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Epilepsy And Aged Care Resources

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Our suite of Epilepsy in the Later Years resources has been developed for older individuals and their families and carers, and for aged care professionals.
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Dementia And Epilepsy

Epilepsy in people in their later years is distinct from other age groups due to other factors which commonly occur as we age. It is important for those working with older people to understand the correlation between epilepsy and dementia.

Dementia and epilepsy in the later years

There are many underlying causes for developing epilepsy but in people in their later years dementia is a significant factor. People with dementia have a 10-fold increased risk of developing epilepsy. 10–20% of older people with dementia also have a diagnosis of epilepsy.

It is estimated that by the year 2025, 50% of new onset seizures will be in older people. Seizures in older people often go unnoticed.
The most common types of seizures seen in older people are focal seizures which are less obvious than generalised seizures. However for older people with dementia, and in particular Alzheimer’s disease, the most common seizure type is generalised seizures. Often the seizure event is mistaken for the general ageing process or signs of dementia.

Epilepsy is not usually linked to dementia associated with diseases such as Huntington’s and Parkinson’s disease.

What does this mean for the older person?

For older people with dementia and epilepsy:

  • Seizures are more likely to be unprovoked meaning there is no known trigger for the seizure. These unprovoked seizures can have significant consequences on the prognosis of dementia.
  • Research suggests that seizures are more likely to occur in the advanced stage of dementia but they can occur at any stage.
  • Symptoms of seizure activity can be confused with dementia symptoms. Confusion in an older person may be due to a seizure or may be a symptom of dementia just as fluctuations in consciousness may be a seizure or part of the dementia.

For older people with dementia and epilepsy, seizure symptoms are more understated than in younger people. These symptoms can include:

  • confusion
  • suspended awareness
  • hearing or seeing things
  • sporadic memory loss

What can you do to help?

  • Difficulties in differentiating mood disorders (common in people with epilepsy) from dementia in older people, need to be taken into account.
  • Diagnosis of epilepsy in people with dementia is challenging as seizures may look the same as other behaviours in people with dementia. The presence of dementia can make recognition and recording of seizures particularly difficult and must be taken into account by staff and carers.
  • It is important to keep a record of any variations in signs or symptoms in those with dementia for use by a doctor when investigating the possibility of an epilepsy diagnosis.
  • Some medications used in the management of dementia may cause seizures so it is important to monitor this.
  • Support the person to get adequate sleep and maintain a good diet. Implement strategies to manage stress, limit alcohol, increase opportunities to get plenty of exercise and engage in stimulating activities all of which can help in seizure management.
  • If seizures are well controlled, epilepsy doesn’t preclude an older person from living independently and having a fulfilling life.

Where to go for further information:

This information is part of a suite of resources that are targeted to aged care workers and carers of older people, to assist with caring for older people living with epilepsy.

The information contained in this publication provides general information about epilepsy. It does not provide specific advice. Specific health and medical advice should always be obtained from an appropriately qualified health professional.

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Behaviours And Epilepsy

Epilepsy in later years and changes in behaviour can be related. Supporting an older person with epilepsy who also exhibits challenging behaviours requires understanding and empathy.

Behaviours and epilepsy in the later years

Behavioural changes and issues may be directly linked to the older person’s seizure activity and/or epilepsy medication, however they can also be linked to a co-existing illness such as dementia. These three impacts need to be understood and the older person supported to manage behavioural changes or issues.

What does this mean for the older person?

Behavioural changes or issues may result from deficits in memory and higher level cognitive skills due to the older person’s epilepsy manifestation or medication. Memory lapses can often be misinterpreted as a sign of dementia, when they may actually relate to the seizure activity or epilepsy medication. Behavioural issues may also emerge as the older person responds to their loss of independence or frustration with their changing environment. The older person may fear the unknown or how people will react should they have a seizure.

People living with epilepsy, of any age, can experience:

  • difficulty with attention and concentration
  • impulsiveness or poor decision making ability
  • inability to plan and organise
  • lack of energy and motivation
  • sleep deprivation
  • loss of time, gaps in memory
  • inappropriate behaviour
  • withdrawal and isolation

What can you do to help?

