Polio Support Group

Polio Support Group

March 31, 2011

Donna Bowyer

Canadian Mental Health Association

Mental Health

• The capacity of individuals to interact with each other and their environments in ways that enhance or promote– Their sense of well-being– Their sense of control and choice in their life– Optimal use of their mental abilities– Achievement of their own goals, and– Their quality of life.

Canadian Mental Health Association, Supporting Seniors’ Mental Health

through Home Care, Toronto (2002)

Canadian Mental Health Association in Saskatchewan

Older Adults

• It is estimated that approximately 95% of older persons at a given point in time live in community rather than in institutions.

• Of those living in the community, approx. 31% (mostly women) live alone.


Older Adults

• Mental disorders are the leading risk factors for institutionalization.

• Keeping older adults in the community , where they prefer to be , means more treatment in the community to stave off costly institutionalizations.


Promoting Senior’s Mental Health

• Dignity

• Independence

• Participation

• Fairness

• Security


Framework for Seniors Mental Health

• Frame work includes– Personal factors– External factors

*Four boxes represent personal factors that affect an individual’s mental health

* The four circles represent external determinants of health that contribute to an individual’s mental health




Being an Effective Communicator

• Use familiar words and a conversational, personal tone.

• Proceed logically, with the most important ideas first, and linked from one paragraph to the next

• Use action verbs and active construction, not passive

• Favour short words and short sentences

• Present ideas with illustrations or diagrams if this makes them easier to understand

• Highlight main ideas and important information with headings


Skills for Care

• Being an Effective Communicator

• Involving Person in Decision-Making

• Being an Effective Advocate

• Peer Advocacy


Issues Affecting Senior's

• Social isolation

• Functional Decline

• Substance Abuse

• Elder Abuse

• Family Caregiver Stress and Burnout

• Changing Life Situation

• DepressionCanadian Mental Health Association in Saskatchewan

Social Isolation

• Encourage more social activities

• Discuss the situation and possible solutions the others involved

• Try to make the person feel needed in valued

• Help to be informed about activities in the community

• Look for ways to improve access to transportation

• Proved the senior with info supports & services

• Arrange to have someone accompany the person when attending a new activity.


Social Isolation

• Loneliness Social Isolation

• Depression Social Isolation

• Anxiety Social Isolation

The Chicken or the Egg


Depression

• Depression can result from psychosocial factors such as death of a spouse, reduced income, change in physical health or other losses


Depression

• Depression is not a normal part of aging any more that in any other age group.

• Depression is less likely to be treated in older adults than younger adults


Depression

• Depression severity is the only psychological or medical variable that was significantly associated with all four outcomes

• Quality of life

• Physical functioning,

• Mental functioning

• Disability


Depression

• As depression severity increases, quality of life and physical and mental functioning declines, while disability increases.

• Depression has a “devastating impact” on both emotional and physical functioning in older adults


Disease and Depression

• 9-27% of diabetes patients

• 22-50% of stoke patients

• 18-39% of cancer patients

• 50% of Parkinson’s patients

• 15-25% of people that have suffered Heart attacks


Social Isolation

• How do we reach people that have become socially isolated whether conscious of unconsciously.

• Home Care

• Meals on Wheels


Comfort Line

• Not a help line

• Not a crisis line

• A phone number that anyone can call to chat about anything to a volunteer

• You do not have to be in or develop a crisis to call someone.


Functional Decline

• Encourage Physical activities – number of benefits including greater independence, better mental health, improved quality of life, less stress, improved self-esteem, and simply having fun.


Substance Abuse

• As people get older their ability to absorb and dispose of alcohol and other drugs changes.

• Lack of understanding of prescription medications can also contribute to substance abuse

• Be aware of the potential for substance abuse by the caregiver


Elder Abuse

• Includes physical, sexual, emotional, financial and neglect.

• Can come from family, friends, family and professional caregivers,

• Be aware of what to look for and report to person that can take action


Family Caregiver Stress and Burnout

• Link the family caregiver with day care, respite or other supports available.

• Write out lists so they don’t have to remember

• Help them be realistic about what they can do

• Help them learn strategies to cope with stress


Changing Life Situation

• Allow them to reminisce. Listen and share their experiences with them

• Assist or have a volunteer assist them in coordinating or gaining the knowledge needed.

• If you feel there is need for other formal care provides (e.g.,counselors, grief therapist) encourage them to make contact.


Post Polio Depression

• Sense of Betrayal of your own body

Turning anger inward

• people that recovered to the point the they lead life where people don’t know they had polio or could live a mobile life.


