Primary Care Mental Health In Older People

This book is a practical resource that will support the delivery of holistic mental health interventions in the primary and community care setting for older people. Primary care delivery is discussed in relation to both functional mental health problems, such as anxiety, depression, and psychotic and personality disorders, and acquired organic mental disorders of old age, such as dementia, cognitive impairments, and delirium. Careful consideration is paid to the complex relationship between mental and somatic health problems, as well as the impacts of multimorbidity and polypharmacy. Further topics include, for example, epidemiology, wider determinants of health, different care models, history taking, neurocognitive and capacity assessment, and pharmacological, psychological, and physical interventions. The wider goals of the book are to support the development of community resilience and self-care in older people; to promote universal access and equity for older people in order to enable them to achieve or recover the highest attainable standard of health, regardless of age, gender, or social position; and to promote pathways to care for older people with mental health problems respecting their autonomy, independence, human rights, and the importance of the life-course approach. This book will be an invaluable resource for all professionals who work with older adults with mental health problems and those training in these fields including physicians, psychiatrists, family doctors, geriatricians, general practitioners, nurses, psychologists, neurologists, occupational therapists, social workers, support workers and community health and social care workers.

This case-based book offers primary care practitioners support in managing older people with difficulties due to mental health problems, emphasising the importance of integrating health and social care. The full range of disorders is covered, including anxiety and depression, delirium, psychosis and the dementias. The discussion of anxiety and depression encompasses diagnosis and management, assessment of risk, evidence for both pharmacological and non-pharmacological interventions, and models of care. Clear guidance is provided on the identification and management of symptoms of delirium and different forms of psychosis in older people. The coverage of the dementias includes presentation, initial management, risks to self and others, referral to specialist care and care of older people in residential and nursing homes. Each chapter is co-written by authors from different professional backgrounds and draws on up-to-date national and international research and guidelines. The book will assist greatly in the commissioning and delivery of evidence-based practice.

At least 5.6 million to 8 million-nearly one in five-older adults in America have one or more mental health and substance use conditions, which present unique challenges for their care. With the number of adults age 65 and older projected to soar from 40.3 million in 2010 to 72.1 million by 2030, the aging of America holds profound consequences for the nation. For decades, policymakers have been warned that the nation's health care workforce is ill-equipped to care for a rapidly growing and increasingly diverse population. In the specific disciplines of mental health and substance use, there have been similar warnings about serious workforce shortages, insufficient workforce diversity, and lack of basic competence and core knowledge in key areas. Following its 2008 report highlighting the urgency of expanding and strengthening the geriatric health care workforce, the IOM was asked by the Department of Health and Human Services to undertake a complementary study on the geriatric mental health and substance use workforce. The Mental Health and Substance Use Workforce for Older Adults: In Whose Hands? assesses the needs of this population and the workforce that serves it. The breadth and magnitude of inadequate workforce training and personnel shortages have grown to such proportions, says the committee, that no single approach, nor a few isolated changes in disparate federal agencies or programs, can adequately address the issue. Overcoming these challenges will require focused and coordinated action by all.

A comprehensive guide to this emerging field, fully updated to cover clinical, policy, and practical issues with a user-centred approach.

Community Mental Health for Older People is the perfect resource for mental health workers as it discuses the ageing population, within the context of community mental health. It provides a comprehensive overview of the important issues and clinical practices that influence mental health care for older people. Written from a multidisciplinary perspective it is suitable for all health workers in community mental health teams (Aboriginal and Torres Strait Islander health workers, clinical psychologists, consumer representatives, medical practitioners, occupational therapists, registered nurses, social workers, etc) as it incorporates the use of case studies to aid in the application of evidence-based practice. Multidisciplinary approach serves to illustrate the breadth and context of mental issues for older people Chapters are topical and relevant, discussing issues such as service provision, cultural and rural issues, major disorders and interventions, as well as ethical and legal issues. Vignettes are included throughout the clinical chapters and serve to illustrate real cases derived from practice Evidence-based practice is a key element to this pivotal new text as it highlights the best method of practise, in a clear and accessible manner. Highly readable style without the bulkiness of excessive references This text will cover issues relevant to the mental health of older people within a community context in Australia and New Zealand. Issues will include population health and the clinical management of the major concerns experienced with the diverse clinical presentations by older people. The mental health care of older people is now considered a specialist area with older person's mental health services being key components of the mental health service framework. The publication is primarily aimed at health workers in community mental health teams (registered nurses, clinical psychologists, medical practitioners, social workers, occupational therapists, Aboriginal and Torres Strait Islander health workers etc), but would incorporate those trainee health professionals involved in relevant undergraduate and postgraduate studies.

