Lesson 1: Conceptual Foundations of Geriatric Mental Health

Attention

mental health for seniors

This course is not only about mental health problems, but about mental HEALTH...we will be exploring some of the challenges of getting older, but we will also explore the opportunity for Positive Aging!

Learning Outcomes

Upon completion of this lesson's material, students will be able to:

  • Identify the potential emerging roles for mental health technicians in geriatric care
  • Discuss personal perceptions and experiences in relation to geriatric care and mental health

Teaching

Read Chapters 1 and 2 in Cohen & Eisdorfer

Chapter 1 Notes

Challenges

  • Medical care system is the de facto mental health care system for the elderly
  • Lack of understanding of geriatric mental health issues
  • It needs to be more than diagnosis and treatment---it impacts successful aging
  • This population is growing
  • Multiple doctors, prescriptions, without communication
  • Over 65 is the highest incidence of suicide

Bittersweet Success of Aging

  • People are living longer, healthier, and more productive
  • Increased likelihood of chronic illness, functional impairments, frailty, and changes in quality of life

Review the list describing the "Future of Geriatric Mental Health Care.

  • What emerging roles do you see for the MHRT/C?
  • What personal experience do you have of any one of these issues?

Chapter 2 Notes

Models of Care

  • Medical model
  • Functional model
  • Rehabilitation model
  • Developmental Perspective

The Developmental Perspective

In this course we are essentially discussing how humans change over time. We examine this issue from a multitude of perspectives, but overall, we are concerned with, and we are informed in our investigations by taking the Developmental Perspective or "DP".

The DP is very simple. When we are faced with a question in Psychology we affirm that the answer to that question may very well be impacted by how OLD the person is.

In this class we will be studying what NORMALLY happens across the lifespan and based on that knowledge we can take the DP on any topic. Here are some examples:

"How does divorce effect the children?"

This is obviously a great question, but for this class it is incomplete. Before we can really answer this question we need to know how old the kids are. We know that changes in family structure can have profound impacts on an individual but these impacts will be different based on how old the person is.

Let's say the person we are asking this about is 10 years old. What is "normally" going on in the life of a 10-year old that may be impacted by a divorce?

What if the person we are asking this about is 17? What if they are 25? What if they are 50? (Remember, a divorce can happen at any time in the lifespan). It should be apparent to you now that it is quite difficult to answer a question without asking how old the person is.

Note: Taking the DP is not the same as applying Developmental Theory. You are NOT taking the DP when you ask something like "How does intelligence change over childhood?" or if you ask "How does memory change in late adulthood?" These are simply applications of theory and knowledge.

The DP ADDS age to the equation of a question that is not about age (to begin with). So we ask questions like these:

  • How well do people remember things? (DP---Depends on how old the person is!)
  • How fast can a person learn a new skill? (DP---Depends on how old the person is!)
  • How will losing a job impact a person? (DP---Depends on how old the person is!)
  • How will having children impact a person's plans? (DP---Depends on how old the person is!)
  • How will a serious injury impact someone? (DP---Depends on how old the person is!)

Concepts and Principles

  1. Aging is not just about old age, it is a natural process occurring across the lifespan
  2. Aging is more than the number of years the person has lived (biospychosocial perspective)
  3. Aging is not a disease or a disorder
  4. Ageism has a destructive influence on geriatric health and mental health care
  5. Normal aging and pathological ageing are interrelated and complex
  6. Successful aging is a concept invoked to describe older persons who live long, happy, and vital lives
  7. Why people age is not well understood
  8. Drawing a sharp distinction between physical and mental health is artificial and antiquated
  9. Mental health is more than the absence of illness
  10. The DSM needs revision to better describe geriatric mental health
  11. Feelings and behaviors (used to construct diagnoses) are subject to individual culture, perceptions, and beliefs
  12. Clinician's attitudes effect their practice
  13. History is key to diagnosis and treatment
  14. The person's experience of illness is important (What does this mean to YOU?)
  15. Social etiquette is important when communicating with the elderly
  16. Drug treatment has to be approached with special care
  17. Health promotion and risk prevention are important
  18. Older persons are at risk for serious negative outcomes
  19. These problems are daunting but they present opportunities

Assessment

Lesson 1 Quiz

  1. What emerging roles do you see for the MHRT/C in light of your reading?

Possible Class Discussion

Select and identify one of the "Concepts and Principles" listed in the Lesson. Outline your perspective on the concept and share a personal experience that supports your perspective.