diane walker asked:


Most older people do not develop mental health problems, but a significant minority have dementia or experience problems such as depression.

Introduction

It is estimated that 18% of the general population in the UK are of pensionable age and that this figure will grow to 20% by 2025. As a society, we tend to assume that older people will develop mental health problems as a ‘normal’ aspect of ageing. Most older people do not develop mental health problems, although a significant minority does. For example:



about 25% of people over 85 have dementia.

between 10-15% of people over 65 have depression

between 4-23% of older adults seen by medical staff have an alcohol problem.



In addition to those older people who have an identifiable mental illness such as dementia, there are many who experience psychological or emotional distress associated with isolation, loneliness or loss. These problems are not recorded by the health or medical care system.

What problems affect people in later life?

Dementia

Dementia is a decline in mental ability which affects memory, thinking, problem solving, concentration, perception and behaviour. Some forms of dementia, such as Alzheimer’s disease, are degenerative. That is, they get worse over time. Other forms of dementia, such as vascular dementia, may be non-degenerative. That is, they may not get worse over time.

People with dementia can become confused. Some people also become restless or display repetitive behaviour. They may also seem irritable, tearful or agitated. This can be very distressing for both the person with dementia and their family and friends. Some people with dementia also develop other problems such as depression, disturbed sleep, aggression, inappropriate sexual behaviour and incontinence, although the latter issues tend to be associated with more advanced dementia.

About one in 20 people over the age of 65 are affected by dementia and this figure rises to one in four people over the age of 85 (Audit Commission, 2000). People under the age of 65 can develop dementia but this is rare and is known as early onset or pre-senile dementia.

What causes dementia?

Dementia occurs as a result of the death of brain cells or damage in parts of the brain that deal with our thought processes and functioning. The most common form of dementia is Alzheimer’s disease. We do not know what causes Alzheimer’s disease but we do know that ageing is the biggest risk factor. The second most common type of dementia is vascular or multi-infarct dementia. This occurs as a result of a series of mini-strokes which constrict blood flow and oxygen to the brain.

Can dementia be prevented and is there a cure?

Most types of dementia cannot be cured but a number of psychological treatments and anti-dementia drugs can be very effective for those in the early stages of dementia. It is therefore very important to get a proper assessment of cognitive function from a medical practitioner as early as possible.

There are no guaranteed ways of preventing dementia, but you may find it helpful to follow a sensible diet and pursue a healthy lifestyle. Regular physical exercise and supplements like Gingko Biloba can help to ensure that there is always a good supply of blood to the brain. Please consult your GP before taking such medication. You can also help yourself by keeping your mind active, for example by doing crosswords or puzzles.

Depression

Depression describes a range of moods, from feeling a bit low to a severe problem, which interferes with everyday life and normal functioning. People with severe depression may experience a range of symptoms including low mood, loss of interest and pleasure as well as feelings of worthlessness or guilt.

Depression can affect anyone, of any culture, age or background but it affects proportionally more older people than any other age group. It is estimated that around 10-15% of elderly people in the community exhibit depressive symptoms, with this proportion rising to about 40% of care home residents. That said, you will not necessarily become depressed just because you are getting older.

What causes depression?

There are a number of risk factors that play a role in increasing older people’s vulnerability to depression including:



being widowed, divorced or retired

neurobiological changes associated with ageing

use of medication for other conditions

greater physical impairment and disease

loneliness and isolation

genetic susceptibility, which increases with age.



Can depression be prevented and is there a cure?

Depression in later life is a widely under recognised and under treated medical condition. Up until recently many health professionals – including GP’s – failed to offer the treatments and supports available to other age groups. Most forms of depression can be treated, using medication, talking treatments or other strategies.

It is can be difficult to diagnose depression in older people because it often occurs alongside other mental and physical illnesses, such as dementia, stroke, diabetes and cancer. In addition many older people do not seek help from their GP until they have a number of symptoms. As with dementia, it is important to seek help as early as possible.

Self-help strategies that can help reduce the risk of depression include:



taking regular exercise

planning for critical transitions such as retirement

seeking support from family and friends following the loss of a long-term partner

ensuring that you pursue a range of interests in later life.



Dementia and depression

The relationship between dementia and depression is complex. The symptoms of dementia and depression – including withdrawal from social activities and general apathy – are very similar. An elderly person with severe depression may occasionally be misdiagnosed as having dementia. A person with dementia may also become depressed.

Alcohol abuse

It is estimated that between 4%-23% of older adults seen by medical staff experience problems with alcohol. Figures also show that older men are currently between two and six times more likely than older women to be at risk of abusing alcohol.

