The 4M's Framework: MENTATION with Tahira I. Lodhi MD

The 4M's Framework: MENTATION with Tahira I. Lodhi MD

“She’s just not right today”. When referring to an older adult, this simple phrase should be a signal to family and formal caregivers alike to begin to find out why.

If a child “wasn’t right” one day, no one would ignore it - and we cannot ignore it in an older adult.
An altered mental state is a broad term for geriatric patients having issues with their cognitive level. Essentially, for older adults with altered mental states, early detection and diagnosis are essential, as the source could be life-threatening.
In line with that, today's episode of This Is Getting Old, will focus on continuing our special series on the Health Systems Initiative and the 4Ms Framework, explicitly talking about MENTATION.
Dr. Tahira I. Lodhi joins us, and we'll talk more about providing health care services to older adults with the limelight on the spheres of Mentation.
Also check out these related podcasts:
Ten Warning Signs of Dementia
Six Tips for Talking to Someone You Think Has a Memory Problem
How Dementia is Diagnosed
Ten Tips for Preventing Alzheimer’s Disease
How to Manage Repetitive Behaviors in Alzheimer’s Disease

Part One of 'The 4M's Framework: MENTATION'.

THE SPHERES OF MENTATION

Mentation is about preventing, identifying, treating, and appropriately managing what is referred to as the 3D's in geriatrics; dementia, delirium, and depression.
The 3D's are a cornerstone of geriatrics, and it can be challenging to tease these three apart when providing care to an older adult.
There are several characteristics in common with depression, dementia, and delirium. Apathy, detachment, and tearfulness can be present in both depression and delirium, especially hypoactive delirium. However, a reliable indicator lies with the onset and duration.
The onset of dementia is slow and insidious. However, deterioration is progressive over time. Delirium develops unexpectedly (for hours or days), and manifestations appear to fluctuate during the day. While a change in mood persisting for at least two weeks characterizes the onset of depression. The duration may coincide with life changes and can last for months or years.
DELVING DEEPER INTO MENTATION

DEPRESSION

It is necessary to remember that depression is not an unavoidable aspect of becoming older, nor is it an indication of failure or character defects. Regardless of your history or past successes in life, it can happen to everyone, at any age. While life changes when you age, retirement, loved ones' demise, deteriorating health may also induce depression.

TOOLS FOR ASSESSING DEPRESSION

For health care providers, it's essential to recognize depression. You can use several instruments, like PHQ-2, PHQ-9, and other Geriatric Depression Scales, to assess depression in older adults.
PHQ-2 (Patient Health Questionnaire-2) uses a valid and reliable depression screening tool for all ages. In comparison, a PHQ-9 is a screening test that can also be used to follow-up on a promising PHQ-2 outcome and to track response to therapy.

SIGNS AND SYMPTOMS OF DEPRESSION IN OLDER ADULTS

Recognizing depression starts with getting familiar with the signs and symptoms. Red flags for depression include:

Sadness or feelings of hopelessness.
Unexplained aches and aggravated pains
Lack of interest in hobbies or socializing.
Loss of weight or appetite.
Feelings of desperation or helplessness.
Lack of encouragement and energy.
Sleep disruptions
Slowed movement or discourse.
Fixation on death; suicidal thoughts.
Problems with memory.
Neglecting personal treatment

READ THE FULL ARTICLE TO LEARN WHAT TO DO: PREVENTIVE MEASURES AS FAMILY MEMBERS OR CAREGIVERS.

[brianreyes]

To fight depression what medical pill would you recommend beside Zoloft?

[ddutton]

At what MoCA score is it generally appropriate to take away one's car keys? I am assuming that there is not recent history of at fault accidents, citations, getting lost, etc. Great Vlogs.