Old Age Disorder

NEUROCOGNITIVE DISORDERS

ALZHEIMER’S DISEASE

Dementia-refers to a disease process marked by progressive cognitive impairment in clear consciousness. Alzheimer’s Disease is one of the most common forms of Dementia. It usually begins with mild memory problems, lapses of attention, and difficulties in language and communication. As symptoms worsen, the person has trouble completing complicated tasks or remembering important appointments. Eventually sufferers also have difficulty with simple tasks, forget distant memories, and have changes in personality that often become very noticeable. For example, a gentle man may become uncharacteristically aggressive. People with Alzheimer’s disease may at first deny that they have a problem, but they soon become anxious or depressed about their state of mind; many also become agitated.  As the neurocognitive symptoms intensify, people with Alzheimer’s disease show less and less awareness of their limitations. They may withdraw from others during the later stages of the disorder, become more confused about time and place, wander, and show very poor judgment. Eventually they become fully dependent on other people. They may lose almost all knowledge of the past and fail to recognize the faces of even close relatives. They also become increasingly uncomfortable at night and take frequent naps during the day. During the late phases of the disorder, they require constant care.

Worried that your loved one / you may suffer from Alzheimer’s Disease?

1. Does your loved one / you forget important dates or events or ask for the same information over and over,
2. Does your loved one / you tend to increasingly rely on aides or family members for things they used to handle on their own?
3. Does your loved one / you face difficulty in developing and following a plan or work with numbers?
4. Does your loved one / you face difficulty in completing familiar tasks at home, at work or at leisure?
5. Does your loved one / you lose track of dates, seasons and the passage of time?
6. Does your loved one / you have trouble following or joining a conversation?
7. Does your loved one / you tend to misplace things easily?
8. Does your loved one / you tend to get easily upset at home, at work, with friends or in places where they are out of their comfort zone?

Services that can help you or your loved one:

• Neuropsychological Assessment
• Counselling
• Cognitive Behavioural Therapy (CBT)
• Family Therapy
• Supportive Therapy
• Medication (if needed)

Delirium- is a major disturbance in attention and orientation to the environment. As the person’s focus becomes less clear, he or she has great difficulty concentrating and thinking in an organized way, leading to misinterpretations, illusions, and on occasion, hallucinations. Sufferers may believe that it is morning in the middle of the night or that they are home when actually they are in a hospital room. Generally, delirium has a sudden onset (hours or days), a brief and fluctuating course, and rapid improvement. Delirium may occur in any age group, including children, but is most common in elderly people. Fever, certain diseases and infections, poor nutrition, head injuries, strokes, and stress (including the trauma of surgery) may all cause delirium. Delirium often involves perceptual disturbances, abnormal psychomotor activity, and sleep cycle impairment.

Worried that your loved one may suffer from Delirium?

1. Does your loved one have difficulty focusing attention, for example being easily distractible, or having difficulty keeping track of what was being said?
2. Is his/her thinking disorganized or incoherent, such as rambling or irrelevant conversation, unclear or illogical flow of ideas, or unpredictable switching from subject to subject?
3. Is he/she able to adequately respond to stimulation?
4. Does he/she tend to get disoriented, such as misjudging the time of day or place where he is in or fail to recognise people around him?
5. Has he demonstrated any memory problems, such as inability to remember events or difficulty remembering instructions?
6. Did he/she show evidence of disturbance of the sleep‐wake cycle, such as excessive daytime sleepiness with insomnia at night?

If you have said yes to most of the above, we might be able to help you.

Services that can help you or your loved one:

• Neuropsychological Assessment
• Counselling
• Cognitive Behavioural Therapy (CBT)
• Family Therapy
• Supportive Therapy
• Medication (if needed)

STROKE-A stroke occurs when blood supply to the brain is reduced or interrupted, decreasing or stopping oxygen supply, causing brain cells to die. Symptomatic and silent are the two types of strokes. While symptomatic strokes, as the name suggests have identifiable symptoms, silent strokes are subtle, and neither the onset nor the side-effects are easily identifiable. In fact, most who have suffered a silent stroke will not even be aware that they have had a stroke till they have a brain scan as side-affects may be attributed to ageing.

Life after a stroke requires regular check-ups, neuromuscular rehabilitation, and mental health care. Also, in addition to movement, memory and speech being affected, those who have had a stroke are at risk of having another one. Risk factors for stroke include age, diabetes, high blood pressure, heart disease, smoking, obesity, family history of strokes, and brain aneurysms.

If you suspect that you or your loved one are having or have had a stroke, get professional medical help immediately as every minute counts.

Worried that your loved or you might have had a Stroke?

