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Mental health issues such as depression and anxiety are NOT a normal part of aging and are hard to discuss, diagnose and treat. The good news is that there are innovative programs, tools and resources that can help.
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An Overview of Barriers & Solutions
© 2013 Griswold International, LLC
© 2013 Griswold International, LLC
“Held annually during Mental Illness Awareness Week in October, National Depression
Screening Day (NDSD) raises awareness and screens people for
depression and related mood and anxiety disorders.”
National Alliance on Mental Illness (NAMI)
© 2013 Griswold International, LLC
Our Goal for Today• Increase awareness of mental health issues in older adults and the importance of treatment
• Drive early and effective…. - Dialogue related to mental health and depression - Mental health screening and diagnosis - Treatment that drives positive outcomes
© 2013 Griswold International, LLC
Presented by:
Chris Kelly, MEd Director of Learning & DevelopmentGriswold Home Care
Thank you for your courage, energy, and dedication!
Professional CaregiversHealthcare Providers
Family Caregivers Clients Living with Mental Illness
© 2013 Griswold International, LLC
Lit Review
Social Media
Advocacy
Solutions Webinar & Toolkit
© 2013 Griswold International, LLC
© 2013 Griswold International, LLC
Brainwriting is…• a fun, engaging way to brainstorm• sharing as many ideas as possible within a short timeframe Brainwriting Process• Listen for our questions• When prompted, enter your solutions using the webinar chat function• Don’t overthink or agonize…There are no right or wrong answers Brainwriting Outcomes• Peer-to-peer learning and sharing• A publication that benefits others who are living with Depression Important• Avoid sharing any information that you would not want others to see
BRAIN WRITINGSolutions
Orange Arrow Button: Minimizes or expands the GoToWebinar control panel.
© 2013 Griswold International, LLC
• 20% of people age 55 years or older have mental health issues
• The most common mental health conditions for older adults are: - Mood disorders - Anxiety - Severe cognitive impairment
• Depression is the most common mental health condition among older adults
Mental Health and Aging in America
TOOLS
http://1.usa.gov/17GDCNqhttp://1.usa.gov/HfIfqP
The State of Mental Healthand Aging in America Mental Health and Aging
© 2013 Griswold International, LLC
The ImpactUntreated mental health conditions in older adults have been connected with chronic conditions such as:
- Heart disease- Diabetes- Stroke- Increased health care costs- Inability to function- Disability
© 2013 Griswold International, LLC
The ImpactOlder adults with untreated depression have…
- More doctor/ER visits- Increased use of medicine- Higher outpatient charges- Longer hospital stays - Increased readmission rates- Highest risk for suicide as compared to other age groups
© 2013 Griswold International, LLC
“Well, I feel as though most people that are depressed really feel
unloved - that’s the main thing or they feel unwanted or they feel as though that they are useless…like…I’m no more
use to you any more so just let me go.”
Quote from older adult with depression
Core Barriers –Older Adults
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2782754/pdf/nihms150724.pdf
- Lou Gehrig
© 2013 Griswold International, LLC
Core Client Barriers - Awareness, Beliefs and StoicismOlder adults are often…- Unaware of the symptoms - Stoic about emotional and physical pain- Reluctant to “complain”
- Skeptical about the need for treatment- Feel they can handle things on their own
TOOLS
http://bit.ly/1ibEAWU http://1.usa.gov/19YXM5d
Depression In Older Adults Older Americans Behavioral Health
© 2013 Griswold International, LLC
Core Client Barriers - �Access to Support and Services
Older adults often lack access to care and support due to:
- Medical issues - Decreased mobility- Lack of transportation- “Digital divide” – low access/comfort with e-tools (email, text, online portal)- Depression - which triggers isolation
© 2013 Griswold International, LLC
“Depression in elderly people often goes untreated because many
people think that depression is a normal part of aging and a natural reaction to chronic
illness, loss and social transition.”
National Alliance on Mental Illness (NAMI)
Core Barriers –Healthcare Providers
© 2013 Griswold International, LLC
Core Healthcare Provider Barriers - Healthcare Provider Time Constraints, Tools, Access
• Healthcare providers work very hard to recognize and treat depression• Recent research highlights that the prevalence of depression in older adults has lowered • Common provider barriers remain: - Inadequate vigilance and screening - Time constraints - Misperception/Stigma - Poor access to older adults - Using language/terms that clients and family caregivers cannot identify with
http://www.huffingtonpost.com/2013/07/11/depression-in-older-adults-down_n_3575569.html
© 2013 Griswold International, LLC
http://www.huffingtonpost.com/2013/07/11/depression-in-older-adults-down_n_3575569.html
“I didn’t know anything about depression,
so I didn’t know I was depressed.”
Older adult with depression
Screen, Discussand DiagnoseDepression
CDCP - http://www.cdc.gov/aging/pdf/cib_mental_health.pdf
© 2013 Griswold International, LLC
CDCP - http://www.cdc.gov/aging/pdf/cib_mental_health.pdf
It is important to learn about the symptoms of depression and treatment that can help
Learn About Depression
TOOLS
http://1.usa.gov/GFAHxt http://bit.ly/1bTH8rh
About Depression Caregiving and Depression
© 2013 Griswold International, LLC
• Memory problems• Confusion • Social withdrawal • Loss of appetite • Weight loss
Know the Symptoms of Depression• Vague complaints of pain • Sleeping too much or too little • Anxious and/or irritated • Delusions (thinking things that are not reality-based)• Hallucinations (seeing, hearing or feeling things that are not reality-based)
TOOLS
http://1.usa.gov/19sleuG http://bit.ly/1ibTLzvhttp://bit.ly/1fgHz38
Depression in OlderPersons Fact Sheet
Screening for Depression in Adults and Older Adults in Primary Care
American PsychiatricAssociation
© 2013 Griswold International, LLC
This is easier said than done. Depression and other mental health conditions are difficult to discuss due to the long-standing stigma of mental illness.
