Conference Abstracts

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Differentiating dementia causation: the first step in providing appropriate care and treatment

McDonald, T. A., 2014

Alzheimer’s Australia, Masterclass, Melbourne

ABSTRACT

Background: The set of symptoms which has come to be known as ‘dementia’ is typified by mental confusion. In older people there are many causes of mental confusion that are not necessarily connected to the central nervous system diseases that result in dementia.

Mental illness resulting in behavioural problems is easily categorised as dementia when in fact the cause could be non-cognitive psychiatric symptoms such as depression, delusions, hallucinations, anxiety or agitation among many others. These symptoms can also arise from the use of medications in different combinations as well as environmental triggers for behaviour.

The more flamboyant symptoms associated with psychiatric conditions frequently lead to psychotropic management whereas depression in the aged person is easy to overlook and can remain untreated. More poignantly, people who have a psychiatric condition as well as dementia arising from nervous system deterioration can be in even greater danger of not having their mental illness acknowledged let alone appropriately treated.

Aims: In this session the growing demand for mental health services in aged care contexts is examined along with a discussion of options for introducing effective mental health services in a residential aged care setting. Examples of mental health strategies and approaches to establishing a differential diagnosis for psychiatric conditions such as schizophrenia, bi-polar disorder and anxiety neuroses as well as dementia-causing diseases will be provided.

Standard approaches for assessing the extent of psychiatric illness within a residential aged care village go some way toward identifying the need for specialist care and treatment. Usually a clinical psychologist is contacted to conduct assessments and recommend treatments however referrals are often limited due to poor staff awareness of diffe psychiatric and dementia symptoms.

Assessment and health practitioner training sessions identify the prevalence of psychiatric issues and the skills needed to provide appropriate care and treatment. An example of a mental health clinical pathway developed by front-line practitioners will be presented along with reports of progress for people who have been placed on the pathway.

Most mental health problems are amenable to help from generalist practitioners (RNs, MDs, therapists) with backup support from mental health specialists. Reversal of common views held about older people’s mental health status requires health practitioners to be aware of these issues and to assist residents to seek help from a mental health specialist as necessary. These themes need to be taken into account when designing mental health interventions for aged care communities.

Learning outcomes

On completion of this two hour session participants will be able to:

  1. describe the symptoms of dementia
  2. understand the similarities and differences between signs and symptoms of mental illness and dementia causing illnesses
  3. discriminate between different categories of cognitive decline causation
  4. assess differences in clinical pictures associated with different confusional states
  5. understand the need for individual assessment and care management for older adults with mental confusion symptoms
  6. determine appropriateness of diagnosis, treatment and support for both psychiatric and organic causes of mental confusion
  7. be aware of the notion of clinical pathway management of older adults with mental confusion in residential and primary care contexts.

CITATION Differentiating Dementia Causation. A three-hour workshop for advanced practice clinicians in nursing, medicine and allied health. Alzheimer’s Australia Clinical Expertise in Dementia Care Forum: Integrating Care: Challenges And Opportunities, Thursday, 22 May 2014 ANZ Centre, Melbourne.

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Last updated 18/11/2019
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