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For older people, what would be considered abnormal may be adaptive under some circumstances. Wht are these traits.
- isolation
- passivity
- aggressivenes
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HOw do we view an adult's behavior from a lifespan perspective?
biological forces: changes in the structure and functioning of the brain; genetics
psychological forces: normative changes can mimic mental disorders; nature of personal relationships
sociocultural forces: social norms and culture important
life-cycle factors: behaviors in adulthood influenced by past
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mental status exams
- useful as a quick screening of measures of mental competence
- - mini-mental status exam (MMSE)
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psychological functioning assessed through:
- interviews
- observations
- test or questionnaires
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Three dimensions of social functioning
- ties with social network
- content of interaction with one's social network
- number and quality of interactions
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assessment methods: interview
- most widely used method
- direct info in response to questions
- non-verbal info such as emotions
- historical info
- determine follow-up procedures
- build rapport with client
- evaluate tx effects
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performance-based assessment
- giving clients specific tasks to perform
- important with cognitive and neuropsychological assessments
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negative biases
making assumptions just because of their different background
- - lead to wrong diagnoses
- - racial, ethnic, age stereotypes
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positive bias
assuming something good
ex: Women do not abuse alcohol and therefore she cannot be an alcoholic
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Clinical depression rate
most comon: female, unmarried, widowed, or recently bereaved; stressful life; lacking social support
individuals with chronic illness
nursing home residents
family care providers
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What is the fact of depression?
Fact: rates of depression decline from young adulthood to old age for healthy people
- less than 5% of older adults living in the community show signs of depression
- for those receiving home health care, the rate is 13%
- cohort effect: most recent born have highest rates of depression
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Depression has characteristics. What are they?
dysphoria: feeling "down" or "blue" and you cant break the sadness
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Accompanying physical symptoms of depression
- insomnia
- changes in appetite
- diffused pain
- trouble breathing
- headaches
- fatigue
- sensory loss
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Symptoms of depression must last __.
Other causes must be __.
__ must determine how symptoms are affecting daily life.
at least two weeks
ruled out
Clinician
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Older __ show higher rates of depression.
__ of older Latinos show depressive symptoms.
__ tend to be diagnosed with depression more than __,
ethnic minorities
women/ men
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depression assessment scales
- Beck Depression inventory
- geriatric depression scale
- center for epidemiological studies--depression scale
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Beck Depression Inventory
items focus on feelings and physical symptoms
some older adults experinece these symptoms naturally
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Geriatric Depression Scale
specific to older adults
reduces bias: physical symptoms omitted; response format is simpler
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causes of depression
biolongical and cognitive-behavioral
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Biological causes of depression
- genetics (run in fams)
- brain structureNT
- brain-derived neurotrophic factor (BDNF)
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cognitive-behavioral of depression
internal belief systems are affected by experiencing unpredictable and uncontrollable events
- instills helplessness and hopelessness
perceiving negative events as one's own fault
ruminative thinking
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Treatments of Depression
medication
stimulations: electroconvulsive therapy and vagus nerve stimulation, as well as repetitive transcranial magnetic stimulation
pyschotherapy: behavior, cognitive, cognitive-behavior therapy
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delirium
disturbance of consciousness and changes in cognition that develops rapidly
difficulty with attention, memory, orientation, and language
issues with perception, sleep, personality, and mood
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Causes of delirium
medical conditions or side effects
substance intox or withdrawal
exposure to toxins
a combo of above
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dementia
a family of diseases characterized by cognitive and behavioral deficits involving some form of permanent brain damage
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dementia affects over ___ globally. Most older adults are not __.
37 million
demented
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What disease is under the umbrella of dementia?
Alzheimers: progressive, degenerative, fatal; 70% of dementia cases
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Neurological changes of Alzheimers
cell death
neurofibrillary tangles
plaques of beta amyloid: a protien, surrounded by degenerated fragments of dying or dead neurons
Tau proteins
May be an exageration of normal aging and not something qualitatitively different
inceased levels of plasma homocysteine
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average duration of it?
can be as short as three or as long as twenty, but averaged, it is 8-10
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Symptoms and Diagnosis
gradual changes in cognitive functioning
declines in personal hygeine and self care
inappropriate social behavior
change in personality
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Research has poured into?
the action of beta amyloid and tau proteins in relation to neurons. Each disrupts neurons in a different way
-
sundowning
symptoms are worse in the evening
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potential causes of Alzheimers
Autosomal dominant inheritance pattern
beta amyloid cascade hypothesis: beta amyloid creates neuritic plaques that lead to tangles that cause neuronal death
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Caregiver's recommendations and dementia patients
caregivers are at risk for depression
patients need help with dressing, bathing, grooming; finances; eating; meds; wandering; incontinence
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caretaking training
face to face and online both effective
taking things away
restricting activities
optomizing person's functioning
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respite care
typically refers to a short-term stay at a senior community, usually an assisted living or memory care community.
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Respite care is a great living option for an elderly or disabled person who needs __, but still desires __(3)__
- some day-to-day supportive services
- social stimulation, engagement and activities.
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