This book provides a comprehensive and systematic state-of-the science review of major primary care delivery models, how they address specific needs of older adults, and available evidence for their efficacy. Written by experts in the field, this book explores the patient-centered medical home model (PCMH) in depth and dives into the complexities of the “medical neighborhood”. It describes and analyzes primary care specifically directed toward special, complex populations, such as the Health Home for safety net patients with mental health needs, and intensive primary care for older adults. It reviews an array of primary care models related to dual eligible patients including the GRACE primary care consultation model and PACE models. It describes primary care with Advanced Practice Nurses and Physician Assistants and explores in-depth the massive effort within the VA to develop the Patient Activated Care Team (PACT), a VA form of the PCMH that also has several offshoots that address complex older veterans and veterans with severe mental illness. Finally, it illuminates rarely discussed primary care that occurs within the home and within long-term care. Throughout the entire book, experts navigate the workforce, care quality, and financing challenges of primary care for older adults. Primary Care for Older Adults is a valuable resource for clinicians, researchers, patients, caregivers and their advocates, and policy makers who have an interest in designing, promoting, and implementing high quality primary care for older adults.

Social isolation and loneliness are serious yet underappreciated public health risks that affect a significant portion of the older adult population. Approximately one-quarter of community-dwelling Americans aged 65 and older are considered to be socially isolated, and a significant proportion of adults in the United States report feeling lonely. People who are 50 years of age or older are more likely to experience many of the risk factors that can cause or exacerbate social isolation or loneliness, such as living alone, the loss of family or friends, chronic illness, and sensory impairments. Over a life course, social isolation and loneliness may be episodic or chronic, depending upon an individual's circumstances and perceptions. A substantial body of evidence demonstrates that social isolation presents a major risk for premature mortality, comparable to other risk factors such as high blood pressure, smoking, or obesity. As older adults are particularly high-volume and high-frequency users of the health care system, there is an opportunity for health care professionals to identify, prevent, and mitigate the adverse health impacts of social isolation and loneliness in older adults. Social Isolation and Loneliness in Older Adults summarizes the evidence base and explores how social isolation and loneliness affect health and quality of life in adults aged 50 and older, particularly among low income, underserved, and vulnerable populations. This report makes recommendations specifically for clinical settings of health care to identify those who suffer the resultant negative health impacts of social isolation and loneliness and target interventions to improve their social conditions. Social Isolation and Loneliness in Older Adults considers clinical tools and methodologies, better education and training for the health care workforce, and dissemination and implementation that will be important for translating research into practice, especially as the evidence base for effective interventions continues to flourish.

A practical guide to providing home-based mental health services, Providing Home Care for Older Adults teaches readers how to handle the unique aspects of home-based care and apply and adapt evidence-based assessment and treatment within the home-based setting. Featuring contributions from experienced, board-certified home care psychologists, social workers, and psychiatrists, the book explains the multifaceted role of a home-based provider, offers concrete and practical considerations for working within the home, and highlights adaptations to specific evidence-based methods used in treating homebound older adults. Also covered are special topics related to hoarding, safety, capacity evaluations, caregivers, case management, and use of technology. Each chapter includes engaging case examples with practical tips that illustrate what it is like to work in this new and exciting frontier. Psychologists, counselors, and other mental health practitioners in home settings will be able to use this guide to provide effective home-based care to older adults.