By the year 2030, one in five Americans will be 65 years or older. The demographic of those aged 80 and older is growing faster than any other age group [1]. There is also a prevailing stereotype of older adults as dependent, depressed, and possibly demented [1].

Taking into consideration this stereotype of the aging population, is there a case to address their mental wellness in addition to the population’s huge demand for basic medical services?

Assumptions About Older Adults

Let’s take my parents, for example: They are in their 80s and 90s. Objectively speaking, one could say that they aren’t engaged as much with either society or their family. Their daily routines are filled with doctor visits, prescription refills, and watching their favorite TV programs. Because they live seemingly stress-free lives, it appears that physical medical services might be all they need.

Two assumptions might be derived from observing people like my parents:

Assumption #1:

Aging people have less mental health challenges due to what appears to be a stress-free world that they live in.

Assumption #2:

From an unemotional and utilitarian point of view, the aging population might not contribute as much to society, so would it be a wise investment of psychological or psychiatric resources to help them?

Older Adults & Mental Health: The Facts

These seemingly valid thoughts can be countered with some sobering statistics. A few points from a recent article show a clearer picture of the aging population [2]:

  • Older adults have the highest suicide rate in the Western world [4]. Those aged 85 and over have the highest suicide rate; the slightly younger cohort (ages 75 to 84) have the second-highest suicide rate, where one in four suicide attempts are successful.
  • Mental health issues compound the high cost of physical illness. Older adults with a mental disorder experience a weakened response to medical treatment.
  • Research shows mental illness slows healing from physical illnesses. A plethora of research indicates that poor mental health can inhibit a person’s recovery from stroke, Parkinson’s disease, cancer, arthritis, and diabetes. Without intervention, older adults’ mental health issues can lead to an increased consumption of illegal substances, alcohol, or medications [5].
  • Mental health issues are not necessarily a natural outcome of aging, though older adults can experience more personal losses and lingering sadness from bereavement can signify clinical depression. One in five older adults experiences mental health challenges – such as depression and anxiety – that are not a normal outcome of aging [5].
  • In addition to their mental health issues being undiagnosed or underdiagnosed, older adults often do not seek help for their mental health, which can leave them untreated.

Data show that over 60 percent of older adults do not receive the services they need when they develop a mental disorder [2].

Sadly, as high as three-quarters of older adults who attempt suicide are seen by a primary care physician (PCP) less than a month before the attempt. About half of older adults receive mental health treatment after discussing specific issues with a PCP, and the PCP fails to diagnose depression half of the time. The lack of awareness or failure to diagnose mental illness is far more common than one would expect [2].

Untreated mental health disorders in older adults can lead to diminished functioning, frequent doctor’s visits, increased usage of emergency services, substance abuse, poorer quality of life, and possibly increased mortality [3].

However, good mental health significantly contributes to an overall feeling of well-being. Healthy older adults can continue to thrive, contribute to society, grow, and enjoy life!

Addressing the Challenges Older Adults Face

Currently, our health system presents barriers to older adults with mental disorders. For example, on average, while Medicare covers roughly 80% of a physical health problem, it only covers only 50% of a mental health problem [2]. This is a systemic barrier to adequate mental health treatment for many older people.

In addition, older adults don’t live in a stress-free world. Being older can actually bring about unique stresses due to vulnerability to illness, injuries, and mental health problems. From a medical cost perspective, there is plenty of justification for giving closer attention to this rapidly growing population.

More resources dedicated to the research and education of gerontology are needed than just a required course in graduate school. How effectively our medical system can respond to a rapidly aging population’s mental health needs will be determined by our continued focus and renewed efforts to examine the multifaceted complexity of longevity and quality of life.

Those who are currently devoting their energy and vigor to improving the lives of older adults will also likely be the benefactors in the future, as one day they, too, will reach the same milestone.

Aside from affording better access to mental health services, there are opportunities in which quality of life for the elderly can be improved even without traditional psychotherapy or outpatient intervention.

If an older adult has both the time and the physical capability, he or she can thrive by engaging in volunteering opportunities, which can help to improve their mental health by giving both purpose and meaning to their lives. Volunteering at an animal adoption center, training service animals for a hospital care team, teaching English as Second Language (ESL) to immigrants, reading books to children at a local library, or teaching exercise classes are a few of the many ways to accomplish those goals.

Lowering stress is another effective way to prevent mental health decline in older adults. For example, reducing their isolation by connecting them with visitors, improving their physical access to methods of transportation (e.g., Dial-a-Ride), and enhancing their problem-solving resources (e.g., finding a reliable handyman to fix things at home) are simple ways to help older adults accomplish their daily living tasks and to facilitate their needs for socialization.

The Unique Challenge

Older adults have unique mental health care needs that set them apart from the needs of other age groups.

They face both physical and mental declines in areas such as strength, reflexes, and memory. Many suffer symptoms of aging that are comorbid with symptoms of other afflictions, such as chronic illnesses or injuries, and some are even faced with lingering past injuries and illnesses. Many are prescribed multiple medications for a variety of illnesses from many different healthcare providers, where complex drug interactions and side effects can compound and affect mood, behavior, and overall health.

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With a rapidly growing population of older adults and their vast medical needs, there is a compelling case to better address this population’s mental health.

By increasing the focus, attention, and dedication to this issue today, we can more quickly and effectively expand our social resources to offer both preventative and interventive measures for the older adult population.

After all, this population might currently include your parents or grandparents, whom you love and cherish, or depending on your stage of life, you may fall into this age group right now.

But inevitably, as long as we move on in life and age, we will all eventually (and hopefully) be older adults, who, just like any other people, hope to receive the attention, the love, and the care needed to enjoy our lives.

References

[1] Zarit, S. H., & Zarit, J. M. (2007). Mental disorders in older adults: Fundamentals of assessment and treatment. New York: Guilford Press.

[2] From “Ten Facts About Mental Health and Aging.” (2010), Older Women’s League (OWL); 1-800-825-3695; www.owl-national.org. http://www.lifeseniorservices.org/seniorline/10_Facts_About_Mental_Health_and_Aging.asp

[3] From “Mental health and older adults.” (2016), World Health Organization (WHO); http://www.who.int/mediacentre/factsheets/fs381/en/

[4] Barlow, D. H., & Durand, V. M. (1995). Abnormal psychology: An integrative approach. Pacific Grove, Calif: Brooks/Cole Pub. Co.

[5] Comer, R. J. (2004). Abnormal psychology. New York: Worth Publishers.

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Dr. Phillip Lowe

Dr. Phillip Lowe

Dr. Phillip Lowe is a licensed psychologist. He completed his doctoral degree in clinical psychology (PsyD) at Fuller School of Psychology. He studied Marital and Family Therapy (MFT) and also received his Bachelor and Master degrees in Electrical Engineering at UCLA. He has been involved in geriatric mental health, family and individual counseling, and radio programs during the past few years. He has conducted numerous workshops on marital enrichment, manhood, and personal growth conferences in the past.
Dr. Phillip Lowe

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