MENTAL HEALTH FIRST AID FOR OLDER ADULTS Betsy

MENTAL HEALTH FIRST AID FOR OLDER ADULTS Betsy Chivers, Training Coordinator The Alaska Training Cooperative

MENTAL HEALTH FIRST AID FOR OLDER ADULTS Objectives Interactive and participatory What is Mental Health First Aid Who should be a ‘Mental Health First Aider’ Facts about Mental Illness Common Mental Health Illnesses Terms Symptoms Risk Factors Why Older Adults are at risk Sharing story

MENTAL HEALTH FIRST AID FOR OLDER ADULTS Mental Health First Aid is the help offered to a person developing a mental health problem or experiencing a mental health crisis. The first aid is given until appropriate treatment and support are received or until the crisis resolves.

MENTAL HEALTH FIRST AID FOR OLDER ADULTS Stand up/raise your hand/shout if you knew or know your Great grandparents Grand parents Parents Aunts, uncles, cousins, nieces, nephews Friends We all have family…someone we care about

MENTAL HEALTH FIRST AID FOR OLDER ADULTS Who Makes a Successful ‘Mental Health First Aider’ Do you have concern and empathy for other people Would you like to create a sense of community and belonging for others Are you warm, accessible, enthusiastic and caring Can you shift gears when circumstances change Do you ask and/or seek help when you need it

MENTAL HEALTH FIRST AID FOR OLDER ADULTS Take a moment to consider these questions Would you like to CELEBRATE your birthday next year? How about CELEBRATING it in 5 years? How about CELEBRATING it in 10 years? How about CELEBRATING it in 15 years? How about CELEBRATING it in 20 years? If you answered YES and you do celebrate any of the above – Chances are GOOD, you will become an OLDER ADULT, you may have family and friends who will be too!

MENTAL HEALTH FIRST AID FOR OLDER ADULTS YOU MAY WANT TO CONSIDER BECOMING A CERTIFIED MENTAL HEALTH FIRST AIDER FOR OLDER ADULTS…. What does it take? A commitment of 8 hours

MENTAL HEALTH FIRST AID FOR OLDER ADULTS Facts Regarding Mental Illness, why Mental Health First Aid Mental health problems are common Stigma and bias are associated with mental health problems Many people are not well informed about mental health problems Professional help is not always on hand People often do not know how to respond People with mental health problems often do not seek help

MENTAL HEALTH FIRST AID FOR OLDER ADULTS A mental disorder or mental illness is a diagnosable illness that: Affects a person’s thinking, emotional state, and behavior Disrupts the person’s ability to Work Carry out daily activities Engage in satisfying relationships

MENTAL HEALTH FIRST AID FOR OLDER ADULTS The Impact of Mental Illness Mental illnesses can be more disabling than many chronic physical illnesses “Disability” refers to the amount of disruption a health problem causes to a person’s ability to Work Carry out daily activities Engage in satisfying relationships

WHY MENTAL HEALTH FIRST FOR OLDER ADULTS

MENTAL HEALTH FIRST AID FOR OLDER ADULTS Recovery from Mental Illness “Recovery is the process in which people are able to live, work, learn, and participate fully in their communities. ” “For some, this is the ability to live a fulfilling and productive life despite a disability. ” “For others, recovery implies the reduction or complete remission of symptoms. ” — President’s New Freedom Commission on Mental Health

Mental Health First Aid for Older Adults COMMON TERMS & ILLNESSES ASSOCIATED WITH OLDER ADULTS Senior Moment Geezer Senile Cancer Grumpy Little Old Lady Type 2 Diabetes Oldster Cataract Shriveled Heart Disease Macular Degeneration Stroke Rumpled Pneumonia Alzheimer’s Disease Parkinson’s Disease Dementia Mature Elderly Kidney Disease Sage Arthritis Senior Hypertension Old coot Decrepit Osteoporosis Lung Disease Coronary Artery Disease Cranky

MENTAL HEALTH FIRST AID FOR OLDER ADULTS Depression and Anxiety Are among the most common mental illnesses Can have some similar signs and symptoms Can frequently co-occur

MENTAL HEALTH FIRST AID FOR OLDER ADULTS Depression Major depressive disorder lasts for at least 2 weeks and affects a person’s Emotions, thinking, behavior, and physical well-being Ability to work and have satisfying relationships

MENTAL HEALTH FIRST AID FOR OLDER ADULTS Anxiety An anxiety disorder differs from normal stress and anxiety An anxiety disorder is more severe, lasts longer and interferes with daily activities and relationships

MENTAL HEALTH FIRST AID FOR OLDER ADULTS Risk Factors for Depression and Anxiety Distressing and uncontrollable event Stressful or traumatic events Difficult childhood; history of childhood anxiety Ongoing stress and anxiety Another mental illness Previous episode of depression or anxiety Family history

MENTAL HEALTH FIRST AID FOR OLDER ADULTS Risk Factors for Depression and Anxiety More sensitive emotional nature Illness that is life threatening, chronic, or associated with pain Medical conditions Side effects of medication Lack of exposure to bright light in winter Chemical (neurotransmitter) imbalance Substance misuse; intoxication, withdrawal

