Older Peoples Assembly 1 December 2015 Agenda 2:00pm - Welcome - - PowerPoint PPT Presentation

Older People’s Assembly

1 December 2015

Agenda

• 2:00pm - Welcome from the Chairperson
• 2:05pm – Update from the Older People’s Champion
• 2.15pm – Stroke Association
• 2.40pm – Diabetes Awareness
• 3.05pm – Talking Therapies - CNWL
• 3.30pm - CLOSE

Reporting issues

• Council Main Switchboard and out-of-hours

service 01895 250111

• Contact numbers – inside back cover of

Hillingdon People

• Do it online 24/7 at www.hillingdon.gov.uk

Podiatry Services

• Experiences of using services
• Contact Graham Hawkes at Healthwatch

Hillingdon

• 01895 272997
• office@healthwatchhillingdon.org.uk

Cllr Ray Puddifoot

Older People’s Champion

Stroke Association

Caroline Humphrey

Information Advice & Support Coordinator

Stroke Helpline 0303 3033 100 stroke.org.uk

Stroke Association

We’re here for you and we are changing the world for people affected by stroke

• Vision

We want a world where there are fewer strokes and all those touched by stroke get the help they need.

• Mission

Our mission is to prevent strokes, and reduce their effect through providing services, campaigning, education and research.

Stroke Helpline 0303 3033 100 stroke.org.uk

What is a stroke?

• A stroke is a brain attack. A stroke is what

happens when the blood supply to part of the brain is cut off.

• Blood carries essential nutrients and
• xygen to the brain. Without a blood

supply, brain cells can be damaged or destroyed.

Stroke Helpline 0303 3033 100 stroke.org.uk

Types of stroke

• Ischaemic Stroke
• Most common type of stroke (approx 85%)
• Caused by a blockage in the arteries or blood vessels

that supply blood to the brain

• Haemorrhagic Stroke
• Caused by bleeding in or around the brain
• A blood vessel bursts within or on the surface of the

brain

Stroke Helpline 0303 3033 100 stroke.org.uk

Risk Factors

INACTIVITY BINGE DRINKING & SUBSTANCE MISUSE PREVIOUS STROKES & TIAs ORAL CONTRACEPTION & HRT OBESITY: UNHEALTHY EATING SMOKING DIABETES HEART DISEASE HIGH BLOOD PRESSURE FAMILY HISTORY AND ETHNICITY AGE RISK FACTORS

Stroke Helpline 0303 3033 100 stroke.org.uk

Common problems after a stroke

• Physical
• Weakness or paralysis of limbs (usually down one side)
• Clumsiness
• Difficulties with balance
• Swallowing
• Incontinence
• Vision

Stroke Helpline 0303 3033 100 stroke.org.uk

Common problems after a stroke

• Communication
• Speech and language

Forming words Finding correct words Understanding language

• Concentration
• Recognising objects and knowing how to use
• Reading and writing

Stroke Helpline 0303 3033 100 stroke.org.uk

Common problems after a stroke

• Emotional Impact
• Personality changes
• Difficulty controlling emotions
• Emotional upheaval

Feelings of grief Low mood / depression Loss of confidence Anxiety

Stroke Helpline 0303 3033 100 stroke.org.uk

What do we do?

• Research
• Raise Awareness
• Fundraise
• Provide support locally

and nationally

Stroke Helpline 0303 3033 100 stroke.org.uk

Stroke is a medical emergency

If the person has failed any one of these tests, call 999 immediately. By calling 999 you can help someone reach hospital quickly and receive the early treatment they need. Prompt action can prevent further damage to the brain and help someone make a full recovery.

Stroke Helpline 0303 3033 100 stroke.org.uk

Not Just a Funny Turn Campaign.

• Transient ischaemic attack (TIA) is a

warning sign of a future stroke – about one in four people who have had a TIA will go on to have a full stroke in future

• 20,000 mini strokes every year
• Symptoms of TIAs are the same as stroke
• TIA symptoms can last up to 24 hours, but

will sometimes resolve within 5 to 20 minutes

• It is important that you should dial 999

urgently if you, or someone you know, have any of the symptoms of a TIA

Stroke Helpline 0303 3033 100 stroke.org.uk

Know Your Blood Pressure Campaign (KYBP)

• High Blood Pressure is the

biggest risk factor for stroke

• 40% of all strokes could be

prevented if undiagnosed high blood pressure is prevented

• The Campaign aims to raise

awareness through free blood pressure readings and providing advice and information

Stroke Helpline 0303 3033 100 stroke.org.uk

Ask First…To help prevent a stroke later

• Atrial fibrillation (AF) is a type of

irregular heart beat.

• Pulse reading will be irregular
• AF can increase your risk of stroke by

up to five times.

