{"id":1125,"date":"2024-05-11T16:30:03","date_gmt":"2024-05-11T20:30:03","guid":{"rendered":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/?post_type=chapter&#038;p=1125"},"modified":"2024-05-11T16:35:45","modified_gmt":"2024-05-11T20:35:45","slug":"2-5-9","status":"publish","type":"chapter","link":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/chapter\/2-5-9\/","title":{"raw":"2.5.9 Mental Health and Substance Use","rendered":"2.5.9 Mental Health and Substance Use"},"content":{"raw":"<h2>Psychotic Disorders<\/h2>\r\n2-3% of individuals in LTC have schizophrenia, however this data does not include all psychotic illness and may be under represented\r\n<ul>\r\n \t<li>Includes:\r\n<ul>\r\n \t<li>Schizophrenia, Schizoaffective<\/li>\r\n \t<li>Delusional Disorder<\/li>\r\n \t<li>Late onset psychosis<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li>Overall prevalence of older adults affected by such disorders is low, 1-2% (new onset).<\/li>\r\n \t<li>Most individuals are diagnosed in early adulthood and have had chronic mental illness.<\/li>\r\n \t<li><strong>Note: Chronic mental illness leads to chronic deterioration of brain tissue, increasing risk for cognitive decline.<\/strong><\/li>\r\n \t<li>Clinical Considerations:\r\n<ul>\r\n \t<li>Geriatric dosing is often half of the adult dose \u2013 is the patient geriatric dosed?<\/li>\r\n \t<li>Does the patient need lab monitoring (kidney, liver, CBC, drug levels) as they are geriatric with increased risk of renal\/hepatic impairment and adverse effects?<\/li>\r\n \t<li>QT Interval \u2013 is it in normal range?[footnote]CIHI, n.d.-a[\/footnote]<span style=\"font-size: 14pt\">[footnote]MacCourt, 2021[\/footnote]<\/span><span style=\"font-size: 14pt\">[footnote]Mental Health Commission of Canada, 2019[\/footnote]<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<h2>Substance Use<\/h2>\r\nSubstance use is noted to increase the likelihood of admission to LTC.\u00a0Individuals with alcohol use disorders have higher rates of LTC placement.\r\n\r\nSubstance Use in the Older Adult includes:\r\n<ul>\r\n \t<li>Alcohol<\/li>\r\n \t<li>Benzodiazepines<\/li>\r\n \t<li>Cannabis Use<\/li>\r\n \t<li>Opioid Use[footnote]Kaplan et al., 2014[\/footnote]<span style=\"font-size: 14pt\">[footnote]De Graaf et al., 2023[\/footnote]<\/span><span style=\"font-size: 14pt\">[footnote]Statistics Canada, 2016[\/footnote]<\/span><span style=\"font-size: 14pt\">[footnote]Simoni-Wastila &amp; Yang, 2006[\/footnote]<\/span><span style=\"font-size: 14pt\">[footnote]Canadian Centre on Substance Use and Addiction, 2018[\/footnote]<\/span><span style=\"font-size: 14pt\">[footnote]Canadian Coalition for Seniors\u2019 Mental Health, 2019[\/footnote]<\/span><\/li>\r\n<\/ul>","rendered":"<h2>Psychotic Disorders<\/h2>\n<p>2-3% of individuals in LTC have schizophrenia, however this data does not include all psychotic illness and may be under represented<\/p>\n<ul>\n<li>Includes:\n<ul>\n<li>Schizophrenia, Schizoaffective<\/li>\n<li>Delusional Disorder<\/li>\n<li>Late onset psychosis<\/li>\n<\/ul>\n<\/li>\n<li>Overall prevalence of older adults affected by such disorders is low, 1-2% (new onset).<\/li>\n<li>Most individuals are diagnosed in early adulthood and have had chronic mental illness.<\/li>\n<li><strong>Note: Chronic mental illness leads to chronic deterioration of brain tissue, increasing risk for cognitive decline.<\/strong><\/li>\n<li>Clinical Considerations:\n<ul>\n<li>Geriatric dosing is often half of the adult dose \u2013 is the patient geriatric dosed?<\/li>\n<li>Does the patient need lab monitoring (kidney, liver, CBC, drug levels) as they are geriatric with increased risk of renal\/hepatic impairment and adverse effects?<\/li>\n<li>QT Interval \u2013 is it in normal range?<a class=\"footnote\" title=\"CIHI, n.d.-a\" id=\"return-footnote-1125-1\" href=\"#footnote-1125-1\" aria-label=\"Footnote 1\"><sup class=\"footnote\">[1]<\/sup><\/a><span style=\"font-size: 14pt\"><a class=\"footnote\" title=\"MacCourt, 2021\" id=\"return-footnote-1125-2\" href=\"#footnote-1125-2\" aria-label=\"Footnote 2\"><sup class=\"footnote\">[2]<\/sup><\/a><\/span><span style=\"font-size: 14pt\"><a class=\"footnote\" title=\"Mental Health Commission of Canada, 2019\" id=\"return-footnote-1125-3\" href=\"#footnote-1125-3\" aria-label=\"Footnote 3\"><sup class=\"footnote\">[3]<\/sup><\/a><\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h2>Substance Use<\/h2>\n<p>Substance use is noted to increase the likelihood of admission to LTC.