MENTAL HEALTH FIRST AID FOR OLDER ADULTS Risk Factors for Depression and Anxiety Perceived poor health Progressive/disabling sensory loss History of recurrent falls Cognitive impairment or dementia Extended or long-standing bereavement Dissatisfaction with social network Preoccupation with somatic (physical) symptoms

MENTAL HEALTH FIRST AID FOR OLDER ADULTS The Snowball

MENTAL HEALTH FIRST AID FOR OLDER ADULTS MENTAL ILLNESS -

MENTAL HEALTH FIRST AID FOR OLDER ADULTS Psychosis is a condition in which a person has lost some contact with reality The person may have severe disturbances in thinking, emotion, and behavior Disorders in which psychosis can occur are not as common as depression and anxiety disorders Psychosis usually occurs in episodes and is not a constant or static condition

MENTAL HEALTH FIRST AID FOR OLDER ADULTS Common Symptoms When Psychosis is Developing Changes in Emotion and Motivation Depression Anxiety Irritability Suspiciousness Blunted, flat, or inappropriate emotion Change in appetite Reduced energy and motivation

MENTAL HEALTH FIRST AID FOR OLDER ADULTS Risk Factors of Psychosis in Older Thyroid disease Diabetes Vitamin B 12 and folate deficiency Sodium-potassium imbalance Sleep deprivation Dehydration Dementia Drug-induced psychosis/delirium Chronic illnesses Schizophrenia Bipolar disorder Psychotic depression Patients

MENTAL HEALTH FIRST AID FOR OLDER ADULTS MENTAL ILLNESS -

MENTAL HEALTH FIRST AID FOR OLDER ADULTS Delirium Symptoms Features Inability to sustain focus or attention Disorientation to time, place and people Impaired judgment Poor impulse control Causes Adverse medication side effect Drug-drug interaction Disturbance in body function (high fever, infection) Reaction to anesthesia Requires immediate medical attention

MENTAL HEALTH FIRST AID FOR OLDER ADULTS Delirium Behavior changes Seeing things that don’t exist Restlessness, agitation, combative behavior Calling out, moaning, or making other sounds Being quiet and withdrawn – especially in older adults Slowed movement or lethargy Disturbed sleep habits Reversal of night/day sleep/wake cycle

MENTAL HEALTH FIRST AID FOR OLDER ADULTS Delirium Risk factors/causes Adverse medication side effect Drug interaction Disturbance in body function (high fever, infection) Reaction to anesthesia Requires immediate medical attention

MENTAL HEALTH FIRST AID FOR OLDER ADULTS Characteristics of Dementia Deterioration in brain function beyond the normal range of age-related brain changes Has many causes - stroke, brain injury, alcoholism, disease (HIV, Parkinsons, Multiple Sclerosis) Alzheimer’s disease is the most common irreversible type Degree of impact and progression varies from mild to severe according to cause, disease course, area of brain affected, etc. Important to address quickly and may be treatable

MENTAL HEALTH FIRST AID FOR OLDER ADULTS Symptoms of Dementia Depending on the cause, type and severity, people may experience any or all of the following symptoms: Struggles with problem solving and/or decision making Difficulty planning and carrying out complex tasks Problems with memory and recognizing familiar people and places Disorientation to time and place Decline in self-care Difficulty learning or retaining information Poor judgment or decision making skills Changes in sensory perception, hallucinations, delusions Difficulty with communication and language Behavioral and mood changes Impulsiveness and poor insight to behaviors

MENTAL HEALTH FIRST AID FOR OLDER ADULTS Risk Factors of Dementia Age The risk of Alzheimer’s disease, vascular dementia, and other dementias goes up significantly with advancing age Genetics/ family history Smoking and alcohol use Atherosclerosis Cholesterol, high levels of “bad” cholesterol (LDL) Diabetes Mild cognitive impairment

MENTAL HEALTH FIRST AID FOR OLDER ADULTS

MENTAL HEALTH FIRST AID FOR OLDER ADULTS Suicide Risk Assessment for Older Adults Marked feelings of hopelessness Pain and/or medical conditions that significantly limit functioning or life expectancy Co-morbid general medical conditions that significantly limit functioning or life expectancy Social isolation Family discord or losses (recent death of a loved one) Inflexible personality or marked difficulty adapting to change Access to lethal means (firearms) Impulsivity in the context of cognitive impairment

MENTAL HEALTH FIRST AID FOR OLDER ADULTS Warning Signs of Suicide Threatening to hurt or kill oneself Seeking access to means Talking or writing about death, dying, or suicide Feeling hopeless Feeling worthless or a lack of purpose Acting recklessly or engaging in risky activities

MENTAL HEALTH FIRST AID FOR OLDER ADULTS Warning Signs of Suicide (continued) Feeling trapped Increasing alcohol or drug use Withdrawing from family, friends, or society Demonstrating rage and anger or seeking revenge Appearing agitated Having a dramatic change in mood

Suicide mortality rate per 100, 000 population - by age group - all Alaskans 2003 -2017 (15 year average)

Why Mental Health First Aid for Older Adults E L L A H C G N I AG SKA A L A N I S E NG Gerontologists in Alaska 3 listed in Anchorage 3 listed in Fairbanks 2 listed in Juneau Gerontologists in Vermont 7 listed in Brattleboro 10 listed in Burlington 22 listed in White River Junction Gerontologists in North Dakota 9 listed in Fargo 7 listed in Bismarck