Polio Support Group

1. Polio Support Group March 31, 2011 Donna Bowyer Canadian Mental Health Association

2. 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

3. 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. Canadian Mental Health Association in Saskatchewan

4. 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. Canadian Mental Health Association in Saskatchewan

5. Promoting Senior’s Mental Health • Dignity • Independence • Participation • Fairness • Security Canadian Mental Health Association in Saskatchewan

6. 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 Canadian Mental Health Association in Saskatchewan

7. Canadian Mental Health Association in Saskatchewan

8. Canadian Mental Health Association in Saskatchewan

9. 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 Canadian Mental Health Association in Saskatchewan

10. Skills for Care • Being an Effective Communicator • Involving Person in Decision-Making • Being an Effective Advocate • Peer Advocacy Canadian Mental Health Association in Saskatchewan

11. Issues Affecting Senior's • Social isolation • Functional Decline • Substance Abuse • Elder Abuse • Family Caregiver Stress and Burnout • Changing Life Situation • Depression Canadian Mental Health Association in Saskatchewan

12. 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. Canadian Mental Health Association in Saskatchewan

13. Social Isolation • Loneliness Social Isolation • Depression Social Isolation • Anxiety Social Isolation The Chicken or the Egg Canadian Mental Health Association in Saskatchewan

14. Depression • Depression can result from psychosocial factors such as death of a spouse, reduced income, change in physical health or other losses Canadian Mental Health Association in Saskatchewan

15. 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 Canadian Mental Health Association in Saskatchewan

16. 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 Canadian Mental Health Association in Saskatchewan

17. 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 Canadian Mental Health Association in Saskatchewan

18. 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 Canadian Mental Health Association in Saskatchewan

19. Social Isolation • How do we reach people that have become socially isolated whether conscious of unconsciously. • Home Care • Meals on Wheels Canadian Mental Health Association in Saskatchewan

20. 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. Canadian Mental Health Association in Saskatchewan

21. 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. Canadian Mental Health Association in Saskatchewan

22. 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 Canadian Mental Health Association in Saskatchewan

23. 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 Canadian Mental Health Association in Saskatchewan

24. 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 Canadian Mental Health Association in Saskatchewan

25. 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. Canadian Mental Health Association in Saskatchewan

26. 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. Canadian Mental Health Association in Saskatchewan

27. 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 Canadian Mental Health Association in Saskatchewan

28. Polio Depression • Not necessarily triggered by normal stresses • Can hit during a holiday – fatigue, crash • Confinement of housebound during recovery from an event. Canadian Mental Health Association in Saskatchewan

29. Other Factors • Anxiety • Isolation • Fear of the future • Uncooperative family Canadian Mental Health Association in Saskatchewan

30. 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 Canadian Mental Health Association in Saskatchewan

31. 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 Canadian Mental Health Association in Saskatchewan

32. 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 Canadian Mental Health Association in Saskatchewan

33. 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 Canadian Mental Health Association in Saskatchewan

34. Depression - Signs 6. Difficulty in making decisions 7. Loss of weight/decreased appetite 8. Disturbed sleep pattern 9. Depressive dreams 10 Thougths of Suicide Canadian Mental Health Association in Saskatchewan

35. 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 Canadian Mental Health Association in Saskatchewan

36. 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 Canadian Mental Health Association in Saskatchewan

37. 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 Canadian Mental Health Association in Saskatchewan

38. 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) Canadian Mental Health Association in Saskatchewan

39. 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. Canadian Mental Health Association in Saskatchewan

40. 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. Canadian Mental Health Association in Saskatchewan

41. Depression in Older Adults • Depression can also lead to increased mortality from other diseases, such as heart disease and possibly cancer. Canadian Mental Health Association in Saskatchewan

42. Myths about dealing with Grief • Don’t feel bad • Replace the loss • Grieve alone • Just give it time • Be strong for others • Keep busy Canadian Mental Health Association in Saskatchewan

43. While there are no stages of grief.. • There are common responses which are normal • Their occurrence and duration is different for everyone. Canadian Mental Health Association in Saskatchewan

44. Common Responses • Reduced Concentration • Preoccupation with emotions of loss • Inability to concentrate • Common to almost all grievers Canadian Mental Health Association in Saskatchewan

45. Common Response • A sense of numbness • Usually first reaction after notification • Physical, emotional or both • Mislabelled as denial • Rarely lasts more than several hours Canadian Mental Health Association in Saskatchewan

46. Common Response • Disrupted sleep patterns • Not being able to sleep • Sleeping too much • both Canadian Mental Health Association in Saskatchewan

47. Common Response • Changed Eating Habits • Little or no appetite • Eat non-stop • Both Canadian Mental Health Association in Saskatchewan

48. Common Response • Roller Coaster of Emotional Energy • Emotional highs and lows • Grievers often feel emotionally and physically drained Canadian Mental Health Association in Saskatchewan

49. 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? Canadian Mental Health Association in Saskatchewan

50. 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 Canadian Mental Health Association in Saskatchewan