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

lgrsnf/64507.pdf

Byrne BSC(Med) MBBS PhD FRANZCP, Gerard J., Neville RN RPN PhD FACMHN, Christine C.

Churchill Livingstone Australia

Elsevier Australia

Chatswood, N.S.W, ©2010

Chatswood, N.S.W, 2009

Australia, Australia

1, PS, 2009

Front Cover
Community Mental Health for Older People
Copyright
FOREWORD
CONTENTS
PREFACE
ABOUT THE AUTHORS
REVIEWERS
ACKNOWLEDGMENTS
SECTION 1
Chapter 1
POPULATION HEALTH AND BURDEN OF DISEASE
INTRODUCTION
THE AGEING POPULATION
HOSPITAL CARE
RESIDENTIAL AGED CARE
EPIDEMIOLOGY
BURDEN OF DISEASE
SUMMARY
REFERENCES
Chapter 2
NORMAL, HEALTHY AND SUCCESSFUL AGEING
INTRODUCTION
NORMAL AGEING
HEALTHY AGEING AND SUCCESSFUL AGEING
BRAIN RESERVE
THE CLINICIAN’S ILLUSION
SUMMARY
Chapter 3
EVIDENCE-BASED CARE IN THE COMMUNITY
INTRODUCTION
QUANTITATIVE VERSUS QUALITATIVE METHODS
THE SCIENTIFIC METHOD
TYPES OF EVIDENCE
OTHER ISSUES IN RELATION TO EVIDENCE
HOW TO LOCATE THE EVIDENCE
EXAMPLES OF EVIDENCE
SUMMARY
Chapter 4
MODELS OF MENTAL HEALTHCARE AND ORGANISATIONAL ISSUES
INTRODUCTION
AREA-BASED SERVICES
INTEGRATED HOSPITAL AND COMMUNITY SERVICES
PRIVATE SECTOR SERVICES
WHO CARES FOR THE ‘GRADUATES’?
WHO CARES FOR PEOPLE WITH DEMENTIA?
TRANSCULTURAL ISSUES
SOURCES OF REFERRALS
DOMICILIARY OR CLINIC-BASED CONSULTATIONS
CASE MANAGEMENT MODEL
CONSULTATION–LIAISON MODEL
THE DAY HOSPITAL
THE MEMORY CLINIC
RESIDENTIAL AGED CARE FACILITIES
INVOLUNTARY CARE IN THE COMMUNITY
THE POLICE SERVICE
SOCIAL AND COMMUNITY SERVICES
SUMMARY
REFERENCES
Chapter 5
COMMUNITY MENTAL HEALTH TEAMS
INTRODUCTION
TEAM SIZE
TEAM COMPOSITION
LEADERSHIP
TEAMWORK
WORKLOAD
GENERIC CLINICAL ROLES
THE VALUE OF DIFFERENT PERSONALITY TYPES
THREATS TO TEAM COHESION
TOLERANCE AND HUMOUR
PROFESSIONAL SUPERVISION
OPERATIONAL MODELS
DOMICILIARY ASSESSMENT AND CARE
AGE POLICY
ADMINISTRATIVE SUPPORT
TEACHING AND TRAINING ROLES
PERSONNEL TRAINING
COMMUNICATIONS
TRANSPORT
RECORD-KEEPING ISSUES
AUDIT ACTIVITIES
RESEARCH ACTIVITIES
TEAM MEETINGS
BURNOUT
SUMMARY
REFERENCE
SECTION 2
Chapter 6
CULTURAL ISSUES
INTRODUCTION
CULTURAL DIVERSITY
CULTURAL AWARENESS
CULTURAL SENSITIVITY
CULTURAL COMPETENCE
SUMMARY
USEFUL WEBSITES
REFERENCES
Chapter 7
SOCIAL ISSUES
INTRODUCTION
AGEISM
GENDER
MARITAL STATUS
SEXUAL ORIENTATION AND GENDER IDENTITY
SUMMARY
USEFUL WEBSITES
REFERENCES
Chapter 8
ISSUES IN RURAL AND REMOTE LOCATIONS
INTRODUCTION
DEMOGRAPHICS
