The importance of ADHD awareness training

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We decided to have an in-depth discussion about how Attention-Deficit/Hyperactivity Disorder (ADHD) in adults can show cognitive symptoms similar to those seen in dementia.

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This insightful conversation involved professionals from ADHD Scotland, an organisation dedicated to offering psychological assessments for both ADHD and autism, along with Sarah Templeton, founder and owner of Headstuff ADHD Therapy, who has personal experience with ADHD, having been diagnosed herself.

Her insights and experiences make her a valuable voice in the conversation about ADHD and dementia having overlapping symptoms.

Dr Emma Field shares her valuable insights

Dr Emma Field shares her valuable insights to equip care providers with the knowledge they need to support older adults in navigating the challenges associated with ADHD.

Individuals with ADHD exhibit a range of symptoms, from the predominantly inattentive presentation type, characterised by difficulties concentrating on tasks they find uninteresting, to hyperfocus on tasks or topics of interest, daydreaming, and forgetfulness.

The combined presentation type includes the symptoms above as well as more noticeable behaviours such as interrupting others, excessive talking, impulsivity, and hyperactivity.

Research shows that while symptoms may change as individuals age, those diagnosed with ADHD in childhood often continue to experience the effects of the condition in adulthood.

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Care providers need to know that ADHD was not a recognised diagnosis during the childhood of today's older adults who are in their 70s and 80s. This means that many individuals from this generation may have shown symptoms associated with ADHD but were never evaluated or treated for the condition.

Clinicians are only now starting to experience a steady increase in requests for ADHD testing from older adults who grew up in the 1940s, 1950s, and 1960s. Many people with the condition may not even know they have it!

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What does ADHD look like in older adults, and what symptoms should care providers look out for?

As individuals age, the hyperactive tendencies commonly associated with ADHD tend to diminish; however, challenges with inattentiveness often continue throughout a person's life.

Various life changes can exacerbate ADHD symptoms significantly, especially when combined with cognitive decline that occurs with ageing, a decrease in physical health, and the absence of the structured daily routines that often come with retirement. Additionally, factors such as lack of exercise, poor diet, sleep deprivation, and hormonal shifts can worsen ADHD symptoms.

Recognising the factors that hinder residents from effectively managing their ADHD symptoms is vital for developing targeted interventions.

By understanding both the internal challenges—such as lack of knowledge about ADHD management techniques—and external obstacles—like insufficient access to resources and support— care providers can devise a comprehensive plan to assist residents.

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This might involve providing educational workshops, getting care staff to undertake ADHD training, enhancing access to mental health services, or creating supportive community environments.

A thorough assessment of these barriers will lead to more personalised and effective strategies for improving residents' overall wellbeing.

Typically, an older individual with ADHD may present in similar ways to dementia patients, displaying:

A capacity for remembering events from a long time ago but unable to remember instructions given five minutes ago or appointments they have that day,
Constantly misplacing items due to a lack of attention and a busy brain, not noticing where items are placed,
Talking excessively, as if needing to 'get things out' sometimes with little awareness and often interrupting,
Trouble following conversations, usually waiting to disgorge their thoughts but unable to listen to others and take turns in conversations,
Difficulty with working memory (the memory for holding short-term items, such as 2/3 items of shopping needed)
Difficulty learning new procedures, but better if shown again and again,
Feeling fondly towards others but not contacting them,
Difficulty keeping their personal items in order,
Walking into a room and forgetting why they are there,
A lifetime of difficulty managing money.

There is no cure for ADHD; symptoms are managed or ignored or tolerated, causing shame, frustration or anger. However, the longer symptoms go undiagnosed, the more impact they can have on a person's life.

For adults, this could be work, relationships and the ability to live effectively. For older adults in a care home, this could be a challenge in maintaining adherence to routines, which is essential for providing stability in a care home setting.

Additionally, social interactions may become more difficult; ADHD can adversely affect social skills, leading to misunderstandings, conflicts, and tension between residents as well as with staff members. These issues can profoundly undermine one's ability to live effectively and harmoniously in a communal living situation.

Evidence also points to a strong impact on a person's self-concept with many comorbidities, such as anxiety, depression, dyslexia and autism.

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Individuals with ADHD can also experience a lifetime of trauma due to others' intolerance of their symptoms and negative reactions, especially if they talk excessively and interrupt.

