Elderly and Mental Health Needs

Candace Williams, LCSW, Director of Clinician Development, WellQor – Published in WALA September 2019 Vol. 24 No 3

As many as one in five older adults experience mental health issues, the most common of which are anxiety or mood disorders (such as depression). In most cases, these mental health issues respond well to treatment. Sadly, far too often older adults do not seek or receive the help they need. left undiagnosed and untreated, mental health illnesses have serious implications for older adults and their loved ones. That’s why it’s important to understand the signs.

MENTAL HEALTH PROBLEMS ARE NOT A NORMAL PART OF AGING.

Older adults experience many losses. Seniors face the usual array of declining health issues since their bodies no longer work properly. They don’t have as much stamina, they lose their hair or looks (or both), and physical activity becomes more exhausting. All this takes a toll on mental health. Many struggle to cope with the fact that their health is declining.

Losing loved ones with age brings a seemingly never-ending parade of grief. Being forced to move out of their long-time homes and into the apparent isolation of an assisted living facility or nursing home can cause some people to feel they have little left to live for. Deep, lingering sadness may signal clinical depression. Similarly, an anxiety disorder is different from normal worries.

MENTAL HEALTH IS AS IMPORTANT AS PHYSICAL HEALTH.

Good mental health contributes greatly to an overall feeling of well-being. Untreated mental health disorders in older adults can lead to diminished functioning, substance abuse, poor quality of life, and increased mortality. Research shows mental illness can slow healing from physical illnesses.

HEALTHY OLDER ADULTS CAN CONTINUE TO THRIVE, GROW, AND ENJOY LIFE.

Reading, walking, and socializing are just a few of the activities that many individuals enjoy at any age. Exercising one’s mind and body and maintaining social connections are good for one’s mental health.

MENTAL HEALTH PROBLEMS ARE A RISK FOR OLDER ADULTS, REGARDLESS OF THEIR HISTORY.

While some adults manage chronic mental illness throughout their lives, mental health problems can also appear late in life. Sometimes mental health deteriorates in response to a stroke, Parkinson’s disease, cancer, arthritis, diabetes, or even some medications. older adults without a history of substance abuse may abuse medications, alcohol, or drugs. In assisted living facilities, as many as 15 to 20 percent of residents battle mental disorders.

SUICIDE IS A RISK AMONG OLDER ADULTS.

Older adults have the highest suicide rate in the country. Adults ages 85 and older have the highest suicide rate and those ages 75 to 84 have the second highest. In addition, older adult suicide attempts are more lethal. For those 65 and older, there is one suicide for every four attempts compared to one suicide for every 20 attempts for all other age groups. 75 percent of those who committed suicide visited a primary care physician within a month of their suicide.

These symptoms call for consultation with a healthcare professional:

  • Prolonged sadness — sadness that has lasted longer than two weeks
  • Consistent worries about issues such as money, family, and health
  • Consistent trouble sleeping or sleeping more than usual
  • Difficulty concentrating
  • Frequent trouble remembering things or feeling confused in familiar places
  • Consuming more than one alcoholic drink a day or taking more medication than prescribed
  • Energy loss
  • Irritability, anger, or pessimism
  • Mervousness or restlessness
  • Feelings of worthlessness, hopelessness, or helplessness
  • Loss of interest in favorite activities
  • Eating more or less than usual
  • Recurring thoughts of death or suicide

OLDER ADULTS CAN BE HELPED WITH THE SAME SUCCESS AS YOUNGER PEOPLE.

As we age, we often face many of the same difficulties we faced earlier in life, amplified because of the loss of social support (friends and family). Eighty percent of older adults recover from depression after receiving treatment.

OUR HEALTH SYSTEM IS NOT ADEQUATELY HELPING OLDER ADULTS WITH MENTAL DISORDERS

Researchers estimate that up to 63 percent of older adults with mental disorders do not receive the services they need. Senior care, especially mental healthcare, is one of the most ignored issues in America. Society acts as though seniors don’t matter much, and few healthcare and mental healthcare professionals deal with specializations, such as geriatric psychology, that can help senior citizens. Hopefully this group of people will soon receive more attention and focus.

MISDIAGNOSIS AND AVOIDANCE ARE COMMON

If older adults take several medications for a variety of illnesses, drug interactions and side effects can affect mood and behavior.

  • Primary care physicians fail to diagnose depression 50 percent of the time.
  • Only half of older adults who discuss specific mental health problems with physicians receive any treatment.

Depression is sometimes misdiagnosed as dementia — a decline in mental ability that can be caused by Alzheimer’s disease, a stroke, a brain tumor, or other illnesses. People with dementia have problems with at least two brain functions, such as memory and language.

An older adult with depression may exhibit dementia-like symptoms, such as forgetfulness, disorientation, and inattentiveness. This so-called pseudodementia sets in after the person has already shown signs of depression. Someone with depression-related pseudodementia will complain about memory loss, whereas a person with Alzheimer’s disease or another form of dementia will try to conceal memory loss. It’s also not unusual for a person with dementia to develop depression.

OLDER ADULTS HAVE UNIQUE MENTAL HEALTHCARE NEEDS

Changing bodies and chemistry, changes in family and friendships, and changes in living situations all influence mental health and need to be addressed. Sometimes helping solve residents’ basic problems, such as transportation, can lower stress, improve community connections, and improve their outlook and mood.

Left untreated, mental illness can affect individuals’ physical health and quality of life. Ask your loved one or resident if he or she feels sad or anxious. Listen carefully and offer emotional support. Take your residents for evaluation and treatment. Consult a WellQor professional who is trained to recognize and treat mental illnesses in older people.

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