Mental Health

There is a growing population of adults living longer as the population ages. There has been an increased need for Geropsych specialists in order to help fulfill the needs of those older adults ages 65 and older. This information provided gives insight into some of the challenges that older adults face surrounding mental health. This information also points to some ways that we can help older adults with mental health illnesses and concerns.

Interesting Points Related to Mental Health in Late Adulthood

* An estimated 20.4 percent of adults aged 65 and older meet criteria for Mental disorder

* Without brain disease mental health improves with age

* Older adults have a lower prevalence of mental disorders than young and middle age adults

* Many of the more common mental disorders associated with older age such as anxiety and depression can be diagnosed and treated in elderly people just as much as in early adulthood

* Two of the most prevalent disorders of older adults are Dementia and Delirium

* Common Mental Disorders seen in those aged 65 and older includes: depression, anxiety, delirium, and dementia (all described below).

Hutchinson, E.D. (2011). Late Adulthood, Dimensions of Human Behavior, (pp.378-379). Sage Publications

Karel, M. J., Gatz, M., Smyer, M. (2012). Aging and mental health in the decade ahead: What psychologists need to know. American Psychologist. Vol. 67 (184-198)

Depression in Late Adulthood

* The most common mental health concern in older adults in depression and major depression is the leading cause of suicide in late adulthood

* Depression is mostly as a result of having to cope with difficult life events, such a death of a loved one or physical illness

* Depression effects 15 - 20 percent of those in late adulthood

* Symptoms for depression are often overlooked and untreated because they may coincide with other late adulthood problems

* Untreated Depression can often lead to: disability, suicide, premature death, worsen symptoms of other illnesses

* Common Symptoms include:

*persistent sadness

*excessive worries about financial and health problems

*loss of interests

*weight loss

*insomnia

*pacing and fidgeting

*difficulties concentrating

Depression in late life: not a natural part of ageing. (n.d.). Geriatric Mental Health Foundation Retrieved from: http://www.gmhfonline.org/gmhf/consumer/factsheets/depression_latelife.html

Administration on Aging. U.S. Department of Health and Human Services (2013) Retrieved from: http://www.aoa.gov/AoARoot/AoA_Programs/HPW/Behavioral/docs2/Issue%20Brief%206%20Depression%20and%20Anxiety.pdf

Anxiety in Late Adulthood

* Anxiety in late adulthood is similar to that of younger adults

* Anxiety effects 10 - 20 percent of those in late adulthood

* Anxiety is typically an indication of an underlying mental or physical illness

* Anxiety often occurs concurrently with depression

*Anxiety often goes untreated, and has not received as much recognition in geriatric practice

*Untreated anxiety can lead to : depression, decrease in cognitive abilities, worsen symptoms of other illnesses

*Common Symptoms include:

*excessive worrying or fear

*hoarding

*avoiding social situations

*dizziness, tremors

*sweating, palpitations

*depression

*self medication with alcohol and other drug use

Anxiety in older adults. (2009). Geriatric Mental Health Foundation. Retrieved from: http://www.gmhfonline.org/gmhf/consumer/factsheets/anxietyoldradult.html

Administration on Aging. U.S. Department of Health and Human Services (2013) Retrieved from: http://www.aoa.gov/AoARoot/AoA_Programs/HPW/Behavioral/docs2/Issue%20Brief%206%20Depression%20and%20Anxiety.pdf

Ways to treat and reduce Anxiety and Depression in Late Adulthood

*Medication - Medicating should not be used a sole way to treat adults with anxiety and/or depression. Medications used are often antidepressants, beta blockers, and anti-anxiety drugs

*Therapy - Treatments with the inclusion of medication is shown to be effective. Therapy can include speaking with a number of trained professionals such as, psychologists, counselors, or social workers

*Remedies - Adopt stress management techniques, meditation, prayer, deep breathing techniques, and exercising

Administration on Aging. U.S. Department of Health and Human Services (2013) Retrieved from: http://www.aoa.gov/AoARoot/AoA_Programs/HPW/Behavioral/docs2/Issue%20Brief%206%20Depression%20and%20Anxiety.pdf

Anxiety in older adults. (2009). Geriatric Mental Health Foundation. Retrieved from: http://www.gmhfonline.org/gmhf/consumer/factsheets/anxietyoldradult.html

Delirium in Late Adulthood

* One of the two most prevalent cognitive disorders in older adults, which is an impairment in awareness

* Prevalence of delirium is high among hospitalized elderly, affecting an estimated 14-56 percent of older adults

* Delirium is potentially preventable and treatable, but major barriers impact the development of successful treatment

*Barriers to delirium include under recognition of the syndrome and poor understanding of the underlying pathophysiology

Hutchinson, E.D. (2011). Late Adulthood, Dimensions of Human Behavior. Sage Publications

Fong, T. G., Tulebaev, S. R., & Inouye, S. K. (2009). Delirium in elderly adults: diagnosis, prevention and treatment. Nature Reviews. Neurology, 5(4), 210–220. doi:10.1038/nrneurol.2009.24

Dementia in Late Adulthood

*The second most prevalent cognitive disorder among older adults is dementia

*Dementia is an umbrella term describing a variety of diseases and conditions characterized by decline in memory, negative changes in behavior and inability to think clearly

*Dementia can be significantly unrecognized and undiagnosed in many older adults

*People with dementia often suffer from depression, paranoia,and anxiety

*Alzheimer's disease is the leading cause of dementia; 1 in 8 older adults has Alzheimer's disease

Hutchinson, E.D. (2011). Late Adulthood, Dimensions of Human Behavior. Sage Publications

Boyle, D. (2011). Retrieved from Cancer Network: http://www.cancernetwork.com/oncology-nursing/cognitive-impairment-older-adults-cancer

Mental Health Services

Researchers confirm that older adults with mental disorders are less likely than younger and middle aged adults to receive mental health services and when they do, they are less likely to receive them from a mental health specialist (Mental Health Foundation, 2011).

Some Reasons Why Mental Health Services are not Utilized

* Inadequate insurance coverage

* Shortage of trained geriatric mental health providers

* Lack of coordination with primary care, mental health, and aging service providers

* Stigma surrounding mental health

* Denial of problems

* Certain access barriers; such as proximity and transportation

Bartels, S.J., Blow, F.C., Brockmann, L.M., & Van Citters, A.D. (2005). Substance abuse and mental health care among older Americans: The state of the knowledge and future directions. Rockville, MD: WESTA

Ageism and Mental Health in Late Adulthood

* Older patients are viewed by health professionals as “set in their ways”

* Mental Health problems often go unrecognized

* Notions indicate mental health problems are an inevitable part of ageing

* Mental Health interventions should primarily be focused on the working population

Dittman, M. (2003, May). Fighting Ageism. Retrieved from American Psychological Association: http://www.apa.org/monitor/may03/fighting.aspx