THE MENTAL HEALTH OF OLDER PEOPLE IN RURALAND REMOTE LOCATIONS
RURAL VALUES
ACCESS TO MENTAL HEALTH SERVICES
SOCIAL ISOLATION
THE POSITIVES OF RURAL AND REMOTE AREA WORK
SUMMARY
USEFUL WEBSITE
REFERENCES
Chapter 9
CONSUMERS AND CARERS
INTRODUCTION
CONSUMER AND CARER PARTICIPATION IN MENTAL HEALTH SERVICES
SUPPORT
SPECIAL CHARACTERISTICS OF OLDER CONSUMERS
SPECIAL POPULATIONS
SPECIAL CHARACTERISTICS OF CARERS FOR OLDER PEOPLE
CARER BURDEN
INTERVENTION STRATEGIES TO SUPPORT CARERS
SUMMARY
USEFUL WEBSITES
REFERENCES
Chapter 10
CONSULTATION–LIAISON SERVICES TO RESIDENTIAL AGED CARE FACILITIES
INTRODUCTION
RESIDENTIAL AGED CARE
THE CONSULTATION–LIAISON PROCESS
INTERVENTIONS
SUMMARY
REFERENCES
SECTION 3
Chapter 11
THE THERAPEUTIC RELATIONSHIP
INTRODUCTION
PERSON-CENTRED CARE
THE SICK ROLE
THERAPEUTIC ALLIANCE
TRANSFERENCE AND COUNTERTRANSFERENCE
DEPENDENCY
SABOTAGE AND SPLITTING
BOUNDARY ISSUES
COGNITIVE IMPAIRMENT
INSIGHT
CHALLENGING THERAPEUTIC RELATIONSHIPS
MEASURING THE THERAPEUTIC RELATIONSHIP
SUMMARY
FURTHER READING
REFERENCES
Chapter 12
PSYCHIATRIC HISTORY TAKING
INTRODUCTION
SOURCES OF INFORMATION
PREPARATION FOR THE INITIAL HOME VISIT
ENGAGEMENT OF THE PERSON’S GENERAL PRACTITIONER
THE HOME VISIT
VISITING A RESIDENTIAL AGED CARE FACILITY
INTRODUCTION TO TAKING THE HISTORY
COMPREHENSIVE PSYCHIATRIC HISTORY
SHORTCUTS TO HISTORY TAKING
BEHAVIOURAL AND PSYCHOLOGICAL SYMPTOMS OF DEMENTIA
SUMMARY
Chapter 13
THE MENTAL STATE EXAMINATION
INTRODUCTION
CULTURAL ISSUES
SENSORY IMPAIRMENT
DETAILED MENTAL STATE EXAMINATION
SUMMARY
FURTHER READING
REFERENCES
Chapter 14
CLINICAL COGNITIVE ASSESSMENT
INTRODUCTION
CONTEXT OF COGNITIVE ASSESSMENT
COMPONENTS OF CLINICAL COGNITIVE TESTING
COMPONENTS OF MEMORY
SCREENING INSTRUMENTS
MINI-MENTAL STATE EXAMINATION
NEWER COGNITIVE SCREENING SCALES
MEMORY TESTING
FRONTAL EXECUTIVE TESTING
FORMAL NEUROPSYCHOLOGICAL TESTING
THE RESIDENTIAL AGED CARE FACILITY RESIDENT
WRITING REPORTS
SUMMARY
REFERENCES
Chapter 15
PHYSICAL HEALTH ASSESSMENT
INTRODUCTION
MEDICAL HISTORY
PERSONNEL INVOLVED IN THE PHYSICAL EXAMINATION
EQUIPMENT NEEDED FOR THE PHYSICAL EXAMINATION
FACTORS TO BE CONSIDERED IN THE PHYSICAL EXAMINATION
REASONS WHY PHYSICAL EXAMINATIONS ARE SOMETIMES NOT DONE
MEDICATION REVIEW
LABORATORY INVESTIGATIONS
NEUROIMAGING
ELECTROCARDIOGRAM
ELECTROENCEPHALOGRAM
NEUROPSYCHOLOGICAL TESTING
COMMON GENERAL MEDICAL CONDITIONS
SUMMARY
REFERENCES
Chapter 16
FUNCTIONAL ASSESSMENT
