Geriatric Mental Health Disaster and Emergency Preparedness

16 Geriatric Mental Health Disaster and Emergency Preparedness
a group of people, is one of the most popular psychosocial interventions
in dementia care and is highly rated by staff and participants. There is some
evidence that reminiscence therapy can lead to improvement in a patient’s
mood, cognition, and functional ability. It can also alleviate the strain on
caregivers (Woods, Spector, Jones, Orrell, & Davies, 2005).
Electroconvulsive Therapy (ECT)
ECT involves the application of an electric current to the head with the
aim of inducing a controlled tonic-clonic convulsion and is usually carried
out at intervals of days. Some reports suggest ECT is particularly effective
in late-life depression (Flint & Rifat, 1998) as well as in therapy-resistant
depressive older people with extensive white matter hyperintensities (Coffey,
et al., 1988). Currently there is no evidence to suggest ECT causes any
kind of brain damage, although temporary cognitive impairment is frequently
reported ( Devanand, Dwork, Hutchinson, Bolwig, & Sackeim, 1994;
Scott, 1995). ECT seems to be a safe procedure even in older persons with
cardiovascular disorders (Rice, Sombrotto, Markowit, & Leon, 1994). ECT
is used more frequently to treat depressed older persons and its use is declining
less rapidly than in the general population (Glen & Scott, 1999).
TREATMENT OF SOME OF THE MOST COMMON
MENTAL HEALTH CONDITIONS IN OLDER PERSONS
Anxiety Disorders
Anxiety symptoms are quite common in the older population. The prevalence
rate of anxiety disorders among older persons living in the community
has been estimated between 10% and 15% (Beekman, et al., 1998;
Kessler, et al, 2005b). However, primary anxiety disorders in later life are
rare, as most patients develop anxiety symptoms secondary to a medical
condition or in the context of a depressive disorder (Flint, 2005). The impact
of anxiety disorders in later life can be significant: They can impair
quality of life by having a negative impact on functioning and well-being
and are associated with increased health care utilization (de Beurs, et al.,
1999). Moreover, patients suffering from anxiety disorders have an increased
risk of depression (Beekman, et al., 2000); left untreated, anxiety
disorders tend to become chronic (Larkin, Copeland, & Dewney, 1992). In
two large cohort studies, anxiety disorders in later life were prospectively
associated with an increased mortality rate (Brenes, et al., 2007). Because of