1. Have your loved one / you experienced sudden weakness/numbness or drooping on one side of the face?
2. Have your loved one / you experienced sudden numbness on an entire side of one’s body?
3. Have your loved one / you experienced sudden dizziness or coordination issues when walking?
4. Have your loved one / you experienced sudden confusion in comprehension?
5. Have your loved one / you experienced sudden difficulty in speech, slurred speech?
6. Have your loved one / you experienced sudden trouble in walking, dizziness or loss of balance/coordination?
7. Have your loved one / you experienced sudden severe headaches unlike any experienced before?

Services that can help you or your loved one:

• Neuropsychological Assessment
• Counselling
• Family Therapy
• Medication (if needed)
• Supportive Therapy

Parkinson’s Disease-is a chronic, progressive neurodegenerative disorder of the brain that causes a gradual loss of muscle control. Age is the largest risk factor, with most people who develop Parkinson’s being 60 or older, and symptoms may take as long as 20 years to become full blown. While a small number of individuals are at risk because of a family history of the disorder, head trauma, exposure o environmental toxins, or illness could be risk factors.

Primary symptoms include slowness of movement, difficulty maintaining balance, muscle rigidity, and tremors. While there is no cure for Parkinson’s there are a number of treatment options available to make everyday life as easy as possible. Using a bath chair in the shower, well-lit stairwells, night lights for rooms and hallways, keeping walking areas clutter-free, avoiding rugs and/or carpets, and wearing low-heeled, comfortable shoes are some safety tips to keep in mind.

Worried that your loved or you might have Parkinson’s Disease?

1. Does your loved one / you experience tremors or involuntary shaking of hands, arms, legs, jaw, and/or face?
2. Does your loved one / you experience shuffling gait with short steps and trouble moving/walking?
3. Does your loved one / you experience impaired balance and coordination?
4. Does your loved one / you experience stiffness of the limbs and trunk?
5. Does your loved one / you experience dizziness or frequent fainting?
6. Does your loved one / you experience stooping or hunching over?
7. Does your loved one / you experience slowness of movement?
8. Does your loved one / you experience reduced arm swinging?

Services that can help your loved one or you:

• Neuropsychological Assessment
• Counselling
• Cognitive Behavioural Therapy (CBT)
• Group Therapy
• Family Therapy
• Supportive Therapy
• Medication (if needed)

EMOTIONAL ISSUES

GRIEF– Older adults experience loss at an accelerated rate due to changes in physical ability, health, living situation, and the deaths of close friends and loved ones. These losses are unbelievably hard to cope with, especially when more than one is experienced at a time. Losing one’s spouse, relative, or friend can be difficult to process. The people who we are close to play a major part in our lives and leave a vacuum when they leave. The period of bereavement is a stressful life event for anyone. Each person will experience bereavement in different ways and reactions to bereavement are strongly influenced by culture and ethnicity. Mourning a death for a days, weeks, or a few months is quite natural, but when it continues beyond this period and begins to interfere with one’s day to day functioning, one might need some extra support and professional help to come out of it. Elderly individuals losing their spouse or children are especially vulnerable and need various degrees of help and support.

Counselling lends a helping hand to the individual during the grieving process to help them walk through the five stages of grief – Denial, Anger, Bargaining, Depression, Acceptance. The stages are not necessarily linear and one may revisit a stage or two or be unable to move beyond a particular stage. Seeking professional help can help give him/her a space to process his/her grief.

Worried that your loved one or you are having trouble dealing with bereavement?

1. Do you repeatedly hear or see the loved one who has passed away?
2. Have you had thoughts like you would be better off dead, or of hurting yourself in some way?
3. Are you unable or unwilling to be emotional or feeling numb?
4. Are you having trouble falling or staying asleep, or are sleeping too much?
5. Are you experiencing reduced appetite, overeating, or considerable weight changes?
6. Have you been avoiding meeting friends and family for an extended period of time?

If you have said yes to most of the above, we might be able to help you.

Services that can help you or your loved one:

• Psychometric Assessment
• Counselling
• Cognitive Behavioural Therapy (CBT)
• Crisis Intervention
• Interpersonal Therapy
• Family Therapy
• Medication (if needed)

GERIATRIC DEPRESSION

Depression is one of the most common mental health problems of older adults. The features of depression are the same for elderly people as for younger people, including feelings of profound sadness and emptiness; low self-esteem, guilt, and pessimism; and loss of appetite and sleep disturbances. Depression is particularly common among those who have recently undergone a trauma, such as the loss of a spouse or close friend or the development of a serious physical illness.