There are a number of things that can be done to help understand and support an older person who is showing changed behaviour patterns and behavioural issues:

  • Consider how activities which have been part of the person’s life prior to a diagnosis of epilepsy can be adjusted to enable continued engagement.
  • Structure tasks to allow additional time for understanding, planning and decision making.
  • Allow flexibility in how day to day activities and outings are conducted, to allow for any behavioural impacts that may be outside the control of the person.
  • Develop a plan with the person on how the behavioural changes or issues should be approached and managed; include this approach in the person’s Epilepsy Management Plan (EMP).

If an older person with epilepsy has behavioural issues it may be helpful to follow these steps:

  1. Identify behaviours of concern and what impact these behaviours have on the person’s life.
  2. Observe and monitor the pattern of behaviours to ascertain why they are occurring.
  3. Identify factors that both trigger and reinforce these behaviours.
  4. Talk with the person about the behaviour; they may not be aware of it.
  5. Determine what can be done and develop a plan to support the person to manage the changed behaviours.
  6. Seek advice and assistance from an appropriate professional if required.
  7. Where behaviours are not under the control of the person, seek training for family and/or friends, aged care workers and carers to build their capacity to support the person.

Where to go for further information:

Australian Government, My Aged Care Resources www.myagedcare.gov.au Search: Caring for someone with dementia Victorian Government

Department of Health and Human Services www.dhs.vic.gov.au Search: Behaviour intervention services

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This information is part of a suite of resources that are targeted to aged care workers and carers of older people, to assist with caring for older people living with epilepsy.

The information contained in this publication provides general information about epilepsy. It does not provide specific advice. Specific health and medical advice should always be obtained from an appropriately qualified health professional.

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Falls And Epilepsy

Falls in people in their later years can lead to death, injuries including fractures, a loss of mobility and independence, a fear of further falls and restriction of physical activity.
The cause of falls should be assessed to identify if any underlying medical condition such as epilepsy is the cause.

Falls and epilepsy in the later years

Around 10% of falls in people aged 65 years or over result in a fracture.

Falls in people in their later years can lead to fractures, a loss of mobility and independence, a fear of falling in the future, severe injuries requiring hospitalization such as a traumatic head injury, and an increased risk of death.
Frequent falls with no recollection of what happened could be a symptom of seizure activity and epilepsy or other underlying medical conditions.

Ongoing falls can lead to the need for increased levels of support and potentially admission to a residential aged care facility. It is therefore important to ensure that falls are investigated and the cause identified.

What does this mean for the older person?

A risk management approach should be taken to prevent falls where possible, to help increase confidence, maintain independence and to ensure that the older person can live safely in the community or in an aged care setting.

It is best to see a doctor if there are any signs of changes in balance and mobility. Home assessment, assistive aids or protective wear may be recommended by the doctor such as, medical alerts, helmets, walking supports or an Occupational Therapist home assessment.

What can you do to help?

For an older person the loss of, or reduction of, independence can be a very confronting challenge to face.

Aged care workers and carers can assist the older person to identify suitable supports which can help them to maintain a safe and active lifestyle and reduce the risk of falls where possible.

Many falls can be prevented so it is important that fall and injury prevention strategies are implemented on a person centred basis. This is especially important for the person living with epilepsy.

There are several programs and services run by trained health professionals for preventing falls which are carried out in the community, e.g. community rehabilitation centres, community health services and specialised falls clinics.

These programs and services can be accessed through the doctor, some of which may require a referral.

Exercise is also recognised as being beneficial for falls prevention, particularly functional strength and balance exercise such as yoga and Tai Chi. Studies have shown that balance can be improved, reducing the number of falls, through doing exercises that challenge the balance systems and improve strength and flexibility.