Although alcohol abuse is a problem for people of all ages, it is more likely to go unrecognised among older people. Many older people use alcohol to deal with loss or loneliness. Approximately 10-30% of older people who abuse alcohol become depressed. They are also at greater risk of *******.

Medication

Prescribed medications can cause mental health difficulties among older people. A 2001 Department of Health survey found that 79% of older people take prescribed medicines. Many older people take four or more medications at the same time. There are risks associated with taking multiple medications, including confusion.

More detailed information about medication and mental health problems can be found at the following sites:

Other mental health problems

There are a number of rarer mental health problems that affect older people, including delirium, anxiety and late-onset schizophrenia. The prevalence, nature, and course of these disorders are different in older people, as are the treatments that may be offered.

Capacity and older people with mental illness

People with dementia or severe mental illness may have difficulty in making and communicating decisions. Very few people are unable to be involved in making choices at all but some may have partial or fluctuating mental capacity and may need help with communication. Different approaches are also required to engage a person with dementia. They often need longer to make decisions, may need an advocate to speak on their behalf and their mental functioning may also vary by day, and time of day. Family members or carers are often useful sources of information but it is important to take account of the views of the person with dementia alongside those of their carer.

Help for carers

Caring for an older person with mental health problems can be very stressful, time consuming and emotionally and physically challenging. Caring for an older person with dementia is associated with higher levels of stress, with a third of carers suffering from depression.

For free advice on depression or a free consultation visit http://www.clairehegarty.co.uk or ring 0151 678 3358 or 07714853524

Visit http://www.in2town.co.uk for all the latest health news and advice

Alex Smith asked:


With pressures from the outside world and the deterioration of environment, more and more people advocate living harmoniously and healthily. At the beginning, most health promotion (Defined as the process of enabling people to increase control over, and improve their health.) activities were driven by individuals. But with the initiation of health promoting hospitals, the effectiveness of health promotion activities in hospitals become vivid.



The International Network of Health Promoting Hospitals (HPH) was initiated more than 10 years ago with the aim to reorient health care institutions to integrate health promotion and education, disease prevention and rehabilitation services in the curative care.

Through evidence, hospitals can have a lasting impact on influencing the behavior of patients and relatives, who are more responsive to health advice in situations of experienced ill-health. Health promotion in hospitals includes interventions directed at structures and processes, as well as interventions directed at individuals (patients and staff).

 Below are some objectives for health promotion in hospitals:

To change the culture of hospital care towards interdisciplinary working, transparent decision-making and with active involvement of patients and partners. Toevaluate health promotion activities in the health care setting and build an evidence-base in this area. Toincorporate standards and indicators for health promotion in existing quality management systems at hospital and at national levels.

With a growing international awareness and development of health promotion in hospitals, the number of hospitals and countries joining the International Network of Health Promoting Hospitals has increased steadily over time. In the near future, I believe, more and more people will benefit from them.

If you are further interested in knowing how to make health promotion video for broadcasting in hospitals, you can click here, another article written by me on how to make it with PowerPoint.

William Rodgers asked:


In the United States, there are about five different types of health insurance available: traditional health insurance; preferred provider organizations or PPOs; point-of-service plans or POS; health management organizations or HMOs; and most recently, health savings accounts or HSAs. With so many types of health insurance, it may be confusing trying to figure out which one best fits your needs, so thoroughly research each and speak with a professional if you need clarification.

Traditional health insurance is the one that most people think of when they think of health insurance. You pay the insurance company a premium every month, and if you have an accident or need for health coverage, you have a deductible amount you must pay and then the insurance company picks up the rest of the bill. You often have an inexpensive office and/or prescription co-pay with traditional health insurance.

With people living longer, health insurance companies began to look for more ways to reduce their costs, developing different health plans such as PPOs. PPOs are plans which will cover nearly all of your medical expenses as long as you stay within a preferred network of physicians or hospitals. This network creates a preferred provider list that you can choose from. Treatment outside this network of providers is covered but only at a reduced rate, meaning you end up paying more to see a physician outside the network. By limiting the physicians and hospitals covered in their network, the insurance company can control, to an extent, their costs and lower your premiums. POS plans work like PPOs, but require you to have a primary care physician through whom you can receive referrals for specialists. If you need to see a neurologist or a dermatologist, you must first visit your primary care physician for an initial diagnosis in order to receive a referral to a specialist for a more thorough diagnosis. POS plans also have a preferred provider network, and if you choose to visit a specialist or physician outside that network, your coverage will be limited.