• 750,000 people in the UK living with

AF.

• Important to Ask First – if you have

AF ask your GP about ways you can reduce your risk of stroke

Stroke Helpline 0303 3033 100 stroke.org.uk

How we help

• National Helpline
• Language line
• Produce 6 core leaflets
• Produce more than 70

Factsheets

• Website and accessible

information

• Facebook and Twitter
• Stroke Association News

Magazine

• Welfare grants for those with

practical needs

Stroke Helpline 0303 3033 100 stroke.org.uk

Our Life After Stroke Services

Communication Support

• ffers a lifeline to people left with

speech and communication problems through:

• 1-2-1 home visits
• Long term support groups
• Providing social opportunities

and outing

Stroke Helpline 0303 3033 100 stroke.org.uk

Services continued …

Information and Advice Support Service

Helps those recently affected by stroke, both survivours and family/carers, to adjust to the changes through:

• 1-2-1 home visits
• Needs assessment
• Guided goal setting
• Referral/signposting to

appropriate support

Stroke Helpline 0303 3033 100 stroke.org.uk

Stroke Association

• National Helpline 0303 3033 100
• Website www.stroke.org.uk
• Jacqui Guyett – Communication Support, Hillingdon
• 07515 596959
• Jacqui.guyett@stroke.org.uk
• Caroline Humphrey – Information, Advice & Support, Hillingdon
• 07515 596961
• Caroline.humphrey@stroke.org.uk

Diabetes Awareness

Veronica Green

Diabetes Team Leader, CNWL

Diabetes

Veronica Green Diabetes Team Leader Hillingdon

Topics for Today

Any Questions What is Diabetes? Why is there so much fuss about it? If I have it what can I do about it? Can I stop my self from getting it?

What is Diabetes?

• Diabetes Mellitus –

“Honey Sweet Urine”

• “ Diabetes is an error in

carbohydrate, lipid and protein metabolism” (World Health Organisation)

Type 1 Diabetes

• Autoimmune condition
• No insulin at all
• Can only be treated

with insulin injections

• Usually starts under the

age of 50 – often in childhood

Type 1 diabetes - Symptoms

• Quick onset
• Severe thirst
• Passing urine +++
• Weight loss +++
• Ketosis

Type 2 Diabetes

• Is a mixture of

insulin resistance

• Lack of insulin
• Progressive – needs

more treatment over time

Type 2 DM Causes

• Central obesity /
• besity
• Family history
• Ethnicity
• Migration
• Old age

Is Type 2 Diabetes Mild?

Treatment of type 2 diabetes

Why all the fuss? – to the state

• Costs £23Billion overall

including NHS £10 BILLION and growing

• 10% of the NHS annual

drugs bill is on diabetes

• £2.3 Billion on in

hospital care

Why all the fuss? – to the individual

• Impact on self

– Loss of identity – Loss of time e.g. Work/life – powerlessness

• Impact on others

– Changing diets – How others perceive you

Complications

Is Type 2 Diabetes Mild? No !

Good Control Can Reduce

Stroke Heart Attack Kidney failure Sight loss Foot problems By 30-70%

If I have it, what can I do about it?

YOU

Blood Pressure Cholesterol Weight Exercise Blood Glucose Know your Targets

Foot problem prevention

Don’t walk bare foot Do wear well fitting shoes/trainers.

Check your feet daily. Seek help if worried

Smoking and Diabetes

• Smoking and having

diabetes does not mix

• Increases the risks of
• Heart attack
• Stroke
• Neuropathy + kidney

problems

• Increases blood

glucose.

Annual Review

Can Type 2 diabetes be prevented?

Fact - Diabetes Prevention

58%

Quiz 100 Calories

Sugar Game

Fruit

Oily or Not?

Any Questions?

Talking Therapies

Heather Joy

High Intensity Therapist/Cognitive Behavioural Psychotherapist, CNWL

Emotional Wellbeing in Later Life

CNWL Talking Therapies Service Hillingdon

Introduction

• Who are we?
• Why are we here?
• 54

Why we’re here: Mental Health Difficulties are Common

• Anxiety, stress, low mood, are all natural human feelings

we will all have at some point.

• 1 in 5 people over 65 experience depression (2 in 5 if

living in care homes).

• Physical ill health, e.g. diabetes, heart problems, make

you more at risk of depression.

• 3 million people over 65 experience mental health

problems that significantly impact on their life.

• Emotional wellbeing is important at all ages.
• 55

Stresses of later life:

• Social Isolation – changes in relationships.
• Life changes and changes in identity – no longer

working, not feeling needed or wanted.

• Loss – death of peers and family, and facing our own

mortality.

