Caring for Our Elders
Please watch the following YouTube video by user sokie007 — September 22, 2009 — A startling statistic is that elderly Asian women commit suicide at a far greater rate than any other women in their age group. Four small-sample studies have examined the mental well-being of older Asian Americans. One study found that older Asian American women have the highest suicide rate of all women aged 65 and older, and the suicide rate among elderly Chinese American women is 10 times higher than the rate among white elderly women.
For information and resources on Asians and mental health, please visit the web site of the New York Coalition for Asian American Mental Health.
Illnesses That Affect Our Elders
Delirium
Delirium is common in the elderly population and can occur in the context of medical conditions such as illness or malnutrition, or it can appear after medical procedures are performed. It is important for the family to understand that delirium is a temporary and treatable condition, although sometimes it can last for weeks to months, and sometimes it may not resolve completely.
Medicinenet.com provides this definition for delirium: A sudden state of severe confusion and rapid changes in brain function, sometimes associated with hallucinations and hyperactivity, in which the patient is inaccessible to normal contact. Symptoms may include inability to concentrate and disorganized thinking evidenced by rambling, irrelevant, or incoherent speech. There may be a reduced level of consciousness, sensory misperceptions and illusions, disturbances of sleep, drowsiness, disorientation to time, place, or person, and problems with memory. Delirium can be due to a number of conditions that derange brain metabolism, including infection, brain tumor, poisoning, drug toxicity or withdrawal, seizures, head trauma, and metabolic disturbances such as fluid, electrolyte, or acid-base imbalance, hypoxia,hypoglycemia, or hepatic or renal failure. Also called acute confusional state and acute brain syndrome.
Some strategies a family can use to reduce the risk of delirium in a setting outside the home (which can be very disorienting):
Medications can not cure the confusion, however, they may be necessary to manage the agitation. It is best to consult psychiatry or geriatrics if your loved elder becomes agitated in the context of a medical setting.
For more information about delirium, please visit the following web site:
http://www.minddisorders.com/Br-Del/Delirium.html
Delirium is common in the elderly population and can occur in the context of medical conditions such as illness or malnutrition, or it can appear after medical procedures are performed. It is important for the family to understand that delirium is a temporary and treatable condition, although sometimes it can last for weeks to months, and sometimes it may not resolve completely.
Medicinenet.com provides this definition for delirium: A sudden state of severe confusion and rapid changes in brain function, sometimes associated with hallucinations and hyperactivity, in which the patient is inaccessible to normal contact. Symptoms may include inability to concentrate and disorganized thinking evidenced by rambling, irrelevant, or incoherent speech. There may be a reduced level of consciousness, sensory misperceptions and illusions, disturbances of sleep, drowsiness, disorientation to time, place, or person, and problems with memory. Delirium can be due to a number of conditions that derange brain metabolism, including infection, brain tumor, poisoning, drug toxicity or withdrawal, seizures, head trauma, and metabolic disturbances such as fluid, electrolyte, or acid-base imbalance, hypoxia,hypoglycemia, or hepatic or renal failure. Also called acute confusional state and acute brain syndrome.
Some strategies a family can use to reduce the risk of delirium in a setting outside the home (which can be very disorienting):
- Keep the patient company; help him or her to feel safe and comfortable
- Bring him or her things that he or she likes, familiar items such as slippers, robes, pajamas, blankets
- Bring foods or snacks that are familiar (if permitted)
- Bring videos (e.g., Chinese soap operas) or other things that might be enjoyed so he or she doesn't feel bored
Medications can not cure the confusion, however, they may be necessary to manage the agitation. It is best to consult psychiatry or geriatrics if your loved elder becomes agitated in the context of a medical setting.
For more information about delirium, please visit the following web site:
http://www.minddisorders.com/Br-Del/Delirium.html
Dementia
Dementia is the most common cognitive (memory / processing) disorder seen in primary care settings. Dementia typically has a slow and gradual course compared to delirium, which is described above and which tends to be more rapid in onset with fluctuations in the level of conciousness.
In the United States, approximately 4 million individuals have advanced dementia, and1.5 million have mild to moderate dementia. That number is expected to double by 2020 due to the continuing growth of the elderly population. The prevalence of dementia in Asian Americans in primary care settings is about 9%, which is lower compared to the 16% prevalence in whites and African Americans.
A study by Chen et al. found that cultural-specific values, concepts of illness, knowledge of curability of an illness, and views of responsibility all affect presentation and help-seeking behavior related to dementia. They quoted a study by Braun and Browne which found that Asian Americans (Chinese, Japanese, Filipino, and Vietnamese) share the following common beliefs:
As a consequence of these beliefs, many Asian Americans either will never initiate or will delay help-seeking behavior for a demented family member. Asian Americans also tend to under-report memory problems. Due to the stigma associated with mental problems and dementia, Asian patients rarely initiate conversations with their doctors about their mental symptoms or forgetfulness. Chen et al. summarized:
Source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1071748/
Dementia is the most common cognitive (memory / processing) disorder seen in primary care settings. Dementia typically has a slow and gradual course compared to delirium, which is described above and which tends to be more rapid in onset with fluctuations in the level of conciousness.
In the United States, approximately 4 million individuals have advanced dementia, and1.5 million have mild to moderate dementia. That number is expected to double by 2020 due to the continuing growth of the elderly population. The prevalence of dementia in Asian Americans in primary care settings is about 9%, which is lower compared to the 16% prevalence in whites and African Americans.
A study by Chen et al. found that cultural-specific values, concepts of illness, knowledge of curability of an illness, and views of responsibility all affect presentation and help-seeking behavior related to dementia. They quoted a study by Braun and Browne which found that Asian Americans (Chinese, Japanese, Filipino, and Vietnamese) share the following common beliefs:
- Dementia is a natural consequence of aging, rather than a medical illness.
- Dementia is an illness with no known cure.
- Children are obligated to take care of the older generation.
- Problems suffered by a family member should be solved within the family.
- To talk about senile (memory) problems of a family member is shameful or embarassing.
As a consequence of these beliefs, many Asian Americans either will never initiate or will delay help-seeking behavior for a demented family member. Asian Americans also tend to under-report memory problems. Due to the stigma associated with mental problems and dementia, Asian patients rarely initiate conversations with their doctors about their mental symptoms or forgetfulness. Chen et al. summarized:
- The diagnosis of various dementias may be difficult in Asian patients because of the reluctance of family members and patients to report symptoms.
- Dementia of the Alzheimer's type is particularly difficult to diagnose because recognition of progressive cognitive deficits is required.
- Major depression, a treatable disorder, is a common cause of reversible or pseudo-dementia.
- It is important to use a culturally appropriate screening tool when screening Asian patients for dementia.
- Referring patients with Alzheimer's disease to a specialty center can help to reduce the huge psychological stress and financial burden on the patient and family members.
Source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1071748/
Other Symptoms of Mental Illness
Elders and grandparents can experience other symptoms of mental disorder. Please refer to the Understand section of this web site for additional information on depression, anxiety, bipolar disorder, and psychosis.