Meeting the needs of an ageing population with interdisciplinary care

28 November 2019  Features

Mental Health Professionals’ Network (MHPN) is progressively growing professional development support for practitioners working with older persons through our interdisciplinary practitioner networks and online program. 

Interdisciplinary practitioners currently run older persons networks in Sydney, Brisbane, Cairns, Sunshine Coast and Goulburn Valley/Hume.

In December, the Goulburn Valley/Hume Older Persons Mental Health Network (formerly the Shepparton Older Persons Mental Health Network) is launching with its first meeting on Wednesday 4 December.

MHPN has produced several webinars covering various aspects of older persons’ mental health which are located in the webinar library on our website.

Positive audience feedback indicates that there is an ongoing interest to roll out more webinars about older persons and mental health.

Over the next 40 years, health practitioners may expect a significant increase in the proportion of patients aged over 65. In 2017, 15 per cent of Australians (3.8 million) were aged 65 and over, according to research from Australian Institute of Health and Welfare[i].

We spoke to diverse mental health practitioners about addressing the needs of older persons:
DR ROD MCKAY (PSYCHIATRIST AND WEBINAR PANELLIST), MS ROCHELLE UMANKSY (PSYCHOLOGIST), MS FIONA HOPE (NETWORK COORDINATOR AND TEAM LEADER OF THE PRINCE CHARLES HOSPITAL (TPCH) OLDER PERSONS MENTAL HEALTH TEAM), AND MR CRAIG PARSONS (NORTHERN SYDNEY PRIMARY HEALTH NETWORK AND NETWORK COORDINATOR).

Older persons have a specific set of characteristics relevant to their life stage in terms of   relationships; finances; living situation; and physical and mental health.

Melbourne psychologist Ms Rochelle Umansky gave a presentation titled ‘A Psycho-educational Approach to Thinking about Retirement’ at the August Caulfield Mental Health Network meeting. 

Ms Umansky emphasises that retirement is a normative life stage, that shouldn’t be pathologised but acknowledges it can be a time of uncertainty and stress.

Nowadays, in the course of their potentially multi-decade retirement, older persons are seeking opportunities to continue to engage with and contribute to their communities and the Australian economy, she says.

At the same time, she says, ‘it’s important to recognise that if your client’s struggle with adjustment to retirement occurs concurrently with other significant life events such as work redundancy, health issues or a death in the family, these factors may compound and contribute to the experience of anxiety and depression’.

HETI Higher Education Director of Psychiatry and Mental Health Programs, Dr Rod McKay, believes that all health practitioners need to begin with a mindset of hope and a focus on recovery.  

‘One of the assumptions is that older people are harder to treat. Or they’re not psychologically-minded so less likely to want psychological services.

‘They do respond well to medication and older people do want access to talking therapy but access is very poor in Australia and we don’t know why that is’.

In communicating with older persons, Dr McKay says avoid ‘speaking louder or slower but find out how they need to speak’.

‘Also avoid speaking to the older person like a child which is a real risk’.

He recommends being ‘ready with appropriate resources for older persons that you can print off from a source on the internet’.

Dr McKay says it’s important to ‘recognise the strengths of the older person; that they have resources; and the potential to have resources around them’.

‘Mental illness is one more thing they may need support for but it isn’t the fundamental challenge to sense of identity that it is for younger people’, according to Dr McKay.

‘In “continuing-to-be-me”, they are more likely to need the support of a family member to continue-to-be-me in dementia which doesn’t mean it takes away the element of recovery but they need the appropriate support’.

Dr Rod McKay appeared on the panel for the MHPN webinar ‘Grief, Loss, Mental Health and Older Persons: An Interdisciplinary response’ during the ‘Working Better Together’ online conference.

Working together for older persons
Ms Fiona Hope is a coordinator of the Brisbane North Older Persons Mental Health Network.

She explains that ‘later in life can often be the first time that older people may experience mental health issues’.

Challenges for older persons in the health system may include ‘ageism, and the stigma of mental health as well as discrimination for older mental health consumers from being accepted by aged care service providers and receiving the services and supports that this vulnerable consumer group require’, says Ms Hope.

The Brisbane North Older Persons Mental Health network aims to address these issues. For instance, the network’s October meeting brought together interdisciplinary aged care practitioners for a ‘Mental Health 101’.

The Older Persons Mental Health team is regularly asked to provide education sessions which would stretch the team’s resources to visit individual organisations given the multiple services in Brisbane North.