• Loss of independence.
• Physical changes – letting go of activities.
• Ill health – less able, needing support.
• 56

Demands Resources

Symptoms of stress and anxiety

• 57

CBT Background

• CBT was developed in America in 1950s – widely

used.

• It is based on the idea that when we feel low or

anxious we tend to think negatively about ourselves,

• ur situation and our ability to cope. It can also

impact our behaviour and how we relate to others.

• CBT was developed as a self-help form of

psychotherapy : To empower individuals to make practical changes in their thoughts and actions in

• rder to improve how they feel.
• 58

• 59

Situation/ Trigger

Thoughts Physical symptoms Feelings Behaviours

Fight or Flight Response to Stress/Anxiety

• 60

• 61

Thought – ‘Something is wrong’ Anxiety Misinterpretation – ‘I’m going to collapse’ Physical sensations – palpitations, dizzy

Vicious cycle

• f anxiety

Behaviour – escape, avoidance, seek reassurance

Trigger – feel breathless

Understanding Depression

• 62
• Triggers - life events and changes, such as losing

partner

• Out of the blue – there may be no one ‘cause’
• Some of us may be more vulnerable - If we have

had depression before, if it is in the family, if we have had difficult life experiences such as many losses.

• 63

Symptoms of Depression

Emotions/Feeling Sad Guilty Alone Upset Overwhelmed Physical/Bodily Sensations Tired Restless Lack of Energy Poor Sleep Fluctuating Thoughts Loosing Confidence in self Thinking the worse will happen Thinking that things seem hopeless Thinking badly of yourself Thoughts that life is not worth living Behaviours Difficulties in making decisions Avoiding people and activities Not doing things you used to enjoy Using drugs or alcohol to cope Can’t be bothered to do everyday tasks

• 64

Feeling Low/ Stressed Negative thinking Loss of Pleasure/ Achievement Reduced Activity

• I cannot cope
• What is the point?
• I have nothing to give
• I am too tired

Vicious cycle

• f depression

What do we offer?

Guided Self help – Telephone guided self help based on CBT interventions-techniques to change thinking and behaviours to break out of vicious cycles Face to face Cognitive Behaviour Therapy (CBT) – more in depth Workshops and Groups-tailored to specific groups Counselling – space to talk through what is happening such as difficult life events like loss, or relationship

• issues. Or to talk through a past life event. To gain

insight, explore feelings.

• 65

CBT Techniques: Changing Behaviour

When we’re stressed, anxious or depression we get into vicious cycles and behave in ways that keep the problem going. What might you be doing that is keeping you stuck, stopping you from moving forward and feeling better? What have you stopped doing that you used to enjoy? What are you not doing because of fear/anxiety/worry?

• 66

• 67

Getting Active

We all need a balance of activities:

• Routine activities – e.g. self care
• Necessary activities – e.g. tasks and chores
• Pleasurable activities – e.g. hobbies, leisure

Ways to maintain balance:

• Break down activities into smaller tasks
• Ensure you have time for rest
• Be aware of your limits – you don’t have to get

everything done all at once

Changing the way we think

• ‘Negative’ and ‘Unrealistic’ thinking vs. BALANCED

thinking

• Blinkered thinking vs. Seeing other options
• Making emotional decisions vs. Pausing for thought
• 68

Unhelpful thoughts can raise adrenaline levels, and in turn increase stress. BUT: we can try to question unhelpful

• thoughts. Ask yourself:

– Am I considering all the evidence? – Am I ignoring any strengths or positives? – Am I jumping to conclusions? – Is this thought really true/true all the time? – What might I say to a friend if they were in this situation?

• 69

Negative Thought: There’s no point in going to the walking group, I won’t be able to keep up anyway – Am I considering all the evidence? – I don’t know unless I go. – Am I ignoring any strengths or positives? – I’ve been walking before with other people so I know I can do it. – Am I jumping to conclusions? – I might be exaggerating how bad it will be. I’m making assumptions. – Is this thought really true/true all the time? – I know it’s not always true, I sometimes feel like going and enjoy it. – What might I say to a friend if they were in this situation? – I know you don’t feel like it now, but it will be good for you and there will be people of all abilities. Why don’t you go with someone first.

• 70

Learning to relax

• Breathing techniques, Progressive Muscle Relaxation,

Visualisation

• Time for yourself
• 71

Photograph: Michelle Cazares

Resources

www.llttf.com – Living Life to the Full www.ntw.nhs.uk/pic/selfhelp - Mental Health Self Help Guides Books – The ‘Overcoming’ Series, e.g. ‘Overcoming Depression’ by Paul Gilbert www.getselfhelp.co.uk

• 72

Assembly dates 2016

Tuesday 2 to 3.30 pm

• 29 March
• 28 June
• 27 September
• 6 December

Registration and refreshments from 1.30 to 2 pm

Thank you for attending.