Aging Summit: Knowledge for Care - Q&A Review Part 1

Two weeks ago, ImpactCE held our very first Aging Summit: Knowledge for Care, a three-day event with a wide variety of speakers, topics, and sessions. From diet changes as we age to social media to supporting caregivers, attendees gained a wide selection of insights from a team of trusted presenters, both new and familiar. 

If you missed the live event, many of the sessions will soon be offered as self-paced, distance-learning courses. As a sneak peek, we’ve compiled a list of questions from each session all from clinicians just like you! 

Like what you see? Keep your eye out for the upcoming self-paced courses, where each of these questions gets a much deeper dive. 

Examining the Impact of the Opioid Epidemic on Mental Health Across the Lifespan - Keith Chan

Q1: How does the perception of pain change as we get older? Would this be contingent on an individual’s work on the endurance of suffering?

A1: I think for some people, they learn better ways of coping. For others, it could be really challenging. When we're talking about people who are experiencing a high degree of social isolation, not everybody who's socially isolated is lonely, but [it] certainly increases the risk. And does that lead to other mental health conditions that might be a risk factor for prescription opioid use? It’s something I'm very curious about as well, in terms of how we're looking at this issue.

The Aging Brain and Resilience - Diane Bigler

Q2: Does early trauma affect cognition when one is older?

A2: It certainly can, because early trauma can affect the development of cognition. Somebody may not develop some executive functioning skills, such as imagination, insight, attention, reasoning, memory, and insight. They may not develop that executive functioning. That's why we may see more of a connection between early childhood trauma and ADHD, and this deficit in this executive functioning and attention. So, yes, early childhood trauma definitely begins to kind of set the stage, and may create some of these particular vulnerabilities that are not dementia-related, but are just vulnerabilities in that person. 

Supporting Older Adults in the Digital Age: Challenges and Opportunities - Jillian Graves

Q3: Are there risks with spending/buying items on TikTok/Amazon? Can this cause risks of hoarding? 

A3: Yes, that's a huge problem. Everything is so monetized on so many different websites, and it can be very satisfying. I've bought stuff off the TikTok shop, and I look later and I'm like, “What the heck was I thinking?” 

There's also this idea about the parasocial relationships that people have with social media personalities, and what they mean is that it's like a social relationship; it's kind of like you're close to this person. You have a relationship, but it's not a real direct relationship. And I think that creates a lot of problems when you think about people spending money, or really looking for validation.

Supporting Clients and Families Experiencing Regressive Illness and Dementia - Christina Marsack-Topolewski 

Q4: What impacts has COVID has on dementia diagnoses? 

A4: We know that many people during COVID, especially when we start to look at specific states on a more granular level, were not getting some of the care in the same way delivered because of some of the impacts of COVID. 

So where we are today and moving forward, certainly, really capitalizing on the necessity and the criticality of 1) how do we really think about ensuring evaluation in all sorts of different ways; medically, from a mental health perspective, as well as looking at when there might be any evidence to suggest clinical indicators of dementia, looking at this and exploring this. 

And 2) in the context of dementia, when we think about the trajectory of individuals getting that evaluation, we want to make sure that people are getting what they need. Certainly, sometimes we are relying on those family caregivers, and so if families and individuals and consumers may not have received this comprehensive care that they might have normally, or might ideally have needed, because of things like COVID.

Ethics and Eating: Closing the Circle of Life - Susan I Wranik

Q5: What are the “Four A’s?” 

A5: Amnesia, Aphasia, Apraxia, and Agnosia. 

Protecting Older Adults: Ethical & Legal Considerations in the Identification & Reporting of Elder Abuse - Kathryn Krase

Q6: Is there a requirement to report our family members abusing our elderly parents?

A6: It depends on the state that you're in. If you are in a universal reporting state for elder abuse, then you would be required to make reports in your professional capacity or outside your professional capacity. And that's a real challenge, because that doesn't necessarily mean that your family's going to get help. The hope is that, as a professional, you can help, whether you feel like you're making a report to APS is the way to do it, or finding another way if you're not required to make a report, that you can help.

Q7: What about institutional abuse? 

A7: I want to make sure people understand that a lot of the criminal law consequences of elder abuse are a result of institutional abuse. So for in this case, we have a client in a memory care unit, and it's discovered that the nursing staff are administering opiates around the clock instead of limited PRN purposes. This would be not just a report to APS, but you can also make a report to the professional licensing bureaus. The memory care is a licensed facility, and there are all reports in those spaces that should be made.

Supporting Clients As They Navigate the Caregiving Journey: Tools, Tips & Resources for Clinicians - Christina Marsack-Topolewski

Q8: Are there studies on how the prior relationship between caregiver/receiver impacts stress level of caregiving? For example, if the caregiver is caring for a parent who was abusive as a child, or even perhaps the parent was just not nurturing when the caregiver was a child?

A8: There is research about this, yes. What I'm going to say is generally, throughout even different things, if we were to even look at grief and loss, what does this look like following the loss of a person where there was kind of this estranged or not great relationship.

I've seen kind of in the grief and loss world. For example, a husband was abusive to his wife for many years. She got up the courage and was eventually going to divorce him, and was trying to figure out her way out of this marriage. They had one child… And then, he's diagnosed with cancer at a very young age, say 30s or 40s.

So she stays. And she cares for him till the day he dies. And what’s very interesting, in this specific case, was when she comes in for grief counseling. In Session one, she asks, “Is it too soon to date?” She had grieved that relationship. She did not want that relationship. He was abusive. She planned to leave that relationship. But she was in this role as a caregiver, and she didn't know who else was going to do it. And that was also her child's father, so she stuck it out. 

But when he died? She was ready.