Where to go for further information:

Australian Government Department of Health and Ageing www.health.gov.au Don’t fall for it. Falls can be prevented! – A guide to preventing falls for older people

Victorian Government, Department of Health and Human Services www.health.vic.gov.au Search: Falls prevention: Information for health professionals

Monash University www.monash.edu Search: No Falls Exercise Program: A program of fall reduction exercises for older people

NSW Government, Department of Health www.activeandhealthy.nsw.gov.au Search: Your active and healthy guide and Staying active and on your feet

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This information is part of a suite of resources that are targeted to aged care workers and carers of older people, to assist with caring for older people living with epilepsy.

The information contained in this publication provides general information about epilepsy. It does not provide specific advice. Specific health and medical advice should always be obtained from an appropriately qualified health professional.

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Medications And Epilepsy

Medication does not cure epilepsy but it can prevent seizures occurring and control them when they do.
Whether or not to prescribe medication will depend on how highly the doctor rates the risk of another seizure and how severely a seizure would impact on the person’s life.

Medication and epilepsy in the later years

Medication should always be taken in accordance with the doctor’s instructions to maximise the beneficial outcomes of the medication and to prevent unwanted side effects. Around 70% of people with epilepsy can have good seizure control if they take their medication correctly.

There are two types of medications that can be prescribed for epilepsy:

1. Antiepileptic drugs (AEDs).

AEDs are the most common treatment for people. While, they will not cure epilepsy, they can control seizure activity. AEDs are usually prescribed based on:

  • how well they work for the person’s seizure type/s
  • how well the person can tolerate them
  • what other health-related conditions the person may have
  • what medications are already being taken
  • how seriously the seizures are affecting the person’s life.

There are many different types of AEDs available. A seizure free outcome is the optimal result sought for the older person and by the doctor.

2. Emergency Medication.

For epilepsy, emergency medication works by stopping the seizure activity if taken when a seizure occurs. Emergency medication reduces the impact of seizure activity on the person’s life. What does this mean for the older person? Commencing medication does not always mean that it must be taken forever, there are a few things that need to be considered:

  • Understanding why the medication has been prescribed.
  • Regular medical reviews as medication may only be needed for a limited time.
  • Always taking medication in the dosage and at the time recommended by the doctor. General advice is that if a dose is missed it can generally be taken as soon as you remember. Do not double up on doses. It is advisable not to take the missed dose if it is close in timing to the next one. Keep a record of doses that have been missed.
  • After starting medication it is important to note any changes in general health or seizure activity. If the medication is not managing seizure activity the doctor should be advised as soon as possible as the medication or dosage may need to be changed.
  • Withdrawing from medication should always be carried out under medical supervision as stopping medication can provoke seizures and can potentially create a medical emergency.

It is quite common for people in their later years to have other health conditions which may require medication. This may have an impact on what type of AED can be prescribed. People in their later years also experience differences in the way drugs are absorbed and broken down (metabolised) or cleared from the body.

It is good practice to ask the doctor to discuss the risks and benefits of all medication. The doctor will describe common side effects of the prescribed medication; however it is also good to ask the pharmacist to go through any possible side effects.

  • Like any medication AEDs can cause some possible undesirable side effects, including: skin rashes, falls, difficulty concentrating or thinking, or problems with memory. People in their later years are more susceptible to side effects.
  • AEDs can contribute to osteoporosis – a condition of decreased bone strength (thinning of the bones) which increases the risk of a broken bone. If taking AEDs for an extended period, bone density assessments may be necessary.

If the older person is having many seizures, or seizures which last a long time, the doctor may also prescribe emergency medication:

  • The doctor will advise when the emergency medication is to be administered, how it is to be stored and how it is to be administered.
  • Emergency medication information will be recorded in an Emergency Medication Management Plan (EMMP).
  • Only medical practitioners or people who have been trained to administer emergency medication in accordance with this plan should do so.

What can you do to help?

AEDs may interact with other medications.

Other medications may impact on the effect of AEDs. Understanding medication, their side effects and impacts can be overwhelming for many people. Support with understanding the role of medication in the person’s Epilepsy Management Plan (EMP) is important. Encourage the older person to ask for more information and discuss the options with their doctor, family, close friend or carer if concerned.

