7 Ways Seniors Can Survive the Heat

September 18, 2014 by Leave a Comment

Heat is a potentially deadly problem—nearly 400 Americans suffer fatal consequences from heat wavessun_thermometer-300x225 each year. Most of them are elderly people who often don’t realize when they are overheating and in danger. Part of the problem lies in the fact that the elderly simply can’t handle the heat as well as younger people, because they don’t sweat as effectively and have poorer circulation. In addition, medical conditions such as dementia, diabetes, obesity medication-adherenceand other chronic conditions can compound the risk of heat stroke. Certain medications, including those for Parkinson’s and hypertension also increase the risk.

To protect seniors, the standard advice is to get them into an air-conditioned building; have them dress lightly; and keep them hydrated.

Caregivers should stay on the alert for signs of confusion or altered mental states in seniors who are out in hot weather, as it could be a sign of heat stroke. If the elderly person should collapse or pass out, it’s a medical emergency. 911 should be called immediately.

Here are seven ways to protect seniors from heat:

1) If elderly relatives complain of the cold indoors, ease off the air conditioning a bit. If they won’t stay inside, have them sit on a shady porch near a fan.elderly-movie

2) To keep the house cooler without running the air conditioning, close curtains or blinds on the east side of the home during the morning, and the west side in the afternoon.

3) If the elderly person doesn’t have air conditioning or refuses to use it in a heat wave, make sure they spend some time in a cool air-conditioned space like a mall or theater. They can stay cool and be entertained.

4) Offer plenty of drinks that seniors prefer, but stay away from highly caffeinated drinks, or sodas loaded with sodium and sugar. Steer clear of alcohol, which is dehydrating.

watermelon5) Keep frozen treats available that have a high water and low sugar content, like sugar-free Popsicles). Or serve fruit with high water content, like watermelon.

6) Seniors sometimes dress inappropriately for warm weather, so make sure that their clothing is lightweight, not form-fitting and light in color. Hats are useful, but make sure that they are loosely woven or ventilated so they don’t trap heat and broad-brimmed so they shade the entire face.

7) UV Rays are harsh. Ensure seniors are wearing protective sunglasses and sunblock if they will be outdoors at all.hat

Keep cool, safe and enjoy the last blast of summer heat!

Sources

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Silencing the Stigma

August 22, 2014 by Leave a Comment

Last month, we discussed the social, institutional, and self-stigmatization of mental illness in the elderly and their ramifications. This week, we will discuss current efforts to eradicate mental health stigma and improve access to care.

How can we influence the media’s depiction seniors with mental illnesses?

notebook2004While the media promulgates inaccurate and damaging stereotypes about mental illness, it can also be a source of positive change in the battle against social stigma. For example, the movie The Notebook (2004) provides a genuine portrayal of strain and heart-ache accompanied by dementia. The vast majority of mass media, however, reinforce social stigma through stereotypical presentations of mental illness.

Organizations such as the Center for Mental Health and Media and Mental Health Reporting have launched their own campaigns to counter prevailing stereotypes by educating the public. They have also posted tips for reporters and screen writers to avoid promoting stigmas. Writers should:

  • Ask, “Is mental illness relevant to the story?”
  • Verify statements that mental illness is a factor in a violent crime. A past history of mental illness is not necessarily a reliable indicator.massmedia
  • Avoid using language that implies people with mental illness are violent.
  • Double-check specific symptoms of diagnoses with valid mental health resources, as necessary.

Ultimately, these organizations hope to inform writers that meaningful stories do not need to peddle incorrect and damaging stereotypes about the mentally ill. They have also initiated their own media campaigns to bring awareness to mental health stigmas.

The biggest advances in combatting stigma against mental illness have come through public policy

The passages of the Mental Health Parity and Addiction Equity Act (MHPAEA) and the Affordable Care Act (ACA), also known as Obamacare, have profoundly improved access to resources for the mentally ill.

mhpThe MHPAEA (2008) ensures that financial requirements (ex. Co-pays, deductibles) and treatment limitations (time of stay in hospital) for mental health or substance abuse disorder benefits are no more restrictive than corresponding surgical or medical benefits.

The ACA (2013) builds upon the principles of the MHPAEA and expands access to mental health services for geriatric patients in a number of ways:

  1. Employer-based insurance for seniors no longer can deny coverage based on preexisting psychiatric acaconditions.
  2. The ACA contains provisions that will increase quality of care in nursing homes.
  3. Healthcare institutions that are categorized as “Health Homes” or “Medical Homes” will receive increased federal funding, which will make mental health treatment more accessible for the disabled and elderly.
  4. All states will be required to have some level of mental healthcare coverage, though specific services are decided on a state-by-state basis.
  5. Medicaid has been expanded in 27 states. Medicaid’s broad range of mental health and community support resources mean that millions more people will be able to obtain treatment for psychiatric disorders.