Changes

• Debilitating fatigue or unrelenting pain can cause change in ability to function and be independent

• Loss of faith in recovery can lead to mild depression

• Exercise for depression??????

• Dramatic change in future goals


Polio Depression

• Not necessarily triggered by normal stresses

• Can hit during a holiday – fatigue, crash

• Confinement of housebound during recovery from an event.


Other Factors

• Anxiety

• Isolation

• Fear of the future

• Uncooperative family


Life Changes

• Sheet of paper and Divide into 12 pieces– 4 things you enjoy doing– 4 things that are important to you– 4 people you enjoy spending time with


Financial Insecurity

• Make person aware of types of financial “scams” that exist

• Contact the individual on the care giving team to discuss situation

• Watch for signs of depression

• Discuss if you have that type of relationship


Depression

• For some seniors, depression is often confused with dementia.

• Depression should be assessed.

• Treatment may take the form of medication, and.or therapy and is often very effective


Depression - Signs

1. A sad mood

2. Ongoing pessimism about the past, present and future

3. Loss of interest in other activities (e.g., social life hobbies, leisure

4. Lack of energy

5. Irritability


Depression - Signs

6. Difficulty in making decisions

7. Loss of weight/decreased appetite

8. Disturbed sleep pattern

9. Depressive dreams

10 Thougths of Suicide


Depression

1. Try to determine if there are supports in the community that can help the senior

2. Contact the individual on the caregiving team that can take action

3. Don’t ignore the warning signs

4. Take all comments about death or suicide seriously


Depression

5. Pep talks don’t work. Urging the person to ‘cheer-up’ isn’t helpful. Instead, support them in their search for appropriate help

6. Listen to the person without criticizing or feeling responsible for the person’s unhappiness. Be supportive and understanding without feeling guilty – you didn’t cause the depression


Stigma of Mental Illness

• Between 60 – 65% of all people with diagnosable mental illness do not seek treatment.

• Stigma disproportionately affects children and older adults to a greater extent than adults


Depression & Suicide in Older Adults

• The most serious consequence of depression in later life – especially untreated or inadequately treated depression is suicide or somatic illness

• Persons 65 + have highest suicide rate of any age group

• Suicide rate of individuals age 85+ is the highest (21suicides per 100,000)


Depression and Suicide in Older Adults

• Using a “psychological autopsy” it has been determined that 60-75% of suicides have diagnosable depression

• Thought of death may be developmentally expected in older adults, suicidal thoughts are not.


Depression & Suicide in Older Adults

• Studies have shown that older adults had seen their physician within a short interval of completing suicide, yet few were receiving mental health treatment.


Depression in Older Adults

• Depression can also lead to increased mortality from other diseases, such as heart disease and possibly cancer.


Myths about dealing with Grief

1. Don’t feel bad

2. Replace the loss

3. Grieve alone

4. Just give it time

5. Be strong for others

6. Keep busy


While there are no stages of grief..

• There are common responses which are normal

• Their occurrence and duration is different for everyone.


Common Responses

• Reduced Concentration– Preoccupation with emotions of loss– Inability to concentrate– Common to almost all grievers


Common Response

• A sense of numbness– Usually first reaction after notification– Physical, emotional or both– Mislabelled as denial– Rarely lasts more than several hours


Common Response

• Disrupted sleep patterns– Not being able to sleep– Sleeping too much– both


Common Response

• Changed Eating Habits– Little or no appetite– Eat non-stop– Both


Common Response

• Roller Coaster of Emotional Energy– Emotional highs and lows– Grievers often feel emotionally and physically

drained


Common Response

• Academy Award Recovery– “I’m fine”– How many have experienced the death of a

lover one in the past 5 years– How many of you still experience pain,

isolation and loneliness as a result of the loss?


Mental Health Lens

• Without mental health there is no health

• When developing any policy or program look through the mental health lens to make sure that not only our physical health issues are dealt with but also our mental health


My Generation

• http://www.youtube.com/watch?v=zqfFrCUrEbY

• http://www.youtube.com/watch?v=VKBqkDxkv30&feature=related

• http://www.youtube.com/watch?v=ZZhsxhG5e-o



Stopping the Stigma: What Can You Do?

• Ask yourself if what you hear about mental health is...

Stereotyping people with mental illnesses

Trivializes /belittles the person or the illness

Offends the person by insulting him/her

Patronizes the person by treating them as if they were not as good as other people




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