Medication continuity is essential and it can be easy to forget to take medication at the appropriate time. Encourage the older person to put strategies in place to remind them to take their medication:

  • Use a pill box or Webster Pack. This is useful particularly if taking numerous medications. It also reduces the chance of double dosing.
  • Encourage the older person to establish a routine and combine taking of medication with a daily task such as brushing teeth or with meals.
  • Keep medication in an easy to see place so they cannot be missed
  • Encourage mindfulness – discuss the importance of pausing and being present when taking medication, to ensure the correct dose is taken.
  • When supporting an older person who has been prescribed emergency medication it is important to receive training in Administration of Emergency Medication.
  • Use technology. Set up reminders on the person’s phone, watch or electronic calendar. There is also a range of apps available for smart phones.
  • Encourage the older person to complete the Medication summary form on the next page.

Where to go for further information:

Download the Medications and Epilepsy PDF

Better Health Channel www.betterhealth.vic.gov.au Search: Safe medication use Australian Government

Department of Health www.health.gov.au Search: Guiding principles for medication management in residential aged care facilities

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This information is part of a suite of resources that are targeted to aged care workers and carers of older people, to assist with caring for older people living with epilepsy.

The information contained in this publication provides general information about epilepsy. It does not provide specific advice. Specific health and medical advice should always be obtained from an appropriately qualified health professional.

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Memory And Epilepsy

It is common for people living with epilepsy to have memory problems which may arise for many reasons. Keeping your brain alert and active is good, however on its own may not necessarily be enough to improve memory.

Memory and epilepsy in the later years

Memory is one of the most important functions of our brain. For most people, as we age, lapses in our memory become more common. This can be frustrating and can affect daily life. People with epilepsy are at a higher risk of developing memory problems due to abnormalities in the frontal lobe of the brain.

There are two types of memories – short-term and long-term.

Short-term memory is used to process information which needs to be remembered for just a short time after first experiencing something. An example of this is when reading a sentence, our short-term memory allows us to remember what we read at the start of the sentence when we reach the end of the sentence.

We need to use our short-term memory to complete particular tasks e.g. calculating how many hours until we need to prepare dinner or playing a game, when this information is no longer needed it is discarded by our brain.

Long-term memory is information that is stored for a long period of time. This information may include things like where our childhood home was, what we did last year or even what we did a few hours ago. It can be very distressing for people when they cannot remember their past. This can be a recurring problem for people living with epilepsy, and can be even more frequent and increasingly distressing for people in their later years.

What does this mean for the older person?

There are three phases to the memory process.

The first phase relates to learning. To be able to remember something new we must first pay attention and learn the new information. Having epilepsy can impact a person’s ability to pay attention over a period of time and may slow the speed of information processing. For some people with epilepsy processing new information can be overwhelming which can restrict their ability to maintain attention for long enough to commit the matter to memory. Important facts may be missed and memory is affected because the information is not being properly received.

The second phase is storage of information in the brain. For some people with epilepsy they may have difficulty in consolidating new information. Epilepsy can cause structural problems in parts of the brain responsible for memory and the storage of these memories.

The third phase is retrieval or recall. This is the brain’s way of finding and using the information that has been learnt. There are a number of factors which can make it difficult to recall information such as time pressure, being put on the spot or being asked to recall information out of context. Often, later in the day when the pressure is off, the information may be remembered more easily. It is difficult to remember information in isolation but when given further information the memory may more easily be recalled.

