Mental health in older people @naomi_gallant www.DementiaCareResearch.com

Naomi Gallant - www.DementiaCareResearch.com

Naomi Gallant - www.DementiaCareResearch.com The 3Ds Dementia Delirium Depression Naomi Gallant - www.DementiaCareResearch.com

The 3D Quiz - Definitions Progressive loss of brain cells… a terminal condition: An acute or sudden onset: A change in mood lasting at least 2 weeks: Dementia Delirium Depression Naomi Gallant - www.DementiaCareResearch.com

Naomi Gallant - www.DementiaCareResearch.com The 3D quiz - Duration Years (usually 8-20): Hours to months, dependant on speed of diagnosis: At least 6 weeks, can last months to years if untreated: Dementia Delirium Depression Naomi Gallant - www.DementiaCareResearch.com

Naomi Gallant - www.DementiaCareResearch.com The 3D Quiz: Thinking Delirium Fluctuates… distorted thinking, incoherent speech: May be indecisive, highlight failures/hopelessness: Gradual loss of cognition: Depression Dementia Naomi Gallant - www.DementiaCareResearch.com

The 3D Quiz: Mental status testing Capable of giving correct answers: Attempt to answer, not aware of mistakes: Testing may vary dependant on fluctuating cognition: Depression Dementia Delirium Naomi Gallant - www.DementiaCareResearch.com

Naomi Gallant - www.DementiaCareResearch.com The 3D Quiz: Memory Recent and past memory impairment: Generally intact, highlights negativity: Recent and immediate memory impairment: Dementia Depression Delirium Naomi Gallant - www.DementiaCareResearch.com

The 3D Quiz: Sleep-wake cycle Disturbed, usually early morning awakening: Disturbed, sleep-wake cycle often reversed: May awaken often at night, may wander: Depression Delirium Dementia Naomi Gallant - www.DementiaCareResearch.com

The 3D Quiz: Hallucinations/delusions Can be present. Usually guilty and negative to self: Can be present, may misperceive: Often frightening or paranoid: Depression Dementia Delirium Naomi Gallant - www.DementiaCareResearch.com

Naomi Gallant - www.DementiaCareResearch.com The 3D Quiz: Diagnosis Dementia Usually diagnosed approx. 3 years after symptom onset: Diagnosis based on rapid onset of fluctuating symptoms: May notice symptoms before the person does: Delirium Depression Naomi Gallant - www.DementiaCareResearch.com

The 3D Quiz: Care approaches Delirium Early recognition is key… find cause and treat quickly: Identify symptoms early. Help person to follow treatment plan and offer hope: Maintain and enhance abilities the remain: Depression Dementia Naomi Gallant - www.DementiaCareResearch.com

Naomi Gallant - www.DementiaCareResearch.com The 3D Quiz: Prognosis Delirium Treatable and reversible if caught early: Treatable and reversible: Progression can be slow but not reversible: Depression Dementia Naomi Gallant - www.DementiaCareResearch.com

Naomi Gallant - www.DementiaCareResearch.com The 3D Quiz: Treatment Delirium Treat cause: Antidepressants, ECT, cognitive therapy: ..slow the progression. Symptomatic treatment with environmental and staff approaches: Depression Dementia Naomi Gallant - www.DementiaCareResearch.com

Naomi Gallant - www.DementiaCareResearch.com Dementia: some stats Dementia is non-discriminatory 1/3 older people will end their lives with dementia 2 million people by 2051 There is no cure Dementia costs the UK £26.3billion a year 670 000 people in the UK act as primary, unpaid carers for people with dementia. Naomi Gallant - www.DementiaCareResearch.com

Naomi Gallant - www.DementiaCareResearch.com Alzheimer’s Vascular Lewy Body Frontal Frontotemporal +100 more Naomi Gallant - www.DementiaCareResearch.com

3 key principles (Dr Jennifer Bute) There is always a reason behind the behaviour Normal human responses to: Confusion Loss of control Fear/anxiety Tiredness Expressing needs (pain, hunger, toilet) Sadness Naomi Gallant - www.DementiaCareResearch.com

Naomi Gallant - www.DementiaCareResearch.com When facts are forgotten, feelings remain “My yesterdays are disappearing, and my tomorrows are uncertain, so what do I live for? I live for each day. I live in the moment… I will forget today, but that doesn’t mean that today doesn’t matter.” ― Lisa Genova, Still Alice Naomi Gallant - www.DementiaCareResearch.com

Familiar patterns of behaviour continue Naomi Gallant - www.DementiaCareResearch.com

Naomi Gallant - www.DementiaCareResearch.com Faith in Dementia Romans 8 v 35, 37-39 – Nothing can separate us from God’s love. Psalm 139 v 7-10 – We cannot go anywhere to escape God. Romans 9 v 14 – 16 – Every day we are alive is an opportunity for mercy. Naomi Gallant - www.DementiaCareResearch.com

Naomi Gallant - www.DementiaCareResearch.com Beyond words… Make the most of every moment – feelings will continue Never forget the person behind the diagnosis or behaviour Explore the senses Naomi Gallant - www.DementiaCareResearch.com