Supporting Mental Health and Schizophrenia in Seniors

1. Schizophrenia Society of Ontario Mental illness and Seniors Jill Dennison Regional Lead, Western Region

2. The Schizophrenia Society of Ontario (SSO) Today’s presentation • What are the services of SSO • What is mental health and mental illness? • Do the elderly develop mental illness? • What are the challenges? • What is the role of stress? • Tips for supporting ourselves and those we care about • Q & A

3. The Schizophrenia Society of Ontario (SSO) The SSO The Schizophrenia Society of Ontario's (SSO) central mission is to make a positive difference in the lives of people, families and communities affected by Schizophrenia and Psychotic Illnesses through our education, support public policy and research programs. We are a provincial organization with 5 regional offices: Toronto, Hamilton, Halton/Peel, Peterborough and Ottawa.

4. Mental Health • Mental health means having balance in your life (work/school and personal life). • Everyone’s balance is unique. • The challenge is to stay mentally healthy by keeping the right balance. • Reaching a healthy balance is a learning process.

5. Understanding Mental Illness Mental illness is a general term that refers to a group of illnesses & disorders of the brain that significantly affects: • Thinking • Feeling • Sensation • Perception • Behaviour

6. Understanding Mental Illness • Serious mental illness includes a diagnosis which typically involve psychosis. Three of the most common types of severe mental illnesses: -Psychosis • -Schizophrenia -Bipolar disorder (manic depression) • Symptoms usually appear between the ages of 15 and 24 • 80% of all major mental illnesses appear by the age of 24

7. Symptoms of Psychosis • Experience confused thoughts • Feel their thoughts have sped up or slowed down • Feel preoccupied with unusual ideas • Believe that others can manipulate their thoughts; or that they can manipulate the thoughts of others • Perceive voices or visions that no one else can hear or see • Feel “changed” in some way • Act differently than they usually would

8. Do seniors develop mental illness? Anxiety Used to be thought that anxiety decreased with age; what really was occurring is seniors were focusing more on reporting physical health issues than psychiatric Anxiety is as common in seniors as it is at any age **Anxiety and Depression Association of America Depression 5-10% of seniors experience depression but that number increases to 30-40% for those in long-term care homes or hospitals Over 80% of seniors respond well to treatment but 90% never seek help Often depression as seen as a normal part of aging, it is NOT **Mood Disorders of Canada Schizophrenia 40 Late Onset Schizophrenia; more women than men, less family history 60 Very-Late-Onset Schizophrenia-Like Psychosis Scarce epidemiological data 10-23.5% of cases occur after age 40 **http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1257410/

9. Psychosis of Alzheimer’s vs. Schizophrenia Psychosis of Alzheimer’s Disease Schizophrenia • Visual hallucinations more common • Delusions typically not bizarre • Misidentification of caregivers occurs frequently • Past history of psychosis is rare • Length of maintenance on antipsychotic mediation is brief • Recommended treatment options: environmental modification, behaviour therapy and work with caregivers • Will worsen over time **Older Adults with Schizophrenia – Julie Loebach Wetherall, PHD, and Dilip V. Jeste, MD • Auditory hallucinations more common • Delusions, bizarre and complex • Misidentification of caregivers is rare • Past history of psychosis is very common • Length of maintenance on antipsychotic medication is long term • Recommended treatment options: cognitive behaviour therapy, social skills training, work with caregivers • Does not worsen over time

10. What are the challenges? Social Isolation Functional Decline Substance Abuse Elder Abuse Family Caregiver Stress & Burnout Changing Life Situation Financial Insecurity Depression Delayed Treatment

11. Role of Staff/Caregivers/Family Understanding the illness Schizophrenia is a highly treatable medical illness Getting to know the person the symptoms vary from person to person Navigating the system for seniors Involving the patient in decision-making to promote a good working relationship Include family members in care-giving Advocate for the patient

12. Support Strategies Changing the environment is easier than changing the person (reduce environmental stimulation), ex removing mirrors from a room where someone is experiencing partition delusions Effective communication & responsive listening (in person communication ; written notes ; repeating information ; clarifying information ; ) Accommodating physical and cognitive disabilities or impairment Preparation of changes (new service / new technologies / new tenants/changes of staff) Keeping a routine

13. Stress Key Strategies to manage stress and stay mentally fit • Store positive memories • Talk to someone • Get lots of rest • Exercise • Have fun – hobbies • Treat/spoil yourself • Laughter • Journal • Set achievable goals

14. Local Resources • COAST (Crisis Outreach and Support Team) : 905-972-8338 • IntAC: 905-528-0683 • Barret Centre – 905-529-4343

15. Contact Info Schizophrenia Society of Ontario Ask the Expert – 1-800-449-6367 ext. 251 Online – asktheexpert@schizophrenia.on.ca Jill Dennison, Regional Lead ext. 305 jdennison@schizophrenia.on.ca

16. Discussion