There are a number of ways that people with epilepsy can develop memory problems. These include:

  • Seizures – Seizures are believed to affect the storage of memory in people with epilepsy. Having seizures over a long period of time can negatively effect memory functions.
  • Anti-epileptic drugs – Anti-epileptic drugs (AEDs) have a number of side effects, one of them can be a negative impact on people’s cognitive functioning. The impact of AEDs on attention and memory is common although some people on lower doses of AEDs find that taking the medication will help with their memory.
  • Surgery – Some people experience increased memory difficulties after epilepsy surgery. It has been found that the risk of this can, in most cases, be identified by a specialist before the surgery.
  • Anxiety and depression – Our mood can impact on our ability to attend to, learn and recall information. When we feel anxious or depressed it is harder to focus on information which, in turn, makes it harder to remember information.
  • Stress and fatigue – When we feel stressed or tired we place more demands on our minds which can affect our ability to retain and recall information. Keeping a healthy sleep and exercise routine is important for people with epilepsy as this helps manage stress and fatigue levels.

What can you do to help?

  • Encourage the older person to write lists for tasks e.g. shopping lists.
  • Put up reminder note boards or calendars.
  • Label cupboards and drawers to assist with remembering what is inside them.
  • Keep a regular routine for people you are supporting.
  •  Arrange the environment so that important items are easily visible and kept in the same locations.
  • Use dosette boxes or dose administration aids (DDA) packaged by the pharmacy in either a unit dose or a multi-dose pack for medications.
  • Encourage the older person to do mental exercises and challenge the brain.

Where to go for further information:

Download the Memory and Epilepsy PDF

Victorian Government, Better Health Channel www.betterhealth.vic.gov.au Search: Healthy mind and older people

Epilepsy Society UK www.epilepsysociety.org.uk Search: Memory

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This information is part of a suite of resources that are targeted to aged care workers and carers of older people, to assist with caring for older people living with epilepsy.

The information contained in this publication provides general information about epilepsy. It does not provide specific advice. Specific health and medical advice should always be obtained from an appropriately qualified health professional.

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Risk And Epilepsy

When looking at strategies to reduce risk and improve safety for an older person living with epilepsy there are a number of things to consider.
A home or aged care facility safety assessment can be performed by a registered Occupational Therapist who can make recommendations to ensure the person’s safety and reduce risk.

Risk and epilepsy in the later years

Managing risk is about identifying negative seizure or medication impacts and putting in place strategies to manage them.

Depending on the seizure type there may also be a number of safety issues which need to be considered, they could include always swimming with a companion, having on-call or in-house support overnight and the need for support with commuting.

What does this mean for the older person?

Managing risk is an important part of the epilepsy management process. The first step in managing risk is identifying the risk factors that apply to each person. Just as each person’s epilepsy presentation is different, each person’s risk assessment will determine different risks to be managed.

For the older person the level of risk and what supports they will need to manage the risk will depend on a number of factors. Does the older person:

  • live independently in their own home with a partner or family?
  • live independently in their own home alone?
  • live independently in their own home alone with carer support visits?
  • live in a supported care environment e.g. aged care facility?

The degree of independence and support available to the older person has a direct impact on the risk associated to an activity. Living independently and alone for example creates a higher level of risk in the home as compared with living within an aged care facility where risk is managed as a matter of course.

When managing risks it is important to look at strategies that will either remove the risk e.g. do not participate in an identified risky activity, or reduce the risk e.g. participate with appropriate protection or support.

Risk management considerations:

  • Living independently and alone carries risk if no one can enter the house to assist when needed; key-locks provide entry to the home in the event of an emergency. Regular visits by family and/or friends also reduces isolation.
  • Floor surfaces can present trip or slip hazards; minimise surface clutter and ensure there are no loose floor coverings.
  • Bed pillows present a suffocation risk for night seizures; firm pillows or antisuffocation pillows are safer to use.
  • Falls present a risk of hitting furniture or items in the home; limiting clutter within the home reduces the risk of injury in the event of a fall.
  • Remove the risk of injury by avoiding working or walking on ladders and ledges.
  • Reduce the risk of drowning, should you have a seizure while swimming by always swim with a companion.
  • Reduce the risk of head injury by wearing a helmet when there is ongoing seizure activity resulting in falls.
  • Reduce the risk of falls when shopping or engaging in community activities by being aware of the immediate environment, keeping hands free as a support or having a companion.

