1 advocates toolbox managing behavior: its all about you presentation by: lawrence t. force, ph.d.,...

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Advocates Toolbox

Managing Behavior: It’s All About You

Presentation by:

Lawrence T. Force, Ph.D., LCSW-R

Gerontologist

© Dr..L.T.Force 2010

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Managing Behaviors: It’s All About You


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DEMOGRAPHIC PROFILE

Review of

Trends…trends…trends…


4© Dr..L.T.Force 2010

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Population Trends

0

10

20

30

40

50

60

70

80

90

100

1900 1960 1980 2000* 2020* 2040*

Age 65+

Age 55-64

1987 Holt, Rinehart, and Winston, Inc.

* Projections© Dr..L.T.Force 2010

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Overview

Everyday in the United States, 5,000 people turn age 65, with the fastest

growing part of the population being age 100 and above.

The impact of the increase in longevity can be felt in systems and

programs across our nation.


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PERSONALITY DEVELOPMENT

&

STAGE DEVELOPMENT


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Human Lifespan Developmental Periods

Conception

Prenatal(Conception-Birth)

Infancy(0-2 years)

Birth

Childhood(2-12 years)

Puberty

Adolescence(12-18 years)

Adulthood(18-75 years)

Old Age(75 years to

Death)

Death

1987 Holt, Rinehart,and Winston, Inc.


Re-Definition of Aging

Very Oldest-Old 100+ Self-Children-Formal Support

Oldest - Old 91+ Self – Children - Peers

Old - Old 76-90 Spouse – Children - Self

Young – Old 61-75 Spouse-Children-Peers-Work

Mid-life Phase 3 51-60 Spouse-Children-Parents-Peers-Work



Young Adulthood 19-30 Parent-Person- Peers-Work

Adolescent 11-18 Parent – Person - Peers

Childhood 3-10 Parent – Child - Peers

Infancy 0-2 Parents - Child

Prenatal Period 10© Dr..L.T.Force 2010

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Aging Related Terms:

• Gerontology• Biological or

Physical Aging• Psychological

Aging

• Social Aging• Normal Aging• Successful

Aging• Pathological

Aging


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We age:

Biologically (Changes that occur in our physical body)

Socially(Changes that occur in our family and social support systems)

Psychologically(Changes that occur in our view of ourselves and others)

Spiritually(Changes that occur in our belief systems)


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AGENCIES

&

PROGRAMS


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Aging Levels of Service:

FEDERAL

STATE

COUNTY© Dr..L.T.Force 2010

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Aging Services

Local Access

Is

County Office for

Aging


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•ALZHEIMER’S ASSOCIATION

•ALZHEIMER’S DISEASE

ASSISTANCE CENTERS

(ADAC’S)


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Adult Day Health Services

• Medical Model Type I

• Social Model Type II


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THOUGHTS

THOUGHTS

&

MORE THOUGHTS


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Themes

• What are the larger societal aging trends developing in our population and what effect will they have on aging individuals?

• What do the current aging trends mean and what large role will these rapidly approaching changes play in determining the direction of the health care delivery system and the mental health care delivery system in the coming decades?


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Mental Health Profile

• Common Mental Health Problems• What are some of the common mental health

problems of older adults?• The United States Surgeon General reports that

while most older adults enjoy good mental health, nearly 20% of those 55 and older experience mental disorders that are not part of normal aging. The following are some of the most common disorders.


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• Signs of depression in older adults include a persistent anxious or "empty" mood; sleeping too much or too little; reduced appetite and weight loss, or increased appetite and weight gain; loss of interest or pleasure in activities once enjoyed, including sex; …….


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• Depression (continued)• irritability; restlessness; persistent physical

symptoms that don't respond to treatment, such as chronic pain or digestive disorders; difficulty concentrating, remembering or making decisions; fatigue or loss of energy; feeling guilty, hopeless or worthless; thoughts of death or suicide.


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• Suicide is the taking of one's own life. Older adults have the highest suicide rate in the country. About 17 older adults take their lives every day. Untreated depression can lead to suicide. One of the unique features of suicide in older adults is that they usually do not commit suicide impulsively. Another is that their attempts are often disguised, which leads to underreporting. There are many that silently give up on life and stop taking care of themselves.


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• Signs of potential suicide in older adults include talking a lot about suicide and the uselessness of living, having well-defined plans for suicide, a history of alcohol abuse and being depressed.


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• Anxiety Disorders is an inability to cope with normal fears and worries that interferes with daily living. It can take the form of panic attacks, physical symptoms, phobias, or general anxiety about living. It involves unrealistic or excessive anxiety about life circumstances.


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• Signs of anxiety disorders include restlessness, muscle tension, intense feelings of stress, obsessive-compulsive behavior. Sometimes physical signs may be confused with the signs of a heart attack, stroke or other medical emergencies.


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• Alcohol Abuse is the use of alcohol to such an extent that it causes physical or mental harm. It often involves needing to take more to have the same effect and having withdrawal symptoms when the person stops consuming. One third of older adult alcoholics develop the disease after age 45. Older adults are more affected by less alcohol because of slower metabolism and the use of medications.


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• Signs of alcohol abuse include incontinence, sleep problems, poor self-care, malnutrition and a withdrawal from activities.


