The last Wednesday of January is Bell Let’s Talk Day, an initiative to encourage conversations, increase awareness and end the stigma around mental illness. One aspect of the conversation that’s not often talked about is mental health among older adults and seniors, and how this intersects with dementia. So today, let’s talk about it.
Here are five things you should know about dementia, mental illness and mental health:
1) Dementia caregivers experience higher rates of depression than all other caregivers.
While caring for someone with dementia can be rewarding, it can also take a major toll on your physical and emotional health. Those who care for a person with dementia experience high rates of caregiver burnout due to the demands of the disease and the length of time a person will live with it. It’s not uncommon for a dementia caregiver to end up in the hospital themselves. That’s why self-care for caregivers is so important. If you’re a caregiver or know someone who is, make sure you recognize the signs of caregiver stress and get help if you need it. Taking care of yourself will make you a better caregiver in the long run.
2) Almost half of long-term care residents are depressed.
A 2010 study by CIHI found that 44% of Canadian seniors living in residential care homes are diagnosed with or have symptoms of depression. The majority of long-term care residents are living with a form of cognitive impairment or dementia, but that doesn’t have to equal poor mental health. After all, people can connect and engage even in the later stages of the disease.
Here’s some good news: right now, researchers are working hard to find better ways to care for and maintain quality of life for people with dementia in residential care settings. Some of this research has already helped us to develop our framework for person-centred care, which aims to positively change the way care is experienced by people with dementia living in long-term care.
3) Dementia and mental illnesses share many common symptoms–but these can’t always be diagnosed and treated in the same way.
Unlike dementia, mental illnesses and mental health symptoms can be treated. But the treatments and approaches that work for most people don’t necessarily work for people with dementia.
Why? Older adults react to medications differently, and medications commonly used to treat psychological symptoms can instead make symptoms worse in the dementia brain. They can also cause other adverse effects, like increasing the risk of falls. Antipsychotics, in particular, should only be used in people with dementia as a last resort, yet are often overprescribed to treat psychological and behavioural symptoms, despite guidelines to the contrary.
It can also be very difficult for medical professionals to diagnose mental illness in people with dementia because there are so many overlapping symptoms. Is the person experiencing depression, or is it a certain part of their brain being affected by the disease?
That said, it’s still important to seek treatment. Some medications can still be very effective, and health care professionals can recommend non-pharmaceutical approaches to treatment. In fact, there is strong evidence that making healthy lifestyle choices can enhance our health and quality of life when living with dementia. Which leads us to our next point…
4) People with dementia can have good mental health.
It’s important to remember that mental illness and mental health mean different things. Everyone can experience varying levels of mental health and well-being, regardless of whether or not they have a mental illness. We all have good and bad days, and might experience varying emotions and moods, but that doesn’t mean we have a mental illness. Similarly, it’s possible for someone with a mental illness to have good mental health with the right treatment and the help of a supportive network.
The same is true for people with dementia. A diagnosis of dementia doesn’t mean the end of good mental health. Of course, this doesn’t mean that people with dementia don’t experience mental illness or mental health symptoms. Some may have lived with mental illness prior to dementia; others may experience depression or anxiety as they struggle to come to terms with their diagnosis. Regardless, it is possible to treat and improve one’s mental health, even when living with dementia.
If you don’t believe us, just read Roger’s story. Roger was in a dark place after he was diagnosed with Alzheimer’s at 57. Now, his outlook couldn’t be more different. Roger credits his doctor and his local Alzheimer Society for giving him the tools he needs to enjoy a full and happy life.
Roger will be the first to admit, though, that there is one particular giant hurdle to overcome…
5) People with dementia and people with mental illness face a common foe: stigma.
Stigma is the biggest thing standing in the way of mental health and well-being in people with dementia. A recent survey found that most Canadians believe they would face discrimination if diagnosed with dementia, and almost half would feel embarrassed or ashamed if they were diagnosed with dementia. One-quarter said they believe their friends and family would avoid them if they were diagnosed.
Isolation is already a major issue for Canadian seniors, and research tells us that loneliness impacts both our mental health and physical health. Stigma only serves to exclude people with dementia from everyday life and add to that isolation and loneliness. It also discourages people from getting a diagnosis and seeking treatment and support.
The good news is that there’s something you can do right now to help end dementia stigma.
Visit ilivewithdementia.ca and hear firsthand from those living with dementia, what it’s really like. Let them help you understand.
And remember: dementia is a marathon, not a sprint. Don’t be afraid to ask for help and lean on your local Alzheimer Society for information and support. We’re here to help.