‘Because of this we thought of trying a more general education session where people come to a central venue, rather than the team spending large amounts of time doing the same sessions at multiple places’.

The network coordinators aimed to attract a wide range of aged care services from residential aged care, to in-home support services, GPs and other non-government agencies.

‘We also chose the education session to gauge what interest there would be in providing basic mental health education to aged care staff and if this may increase knowledge and understanding within Brisbane North aged care services’, says Ms Hope.

Feedback from attendees indicated that many learnt a lot of useful information from the education session and that they would like other opportunities for further education around mental health.

‘We will look at doing it again next year’, says Ms Hope.

‘Some of the feedback provided was that the presentations didn’t just focus on pharmacological interventions, but also included other useful strategies, and some interesting case studies which included some of interventions used by the older persons mental health team’.

Join this network to receive details about future meetings. Or find a network in your area.

In NSW, Mr Craig Parsons, who is co-coordinator of the Sydney North Older Persons Mental Health Network, and Mental Health Drug & Alcohol Commissioning Manager at the Northern Sydney PHN, believes interdisciplinary collaboration can ‘get to heart of the issue and how to address it’.

He says ‘it does help to clarify diagnostic issues, such as whether an older person is experiencing dementia or a mental health issue. Physical health is also often a factor’.

‘If there is a psychiatrist, psychologist, a GP and/or geriatrician working in collaboration, it makes sure people are being followed up around their mental health, physical health and any issues relating to cognitive decline’.

Sydney North Older Persons Mental Health Network met in October for a presentation -‘Did I miss something? Medical issues in older people with a mental health diagnosis’ - delivered by Dr Helen Gillespie, Head of Aged Care Northern Beaches Hospital, Healthscope.

Dr Gillespie’s presentation, and the follow-up discussion, covered a lot of ground on the ageing population; and the impact a growing ageing population will have on services.

The network meeting participants also talked about the interaction between frailty and mental health issues; and common medication interactions and contra-indications.

Attendees spanned GPs, psychologists, a psycho-geriatrician; and other allied health professionals and health workers.

‘This helps build awareness that there are other people working in the sector that have things to offer. That can help to foster interdisciplinary collaboration and support transfer of care where appropriate. That has been one of the big benefits of the network – building awareness’, says Mr Parsons.

Mr Parsons says having a broad range of practitioners at meetings ‘helps to bring different perspectives, not only of individual client issues, but also at a systemic level. Someone might say it’s difficult to get a GP to do this or that. If there is a GP in the room, they can explain it might be due to funding and payment and structures, or time pressure, and provide a solution’.

Dr McKay is also observing the impact of collaborative learning firsthand.

‘I’ve got the pleasure at the moment of working with a cohort of students - peer worker, psychologist, psychiatry and nurse - all discussing material and providing different perspectives. You can see the impact of them seeing what each of them as to offer’.

This is ‘the sort of experience that we need to make the norm’, he says.

‘That’s not to say education isn’t important within our own disciplines but we have to do that in a way that complements each other, not competes with each other’.

Watch the August meeting of the Sydney North Older Persons Network August meeting: ‘Management of Responsive Behaviours (BSPDs)’. The video is the eighth on the page. 

Join this network to receive details about future meetings. Or find a network in your area.

Sign up to MHPN enews or visit our network meetings page for the latest meeting details.

*Please note: The views, thoughts, and opinions expressed in this article are not necessarily those of the author or of the Mental Health Professionals’ Network (MHPN).

* If you or someone you know is in distress, please contact:

Get involved

MHPN can support you to start and run a mental health network in your local community.

MHPN networks help you:

•           benefit from the experience and knowledge of other practitioners

•           connect to practitioners in your local area

•           improve referral pathways

•           improve patient outcomes

Learn about thriving mental health practitioner networks near you.

Do you want to join a practitioner network that focuses on older persons?

Register now via the links below:

Explore these resources:

Online

MHPN webinar library:

Print

  • Dr Rod McKay has co-written several journal articles on older persons’
    mental health which are listed on the Higher Education HETI website.

  • Daring Greatly (2013) by Brené Brown

  • The Reality Slap (2011) by Russ Harris

  • The End of the Retirement Age (2017) by David Kennedy

  • Enjoying Retirement (2018) by Michael Longhurst

  • Any Ordinary Day (2018) by Leigh Sales

 

 


 

[i] https://www.aihw.gov.au/reports/older-people/older-australia-at-a-glance/contents/demographics-of-older-australians/australia-s-changing-age-and-gender-profile