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• Misuse of Medications is taking prescribed medications in the incorrect amount or dosage, or otherwise contrary to the doctor's order.

• Signs of misuse of medication include falls, delirium, confusion, urinary incontinence, insomnia, weakness or lethargy, loss of appetite, changes in speech and depression.


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• Depression: is a disorder characterized by feelings of sadness and despair and ranging in severity from mild to life threatening. When a depressed or irritated mood goes beyond a temporary state and interferes with daily living for more than two weeks, it becomes a medical illness that needs to be treated.


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Depression

• Late-life depression affects about 6 million Americans age 65 and older, but only 10% receive treatment

• Advancing age is often accompanied by loss of key social support systems due to the death of a spouse or siblings, retirement, and/or relocation of residence

• Depression tends to last longer in elderly adults• It also increases their risk of death • Older adults with depression are more likely to

commit suicide than are younger people with depression. Individuals age 65 and older account for 19% of all deaths by suicide


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Mental Health & Demographics

• Disability due to mental illness in individuals over 65 years old will become a major public health problem in the near future because of demographic changes. In particular, dementia and depression present special problems in this age group.


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Depression and Aging

• Probably under-diagnosed in older persons with pre-existing disabilities

• A reaction to stress, loss, and grief• Usually a rapid onset as compared to

Alzheimer’s type dementia• May appear as acute physical illness or

dementia• May be a secondary condition of a

physical illness


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Depression

• Signs of Depression: • An Important Geriatric Behavioral Health Care

Initiative Depression strikes all ages, but experts now recognize that a significant number of older adults suffer from this illness. Special attention is being focused on the early recognition and treatment of this disease. Please call our Geriatric Mental Health Service if you are concerned about the following warning signs:


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Depression

• Loss of interest in formerly pleasurable activities.

• Dissatisfaction with life.

• Withdrawal from social activities.

• Loss of energy.


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Depression

• Feeling useless or hopeless. • Irritability. • Over concern with health problems. • Sadness and crying for no obvious reason. • Worry and/or self criticism. • Difficulty concentrating and/or making

decisions. • Loss of appetite and weight.


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Depression

• Depression is not a normal part of aging. Yet depression is a widely underrecognized and undertreated medical illness.

• Depression often co-occurs with other serious illnesses, such as heart disease, stroke, diabetes, cancer, and Parkinson's disease. Because many older adults face these illnesses as well as various social and economic difficulties, health care professionals may mistakenly conclude that depression is a normal consequence of these problems — an attitude often shared by patients themselves.


http://www.nimh.nih.gov/publicat/depheart.cfm

http://www.nimh.nih.gov/publicat/depstroke.cfm

http://www.nimh.nih.gov/publicat/depdiabetes.cfm

http://www.nimh.nih.gov/publicat/depcancer.cfm

http://www.nimh.nih.gov/publicat/depparkinson.cfm

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Depression

• These factors together contribute to the underdiagnosis and undertreatment of depressive disorders in older people. Depression can and should be treated when it co-occurs with other illnesses, for untreated depression can delay recovery from or worsen the outcome of these other illnesses.


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Mental Health & Aging

• Normal aging is not characterized by mental disorders. Mental or substance use disorders should be recognized and treated. Stressful life events, such as declining health and/or the loss of mates, family or friends increase with age. However, persistent bereavement or serious depression is not normal and should be treated.


Gerontology: An Interactive Textbook

http://www.nsspress.com/gerontology/startup.htm




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Advocacy

• Promoting responsibility in care• Planning is not a reaction• Health promotion is the only option• Your life- Your call• “Poor planning on your part – doesn’t

make it an emergency on my part!”


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Helping Families UnderstandBegins With You:

• Understanding the reasons why an older family member is in need of help

• Understanding the emotions of an aging loved one

• Understanding the feelings and emotions of the family unit as a whole and as individuals

• Understanding your own personal emotions • Understanding that difficult decisions, difficult

choices and difficult changes all have to be made as aging of a loved one progresses


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Promoting responsibility in care

• Planning is not a reaction

• Health promotion is not an option- it is the only option

• Your life – your call


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Listen to the “voice” of the individual

An understanding of the “person” – where they sit, where they stand, where they are . . . is the key to understanding and feeling……... “the quality of life”

QUALITY OF LIFE


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Answers:

Collaborate…Communicate…

Collaborate…


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Future Responsibilities:

• Be Present• Be Vocal• Be Aware• Be Responsible

• For the benefit of others….for the benefit to you


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Caring for Yourself

• Taking care of yourself will give you better capability to care for your loved one

• Seek help from others whenever you can• Maintain healthy eating habits • Join a support group if things seem to be

getting too stressful• Maintain parts of your life that don’t

include the person that you are caring for


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One Voice…..One Sound…..One Action…..

Becomes Two


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Managing Behaviors: It’s All About You


Contact Information

Dr. Lawrence T. Force, Gerontologist

Professor of Psychology

Center on Aging and Policy

[email protected]

http://www.centeronagingandpolicy.com

Twitter: @drforce

(845) 569-3164

(914) 475-7629 (cell phone)


mailto:[email protected]

http://www.centeronagingandpolicy.com/

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