Often, depression makes its presence felt gradually, making it difficult to realise that something is not right. This leads to people trying to cope by themselves instead of reaching out for help. If left untreated, depression raises an elderly person’s chances of developing significant medical problems. If symptoms are present for beyond 21 days, and disturb your family, social, and professional life, it’s time to seek help.

Worried that your loved one or you might have Depression?

1. Do you experience little interest or pleasure in doing things that you liked doing earlier?
2. Are you feeling down, depressed, or hopeless?
3. Are you having trouble falling or staying asleep, or are sleeping too much?
4. Are you feeling tired or as having little energy?
5. Are you experiencing reduced appetite, overeating, or considerable weight changes?
6. Do you tend to feel bad about yourself – that you are a failure or experience feelings of guilt?
7. Are you having difficulty concentrating on things or making decisions?
8. Have you had thoughts like you would be better off dead, or of hurting yourself in some way?

If you have said yes to most of the above, we might be able to help you.

Services that can help you or your loved one:

• Psychometric Assessment
• Counselling
• Cognitive Behavioural Therapy (CBT)
• Interpersonal Therapy
• Family Therapy
• Medication (if needed)

SCHIZOPHRENIA SPECTRUM DISORDERS

Delusional disorder-is characterized by firmly held false beliefs (delusions) that persist for at least 1 month, without other symptoms of psychosis. The belief can be regarding any usual aspect of the person’s life but is not believed by anyone else except him since it is not true. Delusions in the elderly can take many forms; the most common ones are persecutory-patients believe that they are being spied on, followed poisoned, or harassed in some way. Persons with delusional disorder may become violent toward their supposed persecutors. Some persons lock themselves in their rooms and live reclusive lives. Somatic delusions, in which persons believe they have a fatal illness, also ca occur in older persons. Among those who are vulnerable, delusional disorder can occur under physical or psychological stress and can be precipitated by the death of a spouse, loss of a job, retirement, social isolation, adverse financial circumstances, debilitating medical illness or surgery, visual impairment, an deafness.

Delusional disorder is distinguished from schizophrenia by the presence of delusions without any other symptoms of psychosis (eg, hallucinations, disorganized speech or behavior, negative symptoms). Delusional disorder may arise from a preexisting paranoid personality disorder. In such people, a pervasive distrust and suspiciousness of others and their motives begin in early adulthood and extend throughout life.

Early symptoms may include the feeling of being exploited, preoccupation with the loyalty or trustworthiness of friends, a tendency to read threatening meanings into benign remarks or events, persistent bearing of grudges, and a readiness to respond to perceived slights.

Worried that you / your loved one may be suffering from Delusional Disorder?

Since the past 1 month or more,

1. Do you tend to get angry or frustrated very easily?
2. Do you feel that your thoughts tend to get fixed in your mind and you can’t get your mind off them?
3. Do you feel that your thoughts have a definite impact on others as though you can control things or ‘do things’ with your thoughts?
4. Do you feel that your thoughts, feelings and actions are being controlled by someone else?
5. Do you believe that other people can read your mind, or you can read others’ minds?
6. Do you find it difficult to relate to other people and trust them?

If you have said yes to most of the above, we might be able to help you.

Services we can help you with:

Medication

Counselling

Psychometric Assessment

Cognitive Behaviour Therapy

Rational Emotive Behaviour Therapy

Family Therapy

Schizophrenia– is a chronic and severe mental disorder that affects how a person thinks, feels, and behaves. People with schizophrenia may seem like they have lost touch with reality. Commonly, people suffering from this problem, have several other symptoms that are considered to be odd and out of touch with the real world. Thus they might be unable to carry on with their daily life, work, and relationships smoothly. They might even neglect their hygiene and withdraw themselves from the others. Symptoms of schizophrenia usually start between ages 16 and 30. The symptoms of schizophrenia fall into three categories: positive, negative, and cognitive.

Positive symptoms: “Positive” symptoms are psychotic behaviors not generally seen in healthy people. People with positive symptoms may “lose touch” with some aspects of reality. Symptoms include:

• Hallucinations
• Delusions
• Thought disorders (unusual or dysfunctional ways of thinking)
• Movement disorders (agitated body movements)

Negative symptoms: “Negative” symptoms are associated with disruptions to normal emotions and behaviors. Symptoms include:

• “Flat affect” (reduced expression of emotions via facial expression or voice tone)
• Reduced feelings of pleasure in everyday life
• Difficulty beginning and sustaining activities
• Reduced speaking

Cognitive symptoms: For some patients, the cognitive symptoms of schizophrenia are subtle, but for others, they are more severe and patients may notice changes in their memory or other aspects of thinking. Symptoms include:

• Poor “executive functioning” (the ability to understand information and use it to make decisions)
• Trouble focusing or paying attention
• Problems with “working memory” (the ability to use information immediately after learning it)

Worried that you / your loved one may be suffering from Schizophrenia?