Collectively, this means that mental health services will be more accessible than ever before to the majority of Americans, including geriatric patients. Though these policies are an important step forward, it is important to remember that social and self-stigmas are powerful factors in care quality and access, especially for seniors. Furthermore, the ACA only mildly addresses the most pressing issue facing seniors—the lack of geriatrics-specialized physicians and healthcare workers.

Fortunately, numerous colleges offer stipends and scholarships to encourage medical and graduate students to pursue specialty training in geriatric care. The American Association for Geriatric Psychiatry (AAGP) and the Geriatric Mental Health Foundation (GMHF) also support yearly scholarships for students who hope to obtain training in geriatric-focused medical care. As the Baby Boomer generation ages, these scholarships and programs will likely become more common in the nation’s medical colleges and healthcare training institutions.

Next week, we will discuss how practicing gratefulness in your daily life can improve your mental health.

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Products of Prejudice

July 21, 2014 by Leave a Comment

Last week we examined the causes of commonly-held stigmas against geriatric mental illness, including self-stigma, social stigma, and institutional stigma.

How do these stigmas affect the ability of elders to seek care for mental illnesses?

1. Fewer doctors train in geriatric healthcare, which makes it difficult for seniors to find specialized medical doctorattention. Seniors must travel further distances to see doctors with a detailed understanding of mental illness in the elderly.

a. Many doctors believe that they can have a more meaningful impact as pediatric psychiatrists, rather than as geriatric psychiatrists because they can change a child’s future as opposed to alleviating just a few years of suffering in mentally ill seniors.While pediatric psychiatrists provide immeasurable services to mentally ill youths, this mindset devalues the mind of the senior with respect to other age groups.

b. Historically, major healthcare plans have not provided enough incentive for hospital to provide mental health services. This is changing as a result of the Affordable Care Act, which we will discuss more in detail next week.

2. Doctors without training in geriatric care often misdiagnose or directly discriminate and stigmatize patients with mental illnesses. This can have a profoundly negative effect on patients by reducing treatment efficacy. Discrimination from healthcare workers can even worsen treatment outcomes. While many doctors are not directly prejudiced against the elderly, they are just as susceptible to prevailing stereotypes as the next person.

3. Because of social and self-stigmas, patients may distrust the medical establishment’s ability to treat their illness or fear institutionalization in a psychiatric ward. As a result, patients would be less likely to seek treatment for psychiatric disorders.

Education is the best strategy to overcoming stigma

Education and Empowerment of the Mentally Ill
ageismIn order to effect long-lasting change of public sentiment, people afflicted by psychiatric diseases must dispel their own stereotypes against mental illness. These include the incorrect assumptions that:
• Mental illness is incurable
• Mental illness is a normal part of aging
• Elders with mental illnesses are not worth being treated

 

Education and Empowerment of the Public

The public must also be educated about mental health and aging. Today’s mass media often disseminates misleading and derogatory images concerning mental health and the aging process. Seniors are often portrayed as out of touch with reality, childish, and useless. Few films depict old age in a positive light, and many films focus on the dangerous aspects of mental illness, though only a small percentage of mentally ill patients are violent.

bedsideEducation of the next generation of doctors and medical professionals must be a priority for the future. A study conducted at the University of Calgary, Canada, showed that basic psychiatry education in a group of medical students helped to reduce common stigmas and misconceptions about mentally ill patients and improved student confidence when working with patients with psychiatric diseases. Geriatric healthcare must also become an integral part of medical education as America’s senior population (65+) is projected to double by the year 2030. Many of these efforts are currently underway.

Tune in next week to learn about current efforts to eliminate mental illness stigmas.

References

  • CDC.gov. “Depression is Not a Normal Part of Growing Older.” http://www.cdc.gov/aging/mentalhealth/depression.html
  • Mentally Healthy Aging: A Report on Overcoming Stigma for Older Americans. DHHS Pub. No. (SMA) 05-3988. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, 2005.
  • Neelgard, L. “Report: Too little mental health care for seniors.” Associated Press. http://usatoday30.usatoday.com/news/health/story/2012-07-10/aging-mental-health/56132426/1
  • Papish et al. “Reducing the stigma of mental illness in undergraduate medical education: a randomized controlled trial.” BMC Medical Education 2013, 13:141
  • Persky, T. “Overlooked and Underserved: Elders in Need of Mental Health Care.” http://www.mhaging.org/info/olus.html
  • Thornicroft, G et al. “Discrimination against people with mental illness: what can psychiatrists do?” Advances in Psychiatric Treatment, 2010, 16: 53-59

 

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Mentally Ill Seniors—America’s Black Sheep

July 14, 2014 by Leave a Comment

Depression affects over 6.5 million of the 35 million Americans aged 65 and older, and yet only 10% of them are receiving treatment for the condition. This indicates a deep failure on the part of our healthcare system to recognize and treat mental health problems in older adults. While numerous problems contribute to this failure, underlying assumptions about elderly people cause social, self-, and institutionalized stigmas that complicate the ability of older people with mental illnesses to seek treatment for psychiatric diseases.
Let’s briefly discuss some of the different types of stigmas based around mental illness in the elderly:

