Detecting poor mental health in older adults – whose responsibility is it?

Entry into residential care can be one of the most stressful life events which presents a number of challenges. Having a mental health condition, such as depression or anxiety adds to this. The move involves changes to routine, loss of independence and physical relocation to a new environment. According to the latest findings from the Australian Institute of Health and Wellbeing (2012) at admission 52 percent of residents present with symptoms of depression.

Prior to admission to residential care, it is important for the aged care provider to assess the support needs for the individual. This includes assessing the outcome of Aged Care Funding Instrument (ACFI) to determine if the individual is “high” or “low” care recipient, liaison with family and the residents. Aged care facilities must consider the impact of diagnosis of depression on the individual, treatment options and the required person-centered support. In general, residents with symptoms of depression have higher care needs. The sooner the mental illness is detected, discussed with the GP and referred for treatment, the easier it is to treat.

The cost of poor health is very high. If a mental health condition is not treated in time the individual will require more support which adds to the cost of staffing and also the personal toll on the individual and their health. Individuals with depression are likely to have other conditions (co-morbidities) which affect their physical and emotional wellbeing and life expectancy.

Wise Care is one of beyondblue’s two national licensees who deliver Professional Education to Aged Care (PEAC) training for workers in the community and residential care. Our facilitators are accredited to deliver the three hour workshop on site at your organisation.

This training assists workers by providing:

  • a greater understanding of depression and anxiety in older people
  • an understanding of how their work can impact upon a resident or client’s mental health
  • strategies for working with residents or clients who have depression and/or anxiety
  • an understanding of the process for reporting their concerns
  • an understanding of screening tools and referrals/pathways to care
  • an understanding of effective management of older people with depression and/or anxiety and/or dementia.

Offering beyondblue training can save staffing costs for your organisation, up-skill the workers in detecting mental health conditions, and provide appropriate referral pathways for the resident. This process will ensure the resident receives appropriate and timely treatment and are comfortable in their twilight years. In most cases, the cost of individual therapy is paid by the service user.

During the National Psychology Week (11-15 November 2013) we are offering the training at our special rate. Contact us today if you would like to find out more.

Depression in late life is not normal ageing

Late Life Depression

“Every man has his secret sorrows which the world knows not; and often times we call a man cold when he is only sad.” Henry Wadsworth Longfellow

 

Sadness is a normal human emotion and must not be mixed with depression, which consists of persistent impairment in functioning. Depression in older people is widespread, often undiagnosed, and usually untreated and is not a normal part of ageing.

Depression comes in many types and some of the most common include:

  • Minor Depressive Disorder
  • Major Depressive Disorder
  • Depression Without Saddness
  • Mixed Depression and Anxiety Disorder
  • Adjustment Disorder (with/without Depression)
  • Dysthymia

Depression is perhaps the most frequent cause of emotional suffering in later life. The latest findings from the Australian Institute of Health and Wellbeing (2012) indicates that 52% of residents in supported accommodation had symptoms of depression. Unfortunately, many of those individuals are not treated for this condition by a psychologist or a psychiatrist.

Individuals who are alone or require additional support to stay at home are more likely to be depressed than those who have independent life free from cognitive and emotional disturbances. There is a lot of stigma associated with receiving support for mental health and older people often report that they do not discuss their emotional wellbeing with their families, as they don’t want to burden them, or their GPs. Untreated depression can become more complex to manage and may cause decline in other life domains.

The overall long-term prognosis for elderly depression is good. Most individuals would benefit from approximately 6 to 10 counselling consultations and antidepressant medication, if deemed appropriate by their GP or psychiatrist. Research shows the best outcomes are in those individuals who take medication (therefore regulate the chemicals within their brain) and engage in psychotherapy (learn new coping skills and behavioural strategies).

Depression can be difficult to identify and diagnose in older people. This is due to several barriers which include:

  • it is harder to identify
  • More somatically focused
  • Often related to other illnesses (comorbidities)
  • More impariment on psychological testing
  • Higher rate of dementia on follow-up

Risk factors for depression in elderly include:

  • Being female
  • Single (divorced; separated; widowed)
  • Lower socioeconomic level
  • Poor social support
  • Stressful life events
  • Impaired medical health
  • Disability

How can we help older adults who have depression ?

Teach staff on how to recognise symptoms of depression and anxiety. Julie and her team of psychologists nationally deliver beyondblue Professional Education in Aged Care to staff working in community and residential care setting. Contact us today for more details

Encourage older adults to seek support we get many requests for our psychotherapy service from aged care staff, families and doctors and visit a number of aged care facilities.  The sooner we can help someone the better it is for the individual and the less likely they are to require prolonged treatment. We do not charge extra for home visits.

Be there for them and spend 1:1 time we can all fall into the trap of thinking we are helping someone by doing many things for them. Sometimes we just need to take a few minutes and spend the time with the person, they do not necessarily need us to “fix” anything for them. Just listen