Bathing carries additional risks for older people with epilepsy, consider:

  • bathroom and toilet doors that open outward rather than inward, which can be opened in case of a fall or install safety/lift off hinges.
  • using a shower which is safer than a bath, as it reduces the risk of drowning should a seizure occur.
  • using a shower chair which is safer than standing in a shower, to reduce the risk of falling.
  • attaching a shower head/rose to a bath tap and taking a shower sitting down with the bath plug out, which is safer than a bath.

Kitchens can present many hazards due to flame, heat, sharp knives and wet surfaces. Consider the use of a microwave instead of the stovetop and a food processor rather than a knife to reduce risks associated with seizures that involve involuntary movements or falls.

Take care with floor surfaces in wet areas to minimise the risk of slipping or tripping.

Driving and travelling carry additional risks for older people with epilepsy. Refer Information Page – Travelling and epilepsy.

What can you do to help?

Consider the following strategies to support an older person manage the risk associated with their epilepsy and seizure activity:

  • Control any potential risks by ensuring that all support staff and carers understand the impacts of epilepsy and are trained in reading and understanding the person’s Epilepsy Management Plan (EMP). Additionally, ensure all support staff and carers are trained in seizure first aid and administration of emergency medication as required by the individual.
  • Ensure the older person has regular visits from family/friends if living independently or alone which will also reduce risk of isolation.
  • Support the person to complete an Epilepsy Wellbeing MapTM (see the link below) which will assist in identifying individual risks.
  • Support the person to complete a Personal risk register on the next page which will assist in identifying strategies to manage risks.
  • Support the older person to assess whether additional carer support or access to personal alerts or alarms would be of benefit during identified high risk activities e.g. sleep, swimming
  • Ensure there is an observer or swimming companion trained in seizure first aid to support the older person when swimming.

Where to go for further information:

Download the Risk and Epilepsy PDF

Epilepsy Wellbeing Mapping Tool www.epilepsywellbeing.com.au

Victorian Government, Department of Health and Human Services, Seniors Online Victoria www.seniorsonline.vic.gov.au Search: Australia MedicAlert Foundation

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This information is part of a suite of resources that are targeted to aged care workers and carers of older people, to assist with caring for older people living with epilepsy.

The information contained in this publication provides general information about epilepsy. It does not provide specific advice. Specific health and medical advice should always be obtained from an appropriately qualified health professional.

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Self-Esteem And Epilepsy

The fundamentals of selfesteem are developed in childhood and stay with a person throughout their life. A late-onset diagnosis of epilepsy can be upsetting and can cause anxiety in older people impacting their selfesteem.

Self-esteem and epilepsy in the later years

A late-onset diagnosis of epilepsy can have a substantial impact on a person as it changes the known and understood world of the person, a world that has been built over a lifetime of experiences.

Epilepsy differs from other chronic illnesses or age related conditions in its unpredictability. The older person may have no control over the seizure events; this is something that is often very hard for them to come to terms with.

The impact of epilepsy is also different for every person. This can leave the older person living with epilepsy feeling fearful, isolated and not understood, impacting on the way they see themselves and their level of self-esteem, confidence and independence.

Older people with epilepsy experience poorer sleep, decreased mental status and can have a higher prevalence of depression and anxiety. For an older person with low self-esteem these impacts can be intensified.

What does this mean for the older person?

Mental health is very important and an instrumental part of maintaining a healthy self-image. Talking to a doctor and family or friends about what is happening and how living with epilepsy impacts life, is the first step in looking after mental health.

It is important to remember that epilepsy is one of the most common neurological conditions experienced by people today, so an older person living with epilepsy does not have to go it alone.

Self-esteem issues can present as:

  • lack of motivation
  • dependency on assistance to complete normal day to day activities
  • unwillingness to participate in normal known activities
  • risk taking behaviour
  • attention seeking behaviour
  • difficulty forming and maintaining friendships
  • lack of self-care and/or risk of self-harm
  • fear of rejection or judgement by others, concerns over stigmatisation

Concerns about ageing itself are recognised as having psychosocial impacts such as fears about becoming isolated, experiencing loneliness and losing independence which can be present in an older person’s thinking prior to a diagnosis of epilepsy. For older people living with epilepsy the link between concerns about health coupled with managing their epilepsy can compound these psychosocial issues.

