People across the world are living longer and whilst this should be celebrated it also means that some older people will face particular mental health issues as a result of ageing.
Dementia is one of the biggest challenges posed as a result of the ageing population and this is no different in Guernsey. HSC have published a Dementia Framework Dementia Framework [2Mb] as part of the Disability and Inclusion Strategy which outlines 6 areas where Guernsey has an opportunity to make positive changes in the years ahead for people with dementia and their families. The framework views dementia as a hidden disability and a condition that people can continue to live well with if the right support is in place.
Depression is another issue which affects people of all ages and older people face their own particular challenges. Older people may have co-existing physical health issues which impact on daily living or they may have to overcome the loss of a long-term partner. Some people struggle to deal with loss of a previous role or may have reduced income which can limit ones ability to engage fully in daily life and can impact on wellbeing. This page gives an overview of the services available to older adults experiencing mental health issues. Here you will also find information on the steps to take if you are worried about your memory and explains what to expect if you are referred to the Memory Clinic.
- The term dementia can be a confusing and frightening one for many people. It is considered to be the condition that people aged over 55yrs in the UK are most frightened of developing.
- Dementia is not a single disease; it is an umbrella term used to describe a group of diseases that affect the brain and which cause decline in memory, reasoning, planning and language.
- The condition is progressive which means the symptoms gradually get worse over time. The duration of the condition varies depending on various factors including the type of dementia, the age of onset and the person's co-existing health conditions. Dementia should not be considered to be a normal part of ageing.
- The symptoms of dementia are numerous and include:
- Memory loss (recent memories affected more than older memories)
- Difficulty finding the right word when speaking
- Difficulty understanding what is being said
- Difficulty interpreting written language
- Difficulty recognising or naming people
- Having problems with concentration (person may struggle with reading a book or following TV programmes)
- Difficulty planning and completing tasks like cooking, personal care, managing money, paying bills, driving etc.
- Disorientation to time (the person may feel they are at a different stage in their life. They may believe their parents are still alive or that their children are still very young)
- Disorientation to place (the person may not recognise familiar environments or even their own home)
- Managing fine motor skills like doing buttons or tying shoes may become difficult.
- Changes in mood (the person may become worried, anxious or frightened).
- Behaviour changes. The person may act differently as they try to make sense of what is happening. They may get suspicious or possessive of the person closest to them. Much of the behaviour expressed by people with dementia is a form of communication and there is normally meaning attached to it. If we can try to understand what the person is trying to communicate we may be able to meet the need.
- Continence issues (the person may have difficulty remaining independent with toileting or in later stages may not recognise the need to do so)
- The person may have changes in visual perception and interpretation. This can arise as a result of changes in the brain or eyesight and can sometimes be frightening for the person.
- As dementia is a progressive condition many of the symptoms listed above may only occur at certain stages of the illness and not everybody with dementia will experience every symptom on the list. Every person with dementia is unique and will experience the condition in ways that are unique to them. More detailed information on how dementia presents can be found online via the Alzheimer's Society website. www.alzheimers.org.uk
- The term dementia and Alzheimer's are often used interchangeably. There are many causes of dementia but Alzheimer's disease is the most common cause. Alzheimer's type dementia accounts for around 60% of all dementia cases.
- Particular changes occur within the brain of people with Alzheimer's. These changes impair the ability of the brain to function properly. Over time the brain cells die and the brain size often decreases in size and weight.
- The main risk factor associated with Alzheimer's disease is age. After the age of 65 years the likelihood of developing dementia roughly doubles every five years. By the age of 80 years the risk of a person having dementia is about 1 in 5. The likelihood of developing the disease may increase if there is a strong family history of Alzheimer's (e.g. if both parents had the disease, or if many members of one side of the family developed the condition).
- The second most common cause of dementia is vascular dementia. Vascular factors account for about 20% of all the dementias we see. This type of dementia occurs as a result of problems with blood supply to the brain; either the supply is blocked or there are tiny bleeds as a result of mini strokes or TIA's. Studies have shown that up to half of dementias can be a mixture of both Alzheimer's and vascular types.
- There is good evidence to suggest that healthy lifestyles may help reduce the incidence of vascular dementia. Risk factors for vascular dementia are the same as those for strokes. The Alzheimer's Society http://www.alzheimers.org.uk has published guidelines which state "What's good for the heart is good for the head" There are steps we can take now in adulthood to reduce the risks such as:
- Monitoring blood pressure: Get your blood pressure checked when you visit your GP and follow medical advice to keep it under control.
- Monitor cholesterol: Evidence shows that high cholesterol levels in mid-life can increase your risk of dementia later on. Your GP may be able to give you advice on reducing levels if high.
- Avoiding obesity: Obesity can increase the risk of high blood pressure and diabetes which can increase the risk of dementia. Eating a healthy diet and reducing excess sugar and saturated fats is recommended.
- Regular exercise: Try to be physically active for at least 30 minutes, five times a week, with a moderate intensity activity such as brisk walking or cycling. You should be working hard enough to raise your heart rate and break a sweat.
- Stopping smoking: Smoking has an extremely harmful effect on the heart, lungs and blood vessels, including the blood vessels in the brain. Research shows that smokers have a 50 per cent greater chance of developing dementia than those who have never smoked, but this risk can be significantly reduced by quitting the habit.