INTRODUCTION
FUNCTIONAL ASSESSMENT
ACTIVITIES OF DAILY LIVING AND INSTRUMENTALACTIVITIES OF DAILY LIVING
AN OCCUPATIONAL THERAPY ASSESSMENT
SUMMARY
USEFUL WEBSITE
REFERENCES
Chapter 17
PSYCHOSOCIAL AND SPIRITUAL ASSESSMENT
INTRODUCTION
PSYCHOSOCIAL FACTORS
SPIRITUALITY
SUMMARY
FURTHER READING
USEFUL WEBSITE
REFERENCES
Chapter 18
RISK ASSESSMENT
INTRODUCTION
FALLS
ABUSE AND NEGLECT
AGGRESSION
SELF-NEGLECT
SUMMARY
USEFUL WEBSITES
REFERENCES
SECTION 4
Chapter 19
THE OLDER PERSON WITH CONFUSION
INTRODUCTION
CLINICAL CONTEXT
EPIDEMIOLOGY
CLINICAL FEATURES
AETIOLOGY
COMORBIDITY
DIFFERENTIAL DIAGNOSIS
ASSESSMENT
TREATMENT OUTLINES
PREVENTION
SUMMARY
REFERENCES
Chapter 20
THE OLDER PERSON WITH MOOD SYMPTOMS
INTRODUCTION
EPIDEMIOLOGY
RISK FACTORS
CLINICAL FEATURES
COMORBIDITY
DIFFERENTIAL DIAGNOSIS
ASSESSMENT
TREATMENT PRINCIPLES
PREVENTION OF DEPRESSION
MANIA IN OLDER PEOPLE
SUMMARY
REFERENCES
Chapter 21
THE OLDER PERSON WITH SUICIDAL THOUGHTS
INTRODUCTION
EPIDEMIOLOGY
TYPES OF SUICIDAL BEHAVIOURS
METHODS OF SUICIDE
RISK FACTORS
ASSESSMENT
TREATMENT
THE AFTERMATH OF SUICIDE
PREVENTION
SPECIAL TOPICS
SUMMARY
USEFUL WEBSITES
REFERENCES
Chapter 22
THE OLDER PERSON WITH PSYCHOTIC SYMPTOMS
INTRODUCTION
EPIDEMIOLOGY
CLINICAL FEATURES
PSYCHOTIC DISORDERS
ASSESSMENT
TREATMENT OUTLINE
SUMMARY
REFERENCES
Chapter 23
THE OLDER PERSON WITH ANXIETY
INTRODUCTION
EPIDEMIOLOGY
CLINICAL FEATURES
AETIOLOGY
COMORBIDITY
DIFFERENTIAL DIAGNOSIS
ASSESSMENT
TREATMENT PRINCIPLES
PREVENTION
SUMMARY
REFERENCES
APPENDIX A: GERIATRIC ANXIETY INVENTORY
Chapter 24
THE OLDER PERSON WITH SUBSTANCE ABUSE
INTRODUCTION
THE SPECTRUM OF SUBSTANCE ABUSE
EPIDEMIOLOGY
DIFFERENTIAL DIAGNOSIS
RISK FACTORS
SCREENING TOOLS
ASSESSMENT
MANAGEMENT
TREATMENT
PREVENTION
SUMMARY
USEFUL WEBSITES
REFERENCES
Chapter 25
THE OLDER PERSON WITH PERSONALITY DISORDER
INTRODUCTION
PERSONALITY
EPIDEMIOLOGY
CLINICAL FEATURES
COMORBIDITY
DIFFERENTIAL DIAGNOSIS
ASSESSMENT
TREATMENT PRINCIPLES
SUMMARY
REFERENCES
SECTION 5
Chapter 26
PREVENTION AND PROMOTION
INTRODUCTION
A MODEL OF MENTAL HEALTH INTERVENTION
PREVENTION CONCEPTS
Primary prevention
Secondary prevention
Tertiary prevention
HEALTH PROMOTION
SUMMARY
USEFUL WEBSITES
REFERENCES
Chapter 27
COMMUNITY MANAGEMENT OF ACUTELY ILL OLDER PEOPLE
INTRODUCTION
LEGAL ISSUES
MEDICAL ISSUES
WHAT CONSTITUTES AN EMERGENCY?
INDICATIONS FOR HOSPITAL ADMISSION
ALTERNATIVES TO HOSPITAL ADMISSION
ASSESSMENT OF RISK
