older people’s assembly - hillingdon council

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

• [email protected]

mailto:[email protected]

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.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

oxygen to the brain. Without a blood

supply, brain cells can be damaged or

destroyed.


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.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.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.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.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.org.uk

What do we do?

•Research

•Raise Awareness

•Fundraise

•Provide support locally

and nationally


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.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.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.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.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.org.uk

Our Life After Stroke Services Communication Support

offers 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.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.org.uk

Stroke Association • National Helpline 0303 3033 100

• Website www.stroke.org.uk

• Jacqui Guyett – Communication Support, Hillingdon

• 07515 596959


• Caroline Humphrey – Information, Advice & Support, Hillingdon

• 07515 596961


http://www.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 / obesity

• 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

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?

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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.

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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.

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Demands Resources

http://www.clker.com/cliparts/C/4/D/Q/T/6/scale-of-justice-md.png

Symptoms of stress and anxiety

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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, our 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 order to improve how they feel.

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Situation/ Trigger

Thoughts

Physical symptoms Feelings

Behaviours

Fight or Flight Response to Stress/Anxiety

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Thought – ‘Something is wrong’

Anxiety

Misinterpretation – ‘I’m going to collapse’

Physical sensations – palpitations, dizzy

Vicious cycle of anxiety

Behaviour – escape, avoidance, seek

reassurance

Trigger – feel breathless

Understanding Depression

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• 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.

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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

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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 of 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.

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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?

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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

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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?

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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.

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Learning to relax

• Breathing techniques, Progressive Muscle Relaxation, Visualisation

• Time for yourself

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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

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http://www.llttf.com/

http://www.ntw.nhs.uk/pic/selfhelp

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.

older people’s assembly - hillingdon council

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