Elderly Mental Health
Not long ago, doctors offered incomplete explanations for various physical and psychological conditions to elderly people stating “what do you expect? It’s old age”. Today, we know that aging can shape specific types of mental disorders that require careful diagnosis and proper treatment. All these factors gave rise to the field of psychogeriatrics. Within this context, we can add loneliness, grief, insomnia, mobility difficulties, physical pain, anxiety, and depression.
However, geriatric stress may contribute to the development of heart disease, while depression can increase mortality rates following a cardiac event. In psychogeriatrics, the diagnosis of depression or anxiety disorders cannot be done based on standard criteria, but must instead be adapted to the specific characteristics of older adults.
The same applies to psychotic symptoms in this age group, which require careful and precise pharmacological management. Paranoid thoughts, hallucinations, and suspicion are symptoms that can severely exhaust caregivers.
DEMENTIA
Dementia has become a modern-day epidemic, due to the increase in life expectancy and other factors that are still under investigation.
Many people even ask whether it is contagious. On the other hand, there are others who refuse to accept it when it affects a loved one, and they think it is just old age.
For this reason, the diagnosis, prognosis, and treatment must be carried out by a specialized physician.
Dementia refers to a group of disorders that share common features: the decline of memory, thinking and communication abilities. The most common and well-studied form is Alzheimer’s disease (over 60% of all dementia cases).
DIAGNOSIS
There is always a way to manage dementia, as long as we start with timely and accurate diagnosis. At present, there is no reliable marker that can definitively detect Alzheimer’s disease in its early stages.
Diagnosis at the initial stage is mainly based on symptoms such as memory decline, reduced attention and concentration, difficulty in decision-making, frequent forgetfulness, and fatigue.
Diagnosis at the middle stage relies on the early symptoms that become worse, as well as signs such as aimless wandering, inability to perform even simple mathematical calculations, difficulty in social interactions, hiding of personal items, aggressiveness, and suspicion.
Diagnosis at the advanced stage is based on the further deterioration of symptoms, including incontinence, severe hallucinations, and alternating periods of aggression and apathy. Communication becomes extremely difficult, and loss of inhibitions or inappropriate sexual remarks or gestures often appears.
During the middle and advanced stages, families usually wonder whether immediate relocation to a supported living facility is necessary.
Common Questions Answered by a Psychiatrist:
I have a relative with dementia. When should I consider a care facility?
At the middle or advanced stage, this decision becomes necessary when self-care is no longer possible and when the emotional and physical burden on family members becomes overwhelming.
Are only dementia patients admitted to such facilities?
No. Many elderly individuals, with mild to severe geriatric difficulties or mobility issues, choose supported living environments seeking for the appropriate place.
Do all nursing homes offer the same services?
Unfortunately, there are significant differences in the quality of services provided.
When choosing a facility, one should carefully consider the infrastructure, medical and nursing care, physiotherapy, and psychological support that are offered.
Is it true that care facilities ‘turn people into vegetables’?
The goal of a reputable and well-organized unit is to help residents remain functional, mobile, and in good physical and mental health.
Sedative treatments are prescribed only when necessary, e.g. during episodes of agitation, to protect the patient’s well-being and ensure the best possible quality of life.
