Mental Health

MENTAL HEALTH

Changes in cognitive ability, excessive forget fullness and moodswings are not a part of normal aging. Changes in mental status may be related to many factors such alteration in diet and fluid and electrolyte balance. Therefore health professionals must recognize, assess, refer, collaborate, treat and support older adults exhibit noticeable changes in intellect of affect.

Some Of The Common Problems

·           Depression

·           Acute confusional state (Delirium)

·           Anxiety disorders

·           Cognitive impairment and dementia

·           Late life delusional disorder

·           Alcoholism

·           Personality disorder

·           Obsessive compulsive disorder

·           Drug and substance abuse.

·           Sleep and rest pattern

·           Coping abilities

Dementia

Dementia and acute confusional state usually are the result of organic diseases characterised by impairment of intellectual functions. E.g..aphasia, aphaxia

Clinical Manifestations

·           Language impairment

·           Apraxia (difficulty in performing skilled tasks)

·           Agnosia (inability to recognise objects)

·            Impaired executive function (poor performance, poor judgement and planning)

Diagnosis

•            History collection   

•            Clinical  examination  including  mental

•            function

•            CSF examination

•            CT scan

Treatment

·           Home health aid to assist in personal hygiene home cares to assist in house work transportation

·           Support groups such as the alzhemeirs associations are often of value to the family

·           Legal council should be recommended to help the patient and family

Depression

Depression occurs in 5 to 10% of community - dwelling elderly due to lack of social supports.

Clinical Manifestations

·           Sleep disturbance

·           Lack of interest

·           Feeling of guilty

·            Suicidal ideation

Treatment

• Medical and pharmacological Management Methylphenidate 5 to 10 mg at 8 a.m. and noon is often very effective.

•Treatment should be continued for up to a year because relapse rates are higher in the elderly.

Acute Confusional State (Delirium)

•            Delirium called acute confusional state and progressive to disorientation.

•            Delirium due to hyponatraemia, hyperosmolality, hypercapria

Clinical Manifestations

·           Disturbance in memory,

·           Thought disorder

·           Emotional changes

·            Disturbance of perception.

TREATMENT

Supportive treatment ECT (Electroconvulsive Therapy)

Anopsychotics