In our day to day life we often focus on the health of our loved one who is living with dementia. We review aspects of their lives including the amount of physical exercise, whether they are taking their medications, eating well and living safely. But what about their mental health? Is someone monitoring this aspect? Maybe their GP, geriatrician or maybe this aspect falls to you to review.
It is important to regularly review their mental health as it can lead to improvement in quality of life and have beneficial outcomes on their health including their cognition.
Mental health is looking at your loved ones’ psychological well-being, in particular their emotional and behavioural adjustments to what life throws at them each day. It is the aspect of our health that helps us adapt and manage our activities of daily living despite the changes that occur that are outside of our control.
Mental health encompasses their mood whether that is their anxiety, depression, apathy, happiness, agitation, irritability, frustrations, contentment and sadness. These can fluctuate during the day but also over the week or month. It is important to look at the overall mood but also the ability to adapt in the moment.
Making sure we all have good mental health can improve our quality of life. For people who have dementia their cognition is already affected due to their neurodegenerative condition. If their mental health is also impaired this will further influence their cognition. It can also lead to behaviours which can be contributed to their dementia but really are due to their mood. When your mood is affected it can lead to an increase in irritability, lower your threshold for managing changes, increase agitation and anger and can lead to impulsivity. When your mood is low it can lead to depressive symptoms such as apathy- an inability to initiate activities, sadness, a decrease in appetite and problems with good sleeping patterns. Even without dementia – these mood aspects can influence anyone’s cognition. If we can improve their mental health we can potentially improve their cognition.
When our mental health is sub-optimal it can affect other physical aspects of our bodies. In particular, it can lead to an increase in blood pressure, increase in heart rate and decrease in our immune system and thus the ability to fight infections and stabilise chronic illnesses. It can lead to a decrease in physical activity which then increases the risk of stroke and heart disease. A decrease in physical activity can lead to a decrease in balance and muscle strength leading to an increase in falls.
A regular mental health review is thus an essential part of anyone’s life. When someone is living with dementia they may not be able to monitor this aspect by themselves but need help or an advocate. We need to make sure someone is monitoring each of us. If you are concerned that your loved ones’ mental health is not optimal please raise this with their GP, geriatrician, psychiatrist or psychologist. There are medications available to help with mental health. Often people only need to take these medications for a short period of time to optimise their mood. As people age, their neurotransmitters in their brain can decrease and medication does help to top up these neurotransmitters. This can lead to an increase in quality of life. Often these medications are used for a trial of 3 months with regular reviews to determine if they are giving benefit.