MEDICAL WORK-UP IN THE COMMUNITY
ACUTE MANAGEMENT OF PSYCHOSIS
ACUTE MANAGEMENT OF DEPRESSION
ACUTE MANAGEMENT OF DELIRIUM
ACUTE MANAGEMENT OF DEMENTIA
SUMMARY
Chapter 28
MANAGEMENT OF BEHAVIOUR IN DEMENTIA
INTRODUCTION
PREVALENCE
SIGNIFICANCE
SYMPTOM CLUSTERS
DIFFERENTIAL DIAGNOSIS
AETIOLOGY
SCALES TO MEASURE BPSD
INITIAL ASSESSMENT OF BPSD
MANAGEMENT OF BPSD
SERVICE DELIVERY ISSUES
SUMMARY
REFERENCES
Chapter 29
PSYCHOTHERAPEUTIC TREATMENT
INTRODUCTION
SPECIAL ISSUES CONCERNING OLDER PEOPLE
COGNITIVE BEHAVIOUR THERAPY
BEHAVIOUR THERAPY
PSYCHODYNAMIC THERAPY
SUPPORTIVE PSYCHOTHERAPY
PROBLEM-SOLVING THERAPY
LIFE REVIEW AND REMINISCENCE THERAPY
INTERPERSONAL THERAPY
PSYCHOEDUCATION
FAMILY THERAPY
COUNSELLING AND CRISIS INTERVENTION
SUMMARY
REFERENCES
Chapter 30
PHARMACOLOGICAL TREATMENT
INTRODUCTION
CORE CONCEPTS IN PSYCHOPHARMACOLOGY
PHARMACOKINETIC AND PHARMACODYNAMIC CHANGESIN OLDER PEOPLE
POLYPHARMACY
PRINCIPLES OF DRUG TREATMENT
DRUG ADMINISTRATION ISSUES
ANTIDEPRESSANTS
MOOD STABILISERS
ANTIPSYCHOTICS
COGNITION ENHANCERS
SEDATIVES AND HYPNOTICS
MENTAL HEALTH PROBLEMS NOT USUALLY TREATEDWITH MEDICATION
COMPLEMENTARY MEDICINE
SUMMARY
REFERENCES
Chapter 31
ELECTROCONVULSIVE THERAPY AND OTHER PHYSICAL TREATMENTS
INTRODUCTION
ELECTROCONVULSIVE THERAPY
PHYSICAL ACTIVITY
LIGHT
OTHER TREATMENTS
SUMMARY
REFERENCES
SECTION 6
Chapter 32
LEGAL AND ETHICAL ISSUES
INTRODUCTION
INFORMED CONSENT
INVOLUNTARY DETENTION AND TREATMENT
PRIVACY AND CONFIDENTIALITY
BALANCING AND MANAGING RISK
GUARDIANSHIP AND ADMINISTRATION
RESEARCH PARTICIPATION
END-OF-LIFE ISSUES
CAPACITY
SUMMARY
REFERENCES
Chapter 33
DRIVING
INTRODUCTION
OLDER DRIVERS
AGE-RELATED FACTORS
DEMENTIA AND DRIVING
INTERVENTIONS
SUMMARY
REFERENCES
Chapter 34
PALLIATIVE AND END-OF-LIFE CARE
INTRODUCTION
THE ROLE OF THE MENTAL HEALTH WORKER
MENTAL HEALTH ISSUES
THE OLDER PERSON AND FAMILY ASSESSMENT
DEATH AND DYING
SUMMARY
REFERENCES
SECTION 7
Chapter 35
RATING SCALES
INTRODUCTION
GLOBAL ASSESSMENT
COGNITIVE ASSESSMENT
FUNCTIONAL ASSESSMENT
SOCIAL ASSESSMENT
BEHAVIOURAL AND PSYCHOLOGICAL SYMPTOMSOF DEMENTIA
DEPRESSION
SUICIDE
DEMENTIA
ANXIETY
SUBSTANCE ABUSE
CAGE questionnaire
PAIN
QUALITY OF LIFE
CARER WELLBEING AND BURDEN
SUMMARY
REFERENCES
Chapter 36
OUTCOME EVALUATION
INTRODUCTION
LARGE-SCALE OUTCOME MEASUREMENT
SYMPTOM REDUCTION
QUALITY OF LIFE
CONSUMER AND CARER SATISFACTION
SUMMARY
USEFUL WEBSITES
REFERENCES
INDEX

2025-01-04