolism (eg. low salt or blood sugar levels)
An unfamiliar or disorientating environment
those at high risk for delirium
Those with dementia
Over 65
Frailty
Multiple medical conditions
Poor healing/vision
Polypharmacy
Previous delirium
dementia
- progressive impairments in memory and other cognitive functions
- impairs memory, thinking, behaviour
- Prevalence is greater among women and increases with age
- To be considered dementia, impairment must be present in at least two functions: memory, communication/language, ability to focus or pay attention, reasoning/judgment, and visual perception and later mood and behaviour
- types of dementia: Alzheimer’s disease, vascular dementia, Lewy body, frontal-temporal dementia, mixed dementia
- Most common type is alzheimer’s disease
- Degenerative disease of the brain
- Begins with loss of short term memory and progressively destroys most cognitive functioning
- No simple test confirms a diagnosis of alzheimer’s disease
risk factors of dementia
Lower levels of early life education (up to 12 years of age)
Midlife hypertension (45-65 years of age)
Obesity
Hearing loss
Smoking in later life (over age 65)
Depression
Physical inactivity
Diabetes
Social isolation
recommendations for how to deal with rising rates of dementia
1) Increasing the investment in dementia research
2) Providing support for informal caregivers
3) Emphasizing prevention and early intervention
4) Building an integrated system of care
most common chronic illnesses
Hypertension
Osteoarthritis
Ischemic heart disease
Osteoporosis
COPD
chronic illnesses more common among women
Osteoporosis
Rheumatoid arthritis
mood/anxiety disorders
Dementia
Asthma
Osteoarthritis
chronic illnesses more common among men
Gout
Ischemic heart disease
Parkinsons
Diabetes
Cancer
Heart failure
chronic illness and health perception
- Almost half of canadian seniors perceive their health as very good or excellent and over ⅔ report their mental health as being very good or excellent, despite living with chronic illnesses
- Older adults perception of personal health status is not dependent on the absence of health
- Other factors that may attribute to positive perceptions of health status include:
- Economic security
- Social connectedness
- Satisfaction with life and psychological well being
living with multiple diseases can
Affect ADLs
Reduce quality of life
Increase mortality risk
Chronic pain
Lead to use of multiple medications-risk of inappropriate drug use and adverse drug events
Isolation and loneliness
Require greater health care resources
chronic illness: risk factors
Tobacco use
Harmful use of alcohol
Unhealthy eating
Physical inactivity
chronic illness: prevention
through supporting healthy behaviors and choices
the creation of age-friendly, safe, and socially supportive environments
reducing health inequities faced by vulnerable seniors
chronic illness: interventions
Care coordination interventions are most effective combined with:
- Case management
- Care pathways
- Self management
- Education
impact of falls
- falls are the direct cause of 95% of all hip fractures, leading to death in 20% of cases
- The majority of falls resulted in broken or fractured bones, and over ⅓ of fall related hospitalizations were associated with a hip fracture
- Hospitalization was an average of 9 days longer than those hospitalized for any cause
- The number of deaths due to falls increased by 65% from 2003 to 2008
- In 2017-2018, over half of all injury related hospitalizations in Canada were for seniors 65+
Of these hospitalizations 81% were due to falls
risk factors for falls: biological
Acute illness
Balance and gait deficits
Chronic conditions and disabilities
Cognitive impairment
Low vision
Muscle weakness and reduced fitness