- Avoiding excess alcohol: Drinking more than the recommended levels of alcohol increases the risk of developing various forms of dementia, such as Korsakoff's disease & vascular dementia. However, research suggests that light-to-moderate amounts of alcohol may protect the brain against dementia and keep the heart and vascular system healthy.
- Mental activity: It is thought that mental activity increases the brain's ability to cope with, and compensate for physical damage. This would mean a person who often takes part in these activities will be able to tolerate a greater level of damage before symptoms of dementia are detected. Taking up new hobbies or learning new skills are great ways to challenge your brain and keep it active. Social activity is also a very good way of keeping the brain active.
- Research undertaken by Guernsey's Public Health department estimates the numbers of people with dementia to be approximately 1,200. This has increased significantly from what we thought 10 years ago.
- Data on the numbers of people referred by Guernsey GP's with suspected dementia is not fully clear but we receive about 110 new referrals every year. Not all of these people will receive a diagnosis of dementia however. Some will have mild cognitive impairment which needs to be monitored.
- Everyone feels down now and again. It's part of life. Getting older can bring with it particular issues which people may struggle with or need some help to overcome. As we get older it's common to have one or more physical health issues which can make it difficult to engage in daily life. Mobility problems, eyesight issues or shortness of breath can cause people to become isolated and lonely which can impact significantly on wellbeing. Stopping driving may also lead to a significant loss of independence. There are several social centres for older people who may feel isolated at home and transport can be arranged to attend if required.
- Age Concern Guernsey http://www.ageconcernguernsey.org.gg
- Guernsey Voluntary Service www.gvs.org.gg/
- Unfortunately getting older means we may have to face the loss of a loved one or partner. Bereavement can be a difficult process and one which you may need some help in working through. The Guernsey Bereavement Service http://www.guernseybereavementservice.com may be able to offer some help in this regard.
- Being "down in the dumps" for long periods of time is not a normal part of getting older. If you are feeling like this or if you frequently feel tearful, have lost interest in everyday activities, feel tired all the time, cant sleep, lose interest in food (or start eating too much), feel guilty, feel worthless, have difficulty concentrating or have thoughts about harming yourself or killing yourself you may have clinical depression.
- For many people, depression gets better with treatment. Counselling (talk therapy), medicine, or other treatments can ease the pain of depression. You do not need to suffer. You should go to your GP in the first instance who may well be able to devise a treatment plan. Speak with a family member or friend who might be able to support you through this. Your doctor may refer you on to a specialist community nurse or doctor who can offer you added support at home if you need it.
What support can I get after a diagnosis?
- If you have been recently diagnosed with dementia you will be given advice about local support groups run via the voluntary sector and The Committee for Health & Social Care. These groups are also helpful for any family caregiver or friends who support you. A carer support group takes place at the Guernsey Alzheimer's Association, Rue Des Monts, St. Sampson's every Wednesday from 2pm to 3:30pm and also monthly at La Nouvelle Maritaine, Vale from 7pm - 8pm. The support groups will always have a member of the OACMHT present to deliver a talk or to ask advice from. More information on joining the groups can be had via the OACMHT secretary 725241 ext 3595
- If you need ongoing support or advice you may be allocated to a member of the OACMHT or a Social worker. The key worker will be able to advise you on issues around benefits, support networks or about planning ahead for the future. Further information and support can be found via the voluntary agencies below:
- Alzheimer's Society, Guernsey Office Tel: 01481 213367, firstname.lastname@example.org
- Guernsey Alzheimer's Association Tel: 01481 245121, email@example.com; http://www.alzheimers.gg Both Society and Association provide support, advice, education and social activity for people with dementia and their carers. Activities delivered by both groups include music sessions, lunches, talks from professionals as well as peer support. They can sometimes provide financial help to people in a caring role.
- There are other smaller organisations that should be recognised such as Café & church groups who provide social engagement for people with dementia.
Local dementia support services
- Older Adult Community Mental health Team: (OACMHT)
- The OACMHT is a community team that provides mental health support to islanders aged over 65. They also provide support people under the age of 65 where dementia is the primary diagnosis. Referral to the team is usually from your own GP. The team contains professionals from various disciplines including psychiatrists, community mental health nurses, occupational therapist and support workers. The team also has links with social work and psychology. They are supported by a team secretary who can guide you to the appropriate team member. The team can be contacted on 725241 ext 3595
- The team offers specialist assessment, treatment and advice on mental health issues and specific approaches in dementia care. The focus of the team is to help people to remain safely at home for as long as possible. Supporting carers is an important part of their role. Team members also visit Alderney about every three weeks where they run a clinic in the Mignot Memorial Hospital. Members of the team will help devise a personalised care plan once your needs have been assessed. They offer advice and signposting towards local services. They can also offer advice regarding medications and will liaise closely with your GP. If you need daily help with daily personal care like washing & dressing the team can liaise with the Community Services team to put this in place.
- The Occupational Therapist can provide you with a specialist functional assessment and offer advice on adaptations that may help you to remain independent within your home and social environment.
For further memory information please see our Memory Service page.