1. Mental health in older people
@naomi_gallant

2. Naomi Gallant - www.DementiaCareResearch.com

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

4. 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 -

5. 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 -

6. 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 -

7. 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 -

8. 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
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9. 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 -

10. 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
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11. 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 -

12. 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 -

13. 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
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14. 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 -

15. 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
people in the UK act as primary, unpaid carers for people with dementia.
Naomi Gallant -

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

17. 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 -

18. 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
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19. Familiar patterns of behaviour continue
Naomi Gallant -

20. Naomi Gallant - www.DementiaCareResearch.com
Faith in Dementia
Romans 8 v 35, – 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 -

21. 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 -