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1 Advocates Toolbox Managing Behavior: Its All About You Presentation by: Lawrence T. Force, Ph.D., LCSW-R Gerontologist © Dr..L.T.Force 2010
2 Managing Behaviors: Its All About You YOU © Dr..L.T.Force 2010
3 DEMOGRAPHIC PROFILE Review of Trends…trends…trends… © Dr..L.T.Force 2010
6 Population Trends 1987 Holt, Rinehart, and Winston, Inc. * Projections © Dr..L.T.Force 2010
7 Overview Everyday in the United States, 5,000 people turn age 65, with the fastest growing part of the population being age 100 and above. The impact of the increase in longevity can be felt in systems and programs across our nation. © Dr..L.T.Force 2010
8 PERSONALITY DEVELOPMENT & STAGE DEVELOPMENT © Dr..L.T.Force 2010
9 Human Lifespan Developmental Periods Conception Prenatal ( Conception-Birth) Infancy (0-2 years) Birth Childhood (2-12 years) Puberty Adolescence (12-18 years) Adulthood (18-75 years) Old Age (75 years to Death) Death 1987 Holt, Rinehart, and Winston, Inc. © Dr..L.T.Force 2010
Re-Definition of Aging Very Oldest-Old100+Self-Children-Formal Support Oldest - Old91+Self – Children - Peers Old - Old76-90Spouse – Children - Self Young – Old61-75Spouse-Children-Peers-Work Mid-life Phase 351-60Spouse-Children-Parents-Peers-Work Mid-life Phase 241-50Spouse-Children-Parents-Peers-Work Mid-life Phase 131-40Spouse-Children-Parents-Peers-Work Young Adulthood19-30Parent-Person- Peers-Work Adolescent11-18Parent – Person - Peers Childhood3-10Parent – Child - Peers Infancy0-2Parents - Child Prenatal Period 10© Dr..L.T.Force 2010
11 Aging Related Terms: Gerontology Biological or Physical Aging Psychological Aging Social Aging Normal Aging Successful Aging Pathological Aging © Dr..L.T.Force 2010
12 We age: Biologically (Changes that occur in our physical body) Socially (Changes that occur in our family and social support systems) Psychologically (Changes that occur in our view of ourselves and others) Spiritually (Changes that occur in our belief systems) © Dr..L.T.Force 2010
13 AGENCIES & PROGRAMS © Dr..L.T.Force 2010
14 Aging Levels of Service: FEDERAL STATE COUNTY © Dr..L.T.Force 2010
15 Aging Services Local Access Is County Office for Aging © Dr..L.T.Force 2010
16 ALZHEIMERS ASSOCIATION ALZHEIMERS DISEASE ASSISTANCE CENTERS (ADACS) © Dr..L.T.Force 2010
17 Adult Day Health Services Medical Model Type I Social Model Type II © Dr..L.T.Force 2010
18 THOUGHTS & MORE THOUGHTS © Dr..L.T.Force 2010
19 Themes What are the larger societal aging trends developing in our population and what effect will they have on aging individuals? What do the current aging trends mean and what large role will these rapidly approaching changes play in determining the direction of the health care delivery system and the mental health care delivery system in the coming decades? © Dr..L.T.Force 2010
20 Mental Health Profile Common Mental Health Problems What are some of the common mental health problems of older adults? The United States Surgeon General reports that while most older adults enjoy good mental health, nearly 20% of those 55 and older experience mental disorders that are not part of normal aging. The following are some of the most common disorders. © Dr..L.T.Force 2010
21 Mental Health Profile Signs of depression in older adults include a persistent anxious or "empty" mood; sleeping too much or too little; reduced appetite and weight loss, or increased appetite and weight gain; loss of interest or pleasure in activities once enjoyed, including sex; ……. © Dr..L.T.Force 2010
22 Mental Health Profile Depression (continued) irritability; restlessness; persistent physical symptoms that don't respond to treatment, such as chronic pain or digestive disorders; difficulty concentrating, remembering or making decisions; fatigue or loss of energy; feeling guilty, hopeless or worthless; thoughts of death or suicide. © Dr..L.T.Force 2010
23 Mental Health Profile Suicide is the taking of one's own life. Older adults have the highest suicide rate in the country. About 17 older adults take their lives every day. Untreated depression can lead to suicide. One of the unique features of suicide in older adults is that they usually do not commit suicide impulsively. Another is that their attempts are often disguised, which leads to underreporting. There are many that silently give up on life and stop taking care of themselves. © Dr..L.T.Force 2010
24 Mental Health Profile Signs of potential suicide in older adults include talking a lot about suicide and the uselessness of living, having well-defined plans for suicide, a history of alcohol abuse and being depressed. © Dr..L.T.Force 2010
25 Mental Health Profile Anxiety Disorders is an inability to cope with normal fears and worries that interferes with daily living. It can take the form of panic attacks, physical symptoms, phobias, or general anxiety about living. It involves unrealistic or excessive anxiety about life circumstances. © Dr..L.T.Force 2010
26 Mental Health Profile Signs of anxiety disorders include restlessness, muscle tension, intense feelings of stress, obsessive-compulsive behavior. Sometimes physical signs may be confused with the signs of a heart attack, stroke or other medical emergencies. © Dr..L.T.Force 2010
27 Mental Health Profile Alcohol Abuse is the use of alcohol to such an extent that it causes physical or mental harm. It often involves needing to take more to have the same effect and having withdrawal symptoms when the person stops consuming. One third of older adult alcoholics develop the disease after age 45. Older adults are more affected by less alcohol because of slower metabolism and the use of medications. © Dr..L.T.Force 2010
28 Mental Health Profile Signs of alcohol abuse include incontinence, sleep problems, poor self- care, malnutrition and a withdrawal from activities. © Dr..L.T.Force 2010