ADHD misdiagnosis

A significant concern for both care home residents and clinicians is the misdiagnosis of ADHD symptoms in older adults. The symptoms of ADHD in older adults, which also coexist with other disorders, can mimic those of other age-related conditions, such as mild cognitive impairment or dementia. This overlap can lead to misdiagnosis and ineffective treatment.

Consequently, older adults may not receive the appropriate diagnosis and support for ADHD, which can adversely affect their quality of life and overall functioning. Care providers must understand how ADHD symptoms can present differently in older individuals to ensure accurate diagnosis and effective treatment.

Sarah Templeton, who specialises in ADHD, having been diagnosed herself, says:

''I firmly believed I was showing signs of dementia in my early 50s. I spoke to a psychiatrist about it, and he had to assure me that it was ADHD, which I didn't believe at the time.

I felt my memory was deteriorating significantly. My memory had always been quite erratic; some things I could recall, while others I had forgotten entirely. This was highlighted one day when somebody walked into my office and asked me, "How was last night?"

I stood there rooted to the spot, not having a clue what I had done the night before. She looked at me with raised eyebrows and said incredulously, "The Bon Jovi concert?" Everything about the previous night's concert slotted into my brain at that point, but I could not recall it. I remember vividly telling a psychiatrist this and being so concerned that I was losing my mind.

I think memory loss was, for me, one of the biggest indicators of potential dementia, and it was a huge relief to know that I had ADHD, which had probably worsened during menopause - and I was diagnosed mid-menopause.

I believe that it is quite common for individuals in their 50s and older to perceive worsening symptoms of ADHD as potential signs of dementia.

This misinterpretation often stems from various factors, including hormonal changes that can accompany ageing and significant life transitions, such as retirement or changes in family dynamics, which Emma previously mentioned''.

Person Centred Software's ADHD training for care professionals

Understanding ADHD is crucial for care professionals, especially when working with older adults who may be affected by this condition. ADHD can sometimes be overlooked in older adults, as symptoms might be mistaken for normal ageing or other health issues.

Care professionals must recognise the various signs and symptoms of ADHD, as these can significantly impact the quality of life for individuals. Furthermore, knowing how to support and care for individuals living with ADHD involves implementing tailored strategies.

Our Mandatory and compliance training provides a range of courses specifically designed for care professionals. Among these, we offer an in-depth course on ADHD, which covers essential topics such as:

Types and symptoms of ADHD
Causes of ADHD
Assessment and diagnosis of ADHD
Medical treatments
Related conditions
Supporting someone with ADHD

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By being knowledgeable about ADHD and undergoing proper training, care professionals can foster a more supportive environment for individuals facing the challenges associated with ADHD, enhance the quality of care, and improve the overall wellbeing of those they serve.

About ADHD Scotland

Maurice Finn, the director of ADHD Scotland, works closely with Dr Emma Field, also a director at ADHD Scotland and brings a wealth of experience as a counselling psychologist. Together, they support individuals with various neurodivergent conditions, including ADHD and Autism Spectrum Disorder. Their focus is on helping individuals recognise and harness their unique abilities while offering therapeutic options and coaching services designed to support those affected by these conditions.

Maurice and Emma are particularly passionate about running a monthly peer support group for adults with ADHD, providing a safe environment for sharing experiences and learning from each other.

If you suspect that a resident may benefit from an ADHD assessment or need additional support, reach out to ADHD Scotland for expert assistance. They can provide the guidance and resources necessary to help.

About Sarah Templeton

Sarah Templeton is the founder and owner of Headstuff ADHD Therapy, a dedicated practice that provides highly qualified (ADHD-diagnosed) counsellors and coaches for children, adolescents and adults living with ADHD. Sarah, who is herself diagnosed with ADHD, is a notable author specialising in ADHD, as well as an experienced therapist.

In addition to Sarah's work as a therapist and author, Sarah actively participates in the All-Party Parliamentary Group (APPG) for ADHD at the Houses of Parliament, where she advocates for policy changes and increased awareness surrounding ADHD issues.

If you suspect that a resident may benefit from an ADHD assessment or need additional support, you can also contact Headstuff ADHD Therapy for expert assistance.

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The importance of ADHD awareness training

Dr Emma Field shares her valuable insights