Talk About Depression
TOOLS
http://bit.ly/1ioFaRm
How to Talk to Your ElderlyParent About Depression
http://1.usa.gov/1bfewYm
Discussing Sensitive Topics
© 2013 Griswold International, LLC
There are several validated screening tools that help clients, providers and family caregivers to recognize and discuss depression.
Screen for Depression
TOOLS
http://bit.ly/163MP55
http://stanford.io/1bWD7SL
Geriatric Depression Scale
The Hamilton RatingScale for Depression
© 2013 Griswold International, LLC
Get an Early, Accurate DiagnosisA diagnosis of depression should include:- A physical exam - A review of medicines- A clinical interview
- Speaking with family members or close friends- Blood tests and lab studies- Imaging studies
http://1.usa.gov/1cdWNFT
Diagnosis and Treatment ofDepression in Adults: 2012Clinical Practice Guideline
© 2013 Griswold International, LLC
Seek Innovative Treatment Approaches
“Once diagnosed, 80 percent of clinically
depressed individuals can be effectively treated by medication, psychotherapy, electroconvulsive
therapy (ECT) or any combination of the three.”National Alliance on Mental Illness
© 2013 Griswold International, LLC
Seek Innovative Treatment Approaches
“For older adults (age 60+), the top
recommended treatment is home or clinic-based
depression care management (DCM).”
Task Force on Community Preventive Services
http://1.usa.gov/1atPwMV
CDC Promotes Public Health Approach to Address Depression Among Older Adults
© 2013 Griswold International, LLC© 2013 Griswold International, LLC© 2013 Griswold International, LLC© 2013 Griswold International, LLC© 2013 Griswold International, LLC© 2013 Griswold International, LLC© 2013 Griswold International, LLC
Family Doctor/Physician’s Assistant/Nurse Practitioner/ Nurse
Geriatric Psychiatrist
OccupationalTherapist
Physical Therapist
Home Care Professional
Advocacy/Support Group
Speech Therapist
Care management and coordination is critical to successful treatment for older adults with depression.
Depression Care Management (DCM)
Dietician
Wellness Coach
Social worker/Geriatric Care Manager/Psychologist
Your care teamshould include:
© 2013 Griswold International, LLC
Innovative Treatment Approaches
TOOLS
• Cognitive Behavioral Therapy (CBT) – A form of counseling that helps a person to understand and change the thoughts, feelings and beliefs that might be related to depression
• Medicine • Client and Family Education • Support Groups • Wellness
• Electroconvulsive Therapy (ECT) and other brain stimulation therapies
http://bit.ly/1a9OiX1
A Guide to Mental Wellness in Older Age
http://bit.ly/1gFja93
Cognitive–Behavioral Therapy
http://bit.ly/163RaW0
WRAP Plus
© 2013 Griswold International, LLC
• Older adults can be sensitive to medicine, but with proper support, medicine can play an important role
• Geriatric Psychiatrist can play a key role in: - Assessing the need for medicine/s - Choosing the right medicine and dose
About Geriatric Psychiatrists
TOOLhttp://bit.ly/19vx8ny
Find a Geriatric Psychiatrist
© 2013 Griswold International, LLC
Cognitive Behavioral Therapy can help older adults to understand and change the thoughts, feelings and beliefs that might be related to depression.
About Cognitive Behavioral Therapy (CBT)
TOOLS
http://bit.ly/18bZjo1 http://bit.ly/17fMsrf
Find a Therapist ServiceHow to Adapt Cognitive-
Behavioral Therapy for Older Adults
© 2013 Griswold International, LLC
• Family Caregivers also live with depression• It is important for family caregivers to take care of themselves
Supporting Family Caregivers
TOOLS
http://bit.ly/17fMFdO http://bit.ly/1bTH8rh
Caregiver Action Network Toolbox Caregiving and Depression
© 2013 Griswold International, LLC
For Healthcare Providers:Using Technology
http://bit.ly/17J03l6
Geriatricby Doctot
© 2013 Griswold International, LLC
For Clients and Family Caregivers:Using Technology
http://bit.ly/17bUFKI
The 3 Minute Test for Depression, Anxiety, Bipolar Disorder and PTSD
http://bit.ly/1ce5ccx
Digital Technology for the Family Caregiver
http://bit.ly/Hfc77G
Lotsa Helping HandsMobile App
© 2013 Griswold International, LLC
Support Groups Can HelpThe most practical coping strategies for depression can be found through support groups.
http://bit.ly/GFAIBu http://bit.ly/17fO0kU
DBSA Chapters/Support Groups NAMI Support and Programs
© 2013 Griswold International, LLC
© 2013 Griswold International, LLC
Key Takeaways
Depression and mental health issues ARE NOT a normal part of aging
Education, discussion, screening and diagnosis are challenging but essential
Older adults and their family caregivers CAN BENEFIT from treatment and support
Untreated mental health conditions in older adults have a serious impact
© 2013 Griswold International, LLC
Open Q&A
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2. Type questions here
© 2013 Griswold International, LLC
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