181 Mental Health Concerns and The Older Adult
exam, mental status examination, cog- nitive functioning evaluation, and brain imaging. LBD is neither preventable nor curable, and treatments focus on the patient’s safety and quality of life (NIA, 2022e). Interventions can include many disciplines, especially case management. The mental healthcare worker can also offer community resources and nonprofit organizations as care options, dependent on their accessibility to the older adult. Frontotemporal dementia (FTD), also known as Pick’s disease, is named after a physician who described it and the “Pick bodies” seen in the brain postmortem (Sadock et al., 2015). FTD is a rare, pro- gressive disease with an unknown etiolo- gy. It carries a life expectancy of 2 to 10 years after diagnosis and often requires full-time care (NIA, 2022d). It can present with notable personality and behavioral changes. Frontal lobe involvement can cause changes to behavior and move- ment; temporal lobe changes feature language and emotional changes (NIA, 2022d). FTD can have distinguishable symptoms. It can present with Klüver-Bu- cy syndrome: hypersexuality, placidity or complacency, and hyperorality or oral compulsions (Sadock et al., 2015). There is no cure and no way to prevent disease progression. Treatment focuses on symp- tom control (sometimes using antidepres- sants or antipsychotics) and quality of life. This disease can be distressing for fam- ily members and caregivers. The mental healthcare provider can refer all involved to resources and support groups. The most common form of dementia is Alzheimer’s disease. The mental health- care worker will treat older adults with it or will see a family member affected by it. The NIA (2022b) states that over six million Americans, most 65 years and
older, are diagnosed with Alzheimer’s disease. It often presents as dementia. The causes of Alzheimer’s disease remain unclear, but what has been discovered is brain atrophy and inflammation, genetic predispositions on chromosome 17, and environmental exposures such as alumi- num toxicity (Sadock et al., 2015). Old- er adults or caregivers usually note the first symptoms as forgetfulness. The NIA (2022b) notes symptoms of Alzheimer’s disease as difficulty finding words, strug - gles with vision and spatial perception, reduced reasoning and poor judgement, length of time it takes to complete ADLs, repetition of stories or questions, danger due to wandering and getting lost, losing common items, and change in mood and personality (usually more irritable). There are three stages of Alzheimer’s defined by the NIA (2022b): ● Early-stage Alzheimer’s : When a person begins to experience memory loss and other cognitive difficulties, though the symptoms appear gradual to the person and their family. Alzheimer’s disease is often diagnosed at this stage. ● Middle-stage Alzheimer’s : Damage occurs in areas of the brain that control language, reasoning, sensory processing, and conscious thought. People at this stage may have more confusion and trouble recognizing family and friends. ● Late-stage Alzheimer’s : A person cannot communicate, is completely dependent on others for care, and may be in bed most or all the time as the body shuts down. Cognitive testing can be performed, as can brain scans. The mental healthcare worker can refer to neurology if needed. There is no cure, but the U.S. Food and
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