People with low self-esteem can experience protracted negative feelings which can exascerbate depression and anxiety and lead to additional feelings of anger, shame or guilt. Understanding this impact is crucial for providing the appropriate supports to an older person.

What can you do to help?

Aged care workers and carers can provide support by encouraging the older person living with epilepsy to discuss their feelings or concerns with those around them.

If an older person with epilepsy has self-esteem issues it may be helpful to follow these steps:

  • Encourage the person to talk about their feelings and concerns.
  • Determine what you can do, empathise with the person, and develop a plan to support them where possible.
  • Seek advice and assistance from appropriate professionals if required.
  • Where self-esteem issues are having a substantial impact on the person, seek training for family and/or friends, aged care workers and carers to build their capacity to support the person.

Where to go for further information:

Victorian Government, Better Health Channel www.betterhealth.vic.gov.au Search: Self esteem

Beyond Blue www.beyondblue.org.au

Relationships Australia www.relationshipsvictoria.com.au

Mental Health Foundation of Australia www.mhfa.org.au

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This information is part of a suite of resources that are targeted to aged care workers and carers of older people, to assist with caring for older people living with epilepsy.

The information contained in this publication provides general information about epilepsy. It does not provide specific advice. Specific health and medical advice should always be obtained from an appropriately qualified health professional.

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Staying Active And Epilepsy

Being active and mentally alert can help with the management of epilepsy. Staying active is also important for overall health and wellbeing.

Staying active and epilepsy in the later years

Staying active and mentally alert is good for mind and body. A healthy lifestyle also helps with the medical management of epilepsy.

A diagnosis of epilepsy does not mean an older person cannot socialise with family or friends or keep doing the recreational activities that they enjoy. People with epilepsy can continue to take an active part in leisure activities, sport and recreation with the right approach to managing risk.

What does this mean for the older person?

An active lifestyle which includes activities that exercise the mind and the body. Activities such as walking, stretching, yoga, Tai Chi, bowls, swimming, and dance can help the older person maintain a good level of fitness.

A 20–30 minute walk every day is an ideal exercise for maintaining a good level of fitness. If this is too much to begin with it can be broken up into two or three 10 minute walks. In an aged care setting this could be a walk around the garden or participation in lifestyle and leisure activities. A good level of fitness improves the chance of maintaining independence, managing health issues and recovery from illness, as well as reducing risk related to epilepsy.

A healthy diet which includes plenty of fruits and vegetables, good quality fats such as avocado and olive oil, staying away from high sugar foods and limiting alcohol intake.

Sufficient fluid intake is an important part of living a healthy and active lifestyle. The body needs the right level of fuel and water to stay active.

The body also needs the right amount of sleep to maintain a healthy body which can engage in an active lifestyle. Older people living with epilepsy report poorer sleep patterns, generally people who exercise regularly and stay active experience better sleep. Managing poor sleep patterns is therefore an important part of achieving an active lifestyle for the older person living with epilepsy.

There are many strategies that can be tried to improve sleep, including:

  • Understanding the internal body clock, everyone is different so it is important to know how much sleep the person requires to function effectively.
  • Making sure the bedroom is conducive to sleep, with light, temperature and noise under control.
  • Being mindful. Reduce mind chatter prior to sleep. Consider relaxation techniques such as meditation or gentle music.

What can you do to help?

As an aged care worker or carer you can support the older person with epilepsy to:

  • understand any risks that may apply
  • complete a pre-exercise screening test
  • find suitable activities to maintain an active lifestyle
  • find appropriate supports so that an active lifestyle can be maintained post epilepsy diagnosis
  • discuss any concerns they may have to engaging in activities post epilepsy diagnosis
  • discuss any concerns they may have about having a seizure while engaging in activities
  • maintain a healthy diet and weight
  • support the person to quit smoking if needed, or refer them to a quit smoking program.