Social Stigma
• Social stigma against mental illness in the elderly is closely related to ageism, or the idea that older people are not stigmaas able to contribute to society as younger people.
• Oftentimes, depression and related mental illnesses are seen as normal aspects of the aging process. Events such as retirement, the death of loved ones, medical problems, and increased isolation can evince feelings of sadness and grief, but do not directly cause depression. With strong support from one’s family or therapist, these distressing events may be successfully overcome. However, dismissing depression as an unavoidable side effect of aging drastically reduces the chances obtaining treatment for depression and related mental illnesses and can exacerbate the severity of the illness.
• The media commonly portrays elderly people with mental illnesses as childish, stubborn, and resistant to change. While this representation may stem from the self-stigma (discussed below), this portrayal only reinforces existing stereotypes of mental illnesses by imposing judgments on afflicted individuals rather than highlighting the need for change. In this sense, the media contributes to the problem.

Self-Stigma
cycle• Self-stigma occurs for a variety of reasons, including fear of financial repercussions, embarrassment, isolation, and/or distrust of mental health services. At worst, elderly patients fear being institutionalized in psychiatric wards or old-age homes and where they will be cut off from their families and friends.
• The baby boomers’ emphasis on self-reliance in the face of difficulty also contributes to self-stigma. As such, self-stigma is directly caused by and contributes to social stigma.

Institutional Stigma
• Assumptions about older people based on the above stigmas can lead to misguided policy that in effect punishes the mentally ill. For example, Medicaid does not cover services for those suffering from mental illnesses, which means that patients are often forced to find more expensive healthcare plans. To complicate the issue further, many states are cutting funding for mental health services in an effort to balance the budget even while 1 in 6 Americans suffer from some sort of mental illness.

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Each stigma is engendered by and reinforces the others.

Next week, we will discuss existing barriers to eliminating these stigmas and current efforts to bring awareness to the state of mental health services in America.

Sources

  • Depression in Older Adults & the Elderly—http://www.helpguide.org/mental/depression_elderly.htm
  • Goodell et al. “Health Policy Brief—Mental Health Parity.” Health Affairs, April 3, 2014. http://healthaffairs.org/healthpolicybriefs/brief_pdfs/healthpolicybrief_112.pdf
  • Mentally Healthy Aging: A Report on Overcoming Stigma for Older Americans. DHHS Pub. No. (SMA) 05-3988. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, 2005.
  • Persky, T. “Overlooked and Underserved: Elders in Need of Mental Health Care.” http://www.mhaging.org/info/olus.html
  • Tomasky, M. “The Great GOP Mental Health Hypocrisy.” The Daily Beast, Politics, 9/20/2013. http://www.thedailybeast.com/articles/2013/09/20/the-great-gop-mental-health-hypocrisy.html
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Beating the Burnout

July 10, 2014 by Leave a Comment

“I’m taking care of them all by myself.” “I don’t want to burden anyone else with this.” “I’m not getting any rest” “I need help, but who can I turn to?”

balance

If this sounds like you, you’re not alone. About 30% of adults age provide some type of formal or informal care to a family member or friend.This means these caregivers are spending over 20 hours per week, on average, with the arduous task of giving care, while still juggling other responsibilities like children, job, spouse, and managing a household.

As a family caregiver, you may have found yourself faced with several unfamiliar or even intimidating tasks, along with feelings of being overwhelmed. These feelings that come with the role of being a caregiver can place you at high risk for depression, fatigue, anxiety, neglect of your own needs, and ultimately, caregiver burnout. This is the state of mental, physical, and emotional exhaustion that comes from unrelieved stress.

elder_care_stress

Because it is so vital that both you and you elderly or ill loved one stay in the best possible health, here are 3 key points to help you manage and prevent caregiver burnout.

• Reach Out For Help
This is where we can help. At Aarris, we believe in providing your family with quality homecare to help you provide for your loved ones. Through handpicked and personalized caregivers based on expertise and your needs, we’ll be able to help you in the areas you need most; Care for them, peace of mind for you.

Computer-2 • Learn As Much as You Can about your loved one’s illness or condition(s) as well as their needs, especially on a day to day basis from both a family as well as a caregiver perspective. The more you know, the less anxiety you’ll feel about the new role in your loved one’s life and the more effective you can be when communicating with caregivers, other family members, and physicians.

• Take Care of Your Health
In order to provide the best care for your loved one, it’s important to give your best care to yourself and your own health. Try to get some physical activity for at least 20-30 minutes, two or three times per week. A balanced diet coupled with consistent and adequate sleep will help you, your loved one or patient, and caregiver work together to provide the best care and experience for your entire family.

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