G. Stoppe, Switzerland

MentAge Practice-Counsel-Research
G.S. grew up in Northern Germany, studied medicine at the University of Giessen, further training as a specialist in neurology and psychiatry at the Inselspital Bern, the Nordstadt Hospital and the Medical School in Hanover. 1990-2003 Department of Psychiatry at the Medical Faculty of the University of Göttingen. Established a memory clinic there, habilitation on imaging techniques and dementia, management duties. 2003 Transfer to the University of Basel, Head of the Department of General Psychiatry at the University Psychiatric Clinics. Involved in the development of new teaching models. 2013 Change to outpatient care and founding of MentAge, a specialist facility for the treatment of mental disorders in older age. Increasing commitment to mentally ill elderly people, nationally and internationally. Chair of the EPA-Section of Old Age Psychiatry.

Moderator Of 5 Sessions

Clinical/Therapeutic
Date
Mon, 12.04.2021
Session Time
17:30 - 19:00
Room
Channel 7
Session Description
The Live Q&A of this session will take place in the Live Sessions auditorium. Please refer to the interactive programme for the exact time and channel.

Proposed by the EPA section on Old Age Psychiatry -The COVID 19 pandemic quickly showed that the older population is a risk group with particular vulnerability. This was particularly true for patients with dementia. They had difficulty understanding the situation, observing distance rules and using masks appropriately. The situation is particularly difficult in nursing homes. In many countries the visit of relatives and also doctors in nursing homes has been banned. Nevertheless, the proportion of people who died in these institutions was high in all countries, for example in Germany up to one third of deaths. What consequences this has and has had for nursing homes, relatives, dementia patients and the people caring for them is to be discussed in greater depth in this symposium, with particular attention being paid to ethical aspects. It will also be discussed which preventive measures can be derived for the future.

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Pre-Recorded with Live Q&A, Section
EPA Course
Date
Sun, 11.04.2021
Session Time
08:00 - 10:00
Room
Courses Hall A
Session Description
Proposed by the EPA Section on Old Age Psychiatry - Depression is the most frequent mental disorder also in the elderly population and it is soften unrecognized and untreated. Compared to other age groups, there are differences in risk factors, symptomatology, comorbidity, differential diagnosis and management. In the course epidemiology and risk factors will be presented. Diagnosis will be discussed with special focus on the differential diagnosis to grief, dementia and anxiety disorders. Sleep problems and suicidality will deserve special attention. Regarding therapy relevant modifications of drug therapy and psychological therapies will be presented. The different types of psychotherapy for elderly (schema based therapy, psychodynamic psychotherapy, cognitive behavioral therapy) will be discussed. We also discuss neuromodulation therapies, ECT, and exercise. The management in the presence of physical disability or in special settings requires tailored interventions. Case vignettes regarding diagnosis and therapy are discussed.
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Live, Section, Ticket Required
Oral Communication QA

Suicidology and Suicide Prevention

Date
Tue, 13.04.2021
Session Time
17:30 - 18:00
Room
Chatroom
Clinical/Therapeutic
Date
Tue, 13.04.2021
Session Time
10:00 - 11:30
Room
Channel 6
Session Description
The Live Q&A of this session will take place in the Live Sessions auditorium. Please refer to the interactive programme for the exact time and channel.

Proposed by the EPA sections on Psychopharmacology and Old Age Psychiatry-According to the data, more than 50% of elderly patients with mental disorders are treated with multiple drugs (e.g. 5 or more medications), which can lead to medically unnecessary polypharmacy (i.e., irrational polypharmacy). Due to frequent comorbidities and treatments in the elderly, polypharmacy is the rule rather than the exception and can lead to several harms, treatment failures, and inappropriate prescribing. Elderly patients on polypharmacy (rational and irrational) are also excluded from many clinical trials and consequently, this age group is underrepresented in meta-analyses and clinical guidelines as well, which leads to a lack of evidence-based medicine supported results useful for daily practice. In this context, the prudent deprescribing process is a key step in irrational polypharmacy reduction. The purpose of deprescribing is to reduce inappropriate polypharmacy, medication burden and harm, and to improve patient health-related outcomes. There are some tools available that can help in the deprescribing process in clinical practice, including different medication lists (e.g. Beers criteria, STOPP/START, and guidelines). This proposed joint workshop of the Section of Old Age Psychiatry and the Section of Psychopharmacology will address a neglected topic: why and when to use the deprescribing process of psychotropics in elderly patients in real clinical settings. Experts in psychiatry and psychopharmacology will specifically address the use of the deprescribing process of antidepressants, antipsychotics, hypnotics, and other psychotropics in this population. The participants will learn why is important to use deprescribing processes supported by evidence-based data and real clinical pharmacological tools useful for daily practice.

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Pre-Recorded with Live Q&A, Section
Educational
Date
Mon, 12.04.2021
Session Time
08:00 - 09:30
Room
Channel 4
Session Description
The Live Q&A of this session will take place in the Live Sessions auditorium. Please refer to the interactive programme for the exact time and channel.