When the activity needs of an older person with epilepsy are understood and supported, an active lifestyle can be achieved, and continue to be enjoyed.

Where to go for further information:

Victorian Government Better Health Channel www.betterhealth.vic.gov.au Search: Physical activity – how to get started, Physical activity for seniors and Sleep hygiene

Australian Government, Department of Health www.health.gov.au Search: Recommendations on physical activity for health for older

Australians Australian Government Quitline www.quitnow.gov.au

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This information is part of a suite of resources that are targeted to aged care workers and carers of older people, to assist with caring for older people living with epilepsy.

The information contained in this publication provides general information about epilepsy. It does not provide specific advice. Specific health and medical advice should always be obtained from an appropriately qualified health professional.

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Travelling And Epilepsy

In some states older people living with epilepsy might be eligible for a discount card for public transport or for taxi services. Contact the appropriate state public transport authority or taxi directorate to obtain more information.

Travelling and epilepsy in the later years

For many older people living with epilepsy, travelling away from the familiarity of home may be a daunting prospect; however for most people, with a little planning, it will be achievable.

A person living with epilepsy or seizures may be eligible to hold a driver licence for private vehicles as long as their seizures are well-controlled.

The ability of a person with epilepsy to hold a driver licence, at any age, depends on the likelihood of them having a seizure while driving and the impact of a seizure on their ability to drive.

What does this mean for the older person?

When travelling or going on holidays

There are a number of measures that can be taken to ensure that time away is enjoyable and safe. Here are some tips to consider before travelling:

  • Medication must be taken at the usual times.
  • Take a doctor’s letter detailing the epilepsy diagnosis, the name of the medications, how much is to be taken and that it is for personal use only, along with a copy of the prescriptions. It is best to keep the medication in its original packaging.
  • Have enough prescriptions to cover the time away from home if travelling within Australia or overseas. If travelling overseas it may be difficult to obtain medication whilst in another country therefore in most cases it will be necessary to take enough medication to cover the entire journey.
  • Pack medications in a clear plastic bag, stored in carry-on luggage. This will reduce the risk of the medications being lost in transit.
  • Be aware of seizure triggers, e.g. jetlag, tiredness, dehydration.

When licensed to drive

Any person who holds a current driver licence and develops any serious or chronic medical condition or disability including epilepsy and seizures, is required by law to report their condition to the relevant state driving authority. The authority will advise whether a medical report is required, if required it must be no more than six months old.

National driving guidelines for assessing fitness to drive outline the different circumstances under which driving may or may not be permitted for people living with epilepsy.

Assessing fitness to drive is managed separately by each state driving authority.

If there have not been any seizures for 12 months since the loss of licence, it may be possible to have the licence reinstated. The frequency of periodic reviews may vary depending on the medical report and the opinion of the state driving authority’s medical advisors.

What can you do to help?

Some ways you can help include:

  • Discuss with the person what to do with their medications while away from home – how much to take and what they need to do to manage their medication while travelling.
  • Encourage the person to visit their doctor for a check up prior to leaving home.
  • Assist the older person in completing the fitness to drive assessment.
  • Provide support for an older person who may be overwhelmed or upset that they can no longer drive – possibly by referral to a counselling service.

Where to go for further information:

Australian Government, Smart traveller www.smartraveller.gov.au Search: Senior travellers

AustRoads www.austroads.com.au Search: Assessing fitness to drive

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This information is part of a suite of resources that are targeted to aged care workers and carers of older people, to assist with caring for older people living with epilepsy.

The information contained in this publication provides general information about epilepsy. It does not provide specific advice. Specific health and medical advice should always be obtained from an appropriately qualified health professional.

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Epilepsy Smart Australia

Phone: 1300 761 487 Email: support@epilepsysmart.org.au
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The Epilepsy Smart Australia program received funding from the Australian Government.