Since the past 1 month or more,

1. Do you feel that your thoughts often become jumbled, jump around or become blocked?
2. Do you feel that your thoughts tend to get fixed in your mind and you can’t get your mind off them?
3. Do you feel that your thoughts have a definite impact on others as though you can control things or ‘do things’ with your thoughts?
4. Do you feel that your thoughts, feelings and actions are being controlled by someone else?
5. Do you hear voices / see / smell / feel / taste things that other people don’t?
6. Do you believe that other people can read your mind, or you can read others’ minds?
7. Do you find it difficult to relate to other people and trust them?
8. Do you find it difficult to make decisions and get yourself moving to do anything?
9. Do you have difficulties controlling impulses (like shouting in public or suddenly becoming angry) or difficulties engaging in regular daily activities (like bathing or dressing)?
10. Do you experience severe difficulty in expressing your emotions?

If you have said yes to most of the above, we might be able to help you.

Services we can help you with:

• Medication
• Counselling
• Psychometric Assessment
• Cognitive Behaviour Therapy
• Rational Emotive Behaviour Therapy
• Family Therapy

Somatoform Disorders- are a group of conditions that involve physical symptoms and complaints suggesting the presence of a medical condition but without any evidence of physical pathology to account for them. In other words, they involved medically unexplained physical symptoms. They are also not intentionally faking symptoms or attempting to deceive others. For the most part, they genuinely and sometimes passionately believe something is terribly wrong with their bodies and so they frequently show up in the practices of primary-care physicians, who then have the difficult task of managing their complaints, which have no known medical basis.

Patients with somatic symptom and related disorders have usually been evaluated (perhaps many times) for physical illness. These evaluations often lead to testing and treatments that are expensive, time-consuming, ineffective, and sometimes dangerous. The result of such treatment may be only to reinforce the patients’ fearful belief in some non-existent medical illness.

Worried if you / your loved one have/has a Somatoform Disorder?

1. Do you experience pain that is excessive or chronic?
2. Do you experience changes in sensory or voluntary motor functioning, with no physical or physiological malfunctioning as its cause?
3. Do you have chronic, multiple symptoms that seem to lack an adequate explanation?
4. Do you have complaints that don’t improve, despite medical treatment that helps most patients?
5. Are you excessively concerned with your health or bodily appearance?

If you have said yes to most of the above, we might be able to help you.

Services we provide that can help you:

• Psychoeducation
• Psychometric Assessment
• Pharmacotherapy (medication), if required
• Cognitive Behaviour Therapy
• Relaxation Techniques
• Family Therapy
• Interpersonal Therapy

Obsessive-Compulsive Disorder (OCD)- a disorder characterized by recurrent intrusive or uncontrollable thoughts, causing stress (obsessions) that prompt the performance of rituals in a repetitive manner (compulsions). A person with OCD can have either obsessive thoughts and urges or compulsive, repetitive behaviours, or even both. Typical obsessions involve themes of contamination, dirt, or illness (fearing that one will contract or transmit a disease) and doubts about the performance of certain actions (e.g., a preoccupation that one has neglected to turn off a home appliance). Common compulsive behaviours include repetitive cleaning or washing, checking, ordering, repeating, and hoarding. Compulsions tend to relieve the anxiety, but only for a little while.

While such individuals realise that their seemingly uncontrollable behaviour is irrational, they are unable to stop. Their daily life is affected as simple tasks or chores take the form of insurmountable problems. Relationships with family and friends can often become strained or problematic.

Worried that you / your loved one might have OCD?

1. Do you ever experience repetitive thoughts that cause you anxiety?
2. Do you ever fear germs or engage in excessive cleaning?
3. Are you constantly worried that something bad will happen because you forgot something important, like locking the door or turning off appliances?
4. Are there things you feel you must do excessively or thoughts you must think repeatedly to feel comfortable or ease anxiety?
5. Do you experience the need to constantly check on something or arrange things?
6. Do you wash yourself or things around you excessively?
7. Do you keep many useless things because you feel that you can’t throw them away?
8. Do you struggle to control these thoughts or behaviours?
9. Do you spend at least one hour a day thinking obsessive thoughts or performing these ritual behaviours?

Services, we provide that can help you:

• Behaviour Therapy
• Relaxation Training
• Supportive Therapy
• Medication
• Cognitive Behaviour Therapy