29 Mental Health Profile Misuse of Medications is taking prescribed medications in the incorrect amount or dosage, or otherwise contrary to the doctor's order. Signs of misuse of medication include falls, delirium, confusion, urinary incontinence, insomnia, weakness or lethargy, loss of appetite, changes in speech and depression. © Dr..L.T.Force 2010
30 Depression: is a disorder characterized by feelings of sadness and despair and ranging in severity from mild to life threatening. When a depressed or irritated mood goes beyond a temporary state and interferes with daily living for more than two weeks, it becomes a medical illness that needs to be treated. © Dr..L.T.Force 2010
31 Depression Late-life depression affects about 6 million Americans age 65 and older, but only 10% receive treatment Advancing age is often accompanied by loss of key social support systems due to the death of a spouse or siblings, retirement, and/or relocation of residence Depression tends to last longer in elderly adults It also increases their risk of death Older adults with depression are more likely to commit suicide than are younger people with depression. Individuals age 65 and older account for 19% of all deaths by suicide © Dr..L.T.Force 2010
32 Mental Health & Demographics Disability due to mental illness in individuals over 65 years old will become a major public health problem in the near future because of demographic changes. In particular, dementia and depression present special problems in this age group. © Dr..L.T.Force 2010
33 Depression and Aging Probably under-diagnosed in older persons with pre-existing disabilities A reaction to stress, loss, and grief Usually a rapid onset as compared to Alzheimers type dementia May appear as acute physical illness or dementia May be a secondary condition of a physical illness © Dr..L.T.Force 2010
34 Depression Signs of Depression: An Important Geriatric Behavioral Health Care Initiative Depression strikes all ages, but experts now recognize that a significant number of older adults suffer from this illness. Special attention is being focused on the early recognition and treatment of this disease. Please call our Geriatric Mental Health Service if you are concerned about the following warning signs: © Dr..L.T.Force 2010
35 Depression Loss of interest in formerly pleasurable activities. Dissatisfaction with life. Withdrawal from social activities. Loss of energy. © Dr..L.T.Force 2010
36 Depression Feeling useless or hopeless. Irritability. Over concern with health problems. Sadness and crying for no obvious reason. Worry and/or self criticism. Difficulty concentrating and/or making decisions. Loss of appetite and weight. © Dr..L.T.Force 2010
37 Depression Depression is not a normal part of aging. Yet depression is a widely underrecognized and undertreated medical illness. Depression often co-occurs with other serious illnesses, such as heart disease, stroke, diabetes, cancer, and Parkinson's disease. Because many older adults face these illnesses as well as various social and economic difficulties, health care professionals may mistakenly conclude that depression is a normal consequence of these problems an attitude often shared by patients themselves.heart diseasestrokediabetescancer Parkinson's disease © Dr..L.T.Force 2010
38 Depression These factors together contribute to the underdiagnosis and undertreatment of depressive disorders in older people. Depression can and should be treated when it co-occurs with other illnesses, for untreated depression can delay recovery from or worsen the outcome of these other illnesses. © Dr..L.T.Force 2010
39 Mental Health & Aging Normal aging is not characterized by mental disorders. Mental or substance use disorders should be recognized and treated. Stressful life events, such as declining health and/or the loss of mates, family or friends increase with age. However, persistent bereavement or serious depression is not normal and should be treated. © Dr..L.T.Force 2010
Gerontology: An Interactive Textbook http://www.nsspress.com/gerontology/startu p.htm 40© Dr..L.T.Force 2010
41 Advocacy Promoting responsibility in care Planning is not a reaction Health promotion is the only option Your life- Your call Poor planning on your part – doesnt make it an emergency on my part! © Dr..L.T.Force 2010
42 Helping Families Understand Begins With You: Understanding the reasons why an older family member is in need of help Understanding the emotions of an aging loved one Understanding the feelings and emotions of the family unit as a whole and as individuals Understanding your own personal emotions Understanding that difficult decisions, difficult choices and difficult changes all have to be made as aging of a loved one progresses © Dr..L.T.Force 2010
43 Promoting responsibility in care Planning is not a reaction Health promotion is not an option- it is the only option Your life – your call © Dr..L.T.Force 2010
44 Listen to the voice of the individual An understanding of the person – where they sit, where they stand, where they are... is the key to understanding and feeling……...the quality of life QUALITY OF LIFE © Dr..L.T.Force 2010
45 Answers: Collaborate… Communicate… Collaborate… © Dr..L.T.Force 2010
46 Future Responsibilities: Be Present Be Vocal Be Aware Be Responsible For the benefit of others….for the benefit to you © Dr..L.T.Force 2010
47 Caring for Yourself Taking care of yourself will give you better capability to care for your loved one Seek help from others whenever you can Maintain healthy eating habits Join a support group if things seem to be getting too stressful Maintain parts of your life that dont include the person that you are caring for © Dr..L.T.Force 2010
48 One Voice….. One Sound….. One Action….. Becomes Two © Dr..L.T.Force 2010
49 Managing Behaviors: Its All About You YOU © Dr..L.T.Force 2010
Contact Information Dr. Lawrence T. Force, Gerontologist Professor of Psychology Center on Aging and Policy firstname.lastname@example.org http://www.centeronagingandpolicy.com Twitter: @drforce (845) 569-3164 (914) 475-7629 (cell phone) 50© Dr..L.T.Force 2010
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