\u00a0Individuals with alcohol use disorders have higher rates of LTC placement.<\/p>\n<p>Substance Use in the Older Adult includes:<\/p>\n<ul>\n<li>Alcohol<\/li>\n<li>Benzodiazepines<\/li>\n<li>Cannabis Use<\/li>\n<li>Opioid Use<a class=\"footnote\" title=\"Kaplan et al., 2014\" id=\"return-footnote-1125-4\" href=\"#footnote-1125-4\" aria-label=\"Footnote 4\"><sup class=\"footnote\">[4]<\/sup><\/a><span style=\"font-size: 14pt\"><a class=\"footnote\" title=\"De Graaf et al., 2023\" id=\"return-footnote-1125-5\" href=\"#footnote-1125-5\" aria-label=\"Footnote 5\"><sup class=\"footnote\">[5]<\/sup><\/a><\/span><span style=\"font-size: 14pt\"><a class=\"footnote\" title=\"Statistics Canada, 2016\" id=\"return-footnote-1125-6\" href=\"#footnote-1125-6\" aria-label=\"Footnote 6\"><sup class=\"footnote\">[6]<\/sup><\/a><\/span><span style=\"font-size: 14pt\"><a class=\"footnote\" title=\"Simoni-Wastila &amp; Yang, 2006\" id=\"return-footnote-1125-7\" href=\"#footnote-1125-7\" aria-label=\"Footnote 7\"><sup class=\"footnote\">[7]<\/sup><\/a><\/span><span style=\"font-size: 14pt\"><a class=\"footnote\" title=\"Canadian Centre on Substance Use and Addiction, 2018\" id=\"return-footnote-1125-8\" href=\"#footnote-1125-8\" aria-label=\"Footnote 8\"><sup class=\"footnote\">[8]<\/sup><\/a><\/span><span style=\"font-size: 14pt\"><a class=\"footnote\" title=\"Canadian Coalition for Seniors\u2019 Mental Health, 2019\" id=\"return-footnote-1125-9\" href=\"#footnote-1125-9\" aria-label=\"Footnote 9\"><sup class=\"footnote\">[9]<\/sup><\/a><\/span><\/li>\n<\/ul>\n<hr class=\"before-footnotes clear\" \/><div class=\"footnotes\"><ol><li id=\"footnote-1125-1\">CIHI, n.d.-a <a href=\"#return-footnote-1125-1\" class=\"return-footnote\" aria-label=\"Return to footnote 1\">&crarr;<\/a><\/li><li id=\"footnote-1125-2\">MacCourt, 2021 <a href=\"#return-footnote-1125-2\" class=\"return-footnote\" aria-label=\"Return to footnote 2\">&crarr;<\/a><\/li><li id=\"footnote-1125-3\">Mental Health Commission of Canada, 2019 <a href=\"#return-footnote-1125-3\" class=\"return-footnote\" aria-label=\"Return to footnote 3\">&crarr;<\/a><\/li><li id=\"footnote-1125-4\">Kaplan et al., 2014 <a href=\"#return-footnote-1125-4\" class=\"return-footnote\" aria-label=\"Return to footnote 4\">&crarr;<\/a><\/li><li id=\"footnote-1125-5\">De Graaf et al., 2023 <a href=\"#return-footnote-1125-5\" class=\"return-footnote\" aria-label=\"Return to footnote 5\">&crarr;<\/a><\/li><li id=\"footnote-1125-6\">Statistics Canada, 2016 <a href=\"#return-footnote-1125-6\" class=\"return-footnote\" aria-label=\"Return to footnote 6\">&crarr;<\/a><\/li><li id=\"footnote-1125-7\">Simoni-Wastila &amp; Yang, 2006 <a href=\"#return-footnote-1125-7\" class=\"return-footnote\" aria-label=\"Return to footnote 7\">&crarr;<\/a><\/li><li id=\"footnote-1125-8\">Canadian Centre on Substance Use and Addiction, 2018 <a href=\"#return-footnote-1125-8\" class=\"return-footnote\" aria-label=\"Return to footnote 8\">&crarr;<\/a><\/li><li id=\"footnote-1125-9\">Canadian Coalition for Seniors\u2019 Mental Health, 2019 <a href=\"#return-footnote-1125-9\" class=\"return-footnote\" aria-label=\"Return to footnote 9\">&crarr;<\/a><\/li><\/ol><\/div>","protected":false},"author":517,"menu_order":48,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[],"contributor":[],"license":[],"class_list":["post-1125","chapter","type-chapter","status-publish","hentry"],"part":3,"_links":{"self":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/pressbooks\/v2\/chapters\/1125","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/wp\/v2\/users\/517"}],"version-history":[{"count":3,"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/pressbooks\/v2\/chapters\/1125\/revisions"}],"predecessor-version":[{"id":1128,"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/pressbooks\/v2\/chapters\/1125\/revisions\/1128"}],"part":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/pressbooks\/v2\/parts\/3"}],"metadata":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/pressbooks\/v2\/chapters\/1125\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/wp\/v2\/media?parent=1125"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/pressbooks\/v2\/chapter-type?post=1125"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/wp\/v2\/contributor?post=1125"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/wp\/v2\/license?post=1125"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}