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A GP Perspective

A GP Perspective. Isolation & Emotional Wellbeing Dr Fiona Butler. Isolation and Depression. Depression is under diagnosed in primary care K&C prevalence high for London, and highest in older adults (>65 years) Changing age structure means more older adults with depression

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A GP Perspective

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  1. A GP Perspective Isolation & Emotional Wellbeing Dr Fiona Butler

  2. Isolation and Depression • Depression is under diagnosed in primary care • K&C prevalence high for London, and highest in older adults (>65 years) • Changing age structure means more older adults with depression • Local investment in primary care mental health services developed by practice based commissioners • Range of psychological therapies • Personalise care – Time Bank • Exchange of skills and reduction in isolation • Self help support groups

  3. Physical Health and isolation • Increasing numbers with long term conditions • Complex symptoms • Poor mobility, low mood • Isolation • Vulnerable Elderly enhanced service • Holistic review for > 85’s living alone • Screening chronic disease for depression • Deliver NICE guidance for those with physical health problems

  4. Case Study 1 • Eleanor, aged 86 years • Lives alone, no family around • Anxiety and panic attacks for many years • Complex cardiac history involving frequent hospital admissions with palpitations • Does not want to take anti-depressant or cardiac medicines • Cannot get out for psychological therapy as does not feel safe to go out on her own • Isolated, worrying about her health • Most successful intervention is a befriender who takes her to see local gardens

  5. Case Study 2 • Alice, aged 74 yrs • Ex GP practice receptionist • Lives alone • Brought in by daughter who is worried about her low weight and social withdrawal • Not meeting friends and stopped going to social club • Screened for depression and physical health investigated • Treated for depression and low vitamin D levels • Did not fully improve • Final picture was of a dementia • Unable to keep up with bridge • Forgetting to eat

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