HMOs combine a stricter version of PPOs and POS plans. HMOs have a defined list of physicians, often much smaller than PPO networks, which you may see. You will not be covered at all if you see a physician outside your HMO network. Furthermore, you must also get a referral from your primary care HMO physician to see any specialist. However, these restrictions mean that you pay an extra low or no monthly premium.

HSAs were recently signed into law by President Bush. You can deposit money into a special non-taxed, interest-gaining savings account that must be used for medical expenses. The ideal situation for an HSA is to combine the account with a low-cost, high-deductible insurance plan. The savings account is designed to allow you to cover the high deductible if you find the need to cover expensive medical costs while the insurance company will pick up the rest of the bill.

Again, it is important to carefully consider each option before choosing a single health insurance plan. Your health is important so make sure it is protected in the best way possible.

callcare asked:


Registered Nurses trained in http://www.callcarenet.com/products-nursecare.asp

telephone triage are exceptional health care providers.  Many health care services offer around-the-clock telephone support.  It ranges from simple health advice hotlines to full-blown diagnostic assessment.  Telephone triage falls into the later category.  Rather than providing answers to general health questions, the telephone triage nurse has been trained to assess a caller’s health condition without any physical examination.

In many cases the cause of a patient’s concern is obvious – high fever, a non-life threatening injury.But at other times, the cause for concern is masked by a number of overlapping symptoms.  In order to be able to conduct effective telephone triage a nurse must rely on a unique skill set that takes into account a keen ear for detail, an extensive knowledge of how diseases and other ailments present themselves through a broad age range of patients and the ability to communicate in such a way at to create trust and credibility with the public.  It takes a special, highly trained person to excel in this vital healthcare profession.

Sometimes a correct diagnosis through telephone triage will be able keep someone from making an unnecessary trip to the emergency room.  Sometimes it will mean the difference between life and death. But it has not always been easy to get people to see the advantage of this specialized branch of the health care industry. It was hard for people to believe that someone could effectively make assessments as to severity of a health issue and then suggest an appropriate care response without making a thorough physical examination. Even if the nurse had a thick manual to refer to – the time it would take to cross-reference data might end up causing more anxiety and distrust that if the patient just went to the local emergency room.  But all that would change when telephone triage entered the computer age.

The computer revolution changed how telephone triage worked.Taking advantage of sophisticated computer programs loaded with numerous interlaced medical diagnostic problem-solving procedures, the telephone triage nurse is able to discern a pathway that leads to solid diagnosis.The process is something akin to the famous 20-question binary search algorithm developed by early computer scientists.

Telephone triage nurses make use of an electronic chart that displays medical records on a person-by-person basis.  The chart details medical history, recent and past diagnoses and all relevant medical data.  Some systems even have the ability to display x-rays and other raw lab results.  By asking the caller a series of directed questions, the program will guide to triage nurse to a new set of questions ultimately zeroing in on a conclusion.  The end result is a medically sound diagnosis and a suggestion as how the caller should proceed.

http://www.callcarenet.com/products-nursecare.asp Telephone triage is not for everyone.  The medical expertise needed is broad and factors such as personality and the ability to elicit trust and cooperation through a sophisticated communication skill set make this a very non-traditional nursing job.

Bob Taylor asked:

Where to go for a reliable health advice?

People can go many places to get a health advice.

Going to the internet:

With the internet the source for answers to a health question are only a click away. The problem, though, is many people rely too much on sources that may be unreliable for their health question answers.

Before the internet became a household commodity, people only went to one source for their health questions – they doctor.

Today, though, people are searching online and hitting online databases and message boards to get the health questions answered. This can spell trouble, though.

Going to the doctor:

A doctor or other health care professional is the best source for an advice to a health question. They have the training and knowledge necessary to provide an answer. The answer a person gets from a health care professional can be trusted. They can feel secure with the answer and know that they can follow the advice without harming themselves.

The best source for the answer to a health question has been and always will be a medical professional.

When a person seeks answers to a health question from an unqualified source they are putting their health at risk. Getting advice from someone whose only knowledge may be form a personal experience or something they read somewhere is dangerous. There are many things that can go wrong. A person could take the advice and end up with an allergic reaction or prolonging treatment for a serious illness or injury. Taking this type of advice should lead to further illness or injury.

Luckily many health insurance plans now offer an on call burse that is available to answer health questions every day at any time. If a person has a health question they should consider picking up the phone before clicking on the internet

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