Proposed by the EPA sections on Old Age Psychiatry and Suicidology and Suicide Prevention -At advanced age, rates of males diverge even more from those of females. A better understanding of these factors may reduce the toll of suicide at these extreme ages as Prof. de Leo is going to discuss. Prof. Zeppegno will focus on the even twofold rate of suicidal behaviours when there is a chronic or terminal illness. Psychiatrists and geriatricians will likely meet mentally competent older adults expressing a wish to die: sometimes entangled with e.g.chronic illness, sometimes in the absence of terminal illness, but due to the feeling that they have already lived a completed life. The possibility of a "rational suicide" will be discussed. Prof. Stek is going to discuss the problem that in late life depression the clinical management of suicidality is often complicated by the presence of physical and neuropsychiatric comorbidity. Moreover, in The Netherlands the position of euthanasia in end of life choices may interfere with available diagnostic and treatment options. The challenges of well substanciated decision making in these situations will be discussed. Although interventions for suicide prevention are known, their relative effect for the elderly in general have not been explored. Prof. van der Feltz-Cornelis will discuss in her lecture what could be aspects of relevance for interventions in this specific age group. And finally Prof. Hegerl will show – at the example of a recent increase in gassing suicides – which role the media and especially the internet plays for the methods of suicide and what it could mean for suicide prevention.

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Pre-Recorded with Live Q&A, Section

Presenter Of 6 Presentations

Workshop: Medication Deprescribing in Elderly Patients with Mental Disorders: Why, When, and How? (ID 273) No Topic Needed

Live Q&A

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Pre-Recorded with Live Q&A, Section
Date
Tue, 13.04.2021
Session Time
10:00 - 11:30
Room
Channel 6
Lecture Time
11:08 - 11:28
Workshop: (Assisted) Suicide in the Elderly (ID 347) No Topic Needed

Live Q&A

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Pre-Recorded with Live Q&A, Section
Date
Mon, 12.04.2021
Session Time
08:00 - 09:30
Room
Channel 4
Lecture Time
08:56 - 09:30
Symposium: COVID-19 Pandemia and the Demented Patients in Nursing Homes (ID 348) No Topic Needed

Live Q&A

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Pre-Recorded with Live Q&A, Section
Date
Mon, 12.04.2021
Session Time
17:30 - 19:00
Room
Channel 7
Lecture Time
18:38 - 18:58
Course 09: Depression in Old Age: State of the Art (ID 350) No Topic Needed

Depression in Old Age: State of the Art

Session Icon
Live, Section, Ticket Required
Date
Sun, 11.04.2021
Session Time
08:00 - 10:00
Room
Courses Hall A
Lecture Time
08:00 - 10:00
Symposium: COVID-19 Pandemia and the Demented Patients in Nursing Homes (ID 348) No Topic Needed

S0101 - Dementia and COVID-19 Pandemia: the Situation in Various European Countries

Session Icon
Pre-Recorded with Live Q&A, Section
Date
Mon, 12.04.2021
Session Time
17:30 - 19:00
Room
Channel 7
Lecture Time
17:30 - 17:47

ABSTRACT

Abstract Body

COVID-19 pandemia means a special threat to elderly patients in nursing homes. Dementia sufferers, who make up most of nursing home clients throughout Europe, have been in a critical situation. They bear a higher risk of delirium when affected by the virus. They often do not understand and easily forget, how to use a mask and keep the distance required. In many institutions the elderly were isolated and could not even take their meals together. And finally they do not recognize and even fear nursing staff and other personnel, which has to wear "protective clothes". Caregivers were told not to visit their loved ones any more.
Where available, modern techniques werde used. Skype and/or Zoom, Facetime telephone should replace face to face contacts. Some insitutions offered visitor rooms, where clients and visitors were separated by acrylic windows and microphones were applied. In some areas, physicians' visits were reduced to a minimum.
Just recently, regular testing of staff and clients in nursing homes has been introduced. However, this is consuming staff time, which - again - is taken from the patients. We discuss, whether the elderly and their caregivers could set their own preferences.

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Workshop: Medication Deprescribing in Elderly Patients with Mental Disorders: Why, When, and How? (ID 273) No Topic Needed

W0062 - Deprescribing Process in Demented Patients: What Is the Rationale?

Session Icon
Pre-Recorded with Live Q&A, Section
Date
Tue, 13.04.2021
Session Time
10:00 - 11:30
Room
Channel 6
Lecture Time
10:34 - 10:51

ABSTRACT

Abstract Body

Polypharmacy is rather a rule than an exemption in the elderly. This applies also to the demented population, whether they live in private homes or in nursing homes. The application of multiple drugs increases the risk to develop delirium, to promote falling and to hasten cognitive decline, What can be done to reduce these risks? First of all, drugs should be given on the basis of an appropriate assessment. Pain e.g. may be misunderstood as challenging bevhaviour. Side affects might be misunderstood as newly occuring symptoms. Drugs should be prescribed with a written protocol, what the drug is expected to do. If this does not occur, the drug should be deprescribed. In addition, antidepressants should be deprescribed. Many demented patients receive more than two of them, mostly for years. Depresciption follows the evidence, that antidepressants are not much helpful in dementia. They may induce hyponatriamia, too. The deprescription of benzodiazepines requires patience and a long tapering-out. And overall, what about the antipsychotics? They shall be given at a minimum dosage and duration. That means, that drug pauses should be established regularly. And finally, what about the antibiotics, antihypertensive drugs and more? Having in mind, that severe dementia is mostly a state, where the priniciples of palliative medicine should be applied, also many of these drugs can be deprescribed.

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