As the world's population of seniors rapidly grows, the need for effective care and treatment for geriatric mental health conditions is quickly growing with it. The number of adults over 60 years old is expected to nearly double by 2050, from about 900 million people to approximately 2 billion. By that same time, the population of older adults over the age of 85 is expected to triple.
While some changes to health and lifestyle are a normal part of aging, mental or neurological conditions in older people are under-diagnosed, and many seniors are not able or willing to identify mental health problems due to the stigma surrounding them.
As about 1 in 4 older adults experience mental health issues, attention to the special needs of elderly patients is more crucial than ever.
Geriatric Neurological Disorders
While many issues occur naturally as part of the aging process, mental illness is not something that should impact every elderly patient. According to the National Institute of Mental Health, younger adults are more likely to suffer from mental health disorders. Unfortunately, mental disorders are often missed or overlooked in senior patients, as they are less likely to seek help or diagnosis. More than 20% of senior patients ages 60 and above are living with a mental illness of some kind.
Some of the most common mental health problems faced by this age group are depression, impacting about 7% of all adults over 60, followed closely by dementia which impacts approximately 5% of older adults. According to the Alzheimer's Association, nearly 10% of people over the age of 65 (5 million people) have Alzheimer's disease.
Anxiety disorders also are seen in about 3.8% of the senior population. Substance abuse issues also impact about 1% of the world population over 60 years old, though many substance issues are often overlooked. These and other mood related disorders are even more common in older adults who are homebound or are otherwise unable to care for themselves.
Dementia and Alzheimer's Disease
An umbrella term often used to refer to a syndrome or even multiple chronic conditions, dementia results in a deterioration of memory and severe cognitive impairment. While dementia mainly impacts older adults, it is not a natural part of healthy aging. There are many different causes that can lead to dementia in seniors by causing damage to brain cells or the connections between them.
Worldwide, about 50 million people are currently living with dementia, and the number is expected to reach 82 million by the end of the decade, as well as nearly doubling by 2050. The symptoms of dementia can often make it difficult for patients to live without carers, which often comes with many financial and emotional burdens for the patient's family. Some of the more common symptoms of dementia are:
- Difficulty with problem-solving and reasoning
- Memory loss
- Personality changes
- Anxiety, paranoia, irritability
- Confusion and disorientation
One of the diseases most likely to cause dementia is Alzheimer's disease, which accounts for up to 70% of dementia cases. Alzheimer's also often comes with changes to the patient's personality, concentration, and memory. As patients are often less aware of their surroundings and can have trouble remembering the people they see regularly, sudden shifts to the mood and general paranoia and distrust of others is common.
Impacting almost 10% of adults over 60, depression can severely impair the daily life of elderly patients. It is often underdiagnosed by doctors and underreported by patients, since symptoms can often overlap with other common issues faced by older adults.
Due to the significant problems with daily functioning that depression can cause for seniors, depression can be more detrimental than some chronic medical conditions such as diabetes or lung disease. Those with depressive symptoms are less likely to seek help, and their health may visibly deteriorate more quickly as a result. Some signs that an elderly patient is suffering from depression are:
- Sleep changes like hyper- and hyposomnia
- Difficulty concentration
- Patient seems emotionally flat or has difficulty feeling positive emotions
- Changes in energy and appetite
- Mood changes such as increased anger, stress, restlessness, and sadness
- Suicidal thoughts or ideation
- Drug and alcohol abuse
- Sense of hopelessness
- Sudden changes in behavior such as self-isolating
Ways to Address Geriatric Mental Health Issues
Dealing with mental issues in older adults, especially chronic or permanent disorders, requires a lot of attention. Health providers and family members need to do a lot of work to meet the particular needs of this population. Training that is specific to geriatric patients is needed, including training to better catch or manage mental or neurological disorders before they cause irreparable damage.
Services that are designed specifically for older patients with mental issues must be developed, and policy changes may also be needed, especially as this population continues to rapidly grow.
Intervention and Confrontation
One of the most essential pieces of properly caring for many older adults with mental health problems or substance abuse issues is intervention as soon as symptoms are noticed. While many neurological issues that older adults face have no cure, diagnosing early and seeking treatment immediately can significantly improve the quality of life for the patient.
Conditions can significantly deteriorate if ignored or not addressed properly, and confronting the issues as soon as possible can make them easier to manage for both patients and their families. Early intervention can also help families and health professionals identify concurrent physical health issues or behavioral changes that can make managing mental conditions more challenging.
Social Well Being
Since older adults more regularly live with social isolation, proper care must include a social and community-minded approach (especially for those with mental or neurological disorders). Ensuring that older people are able to have consistent social interaction, and not exclusively with other seniors, can have a very positive impact on the progression or severity of some mental health problems.
Promoting Health Aging
Going hand-in-hand with promoting social engagement within a patient's community, health promotion for older people can allow you to foster an environment in which a patient's wellbeing is better supported. Ensuring that older patients have their needs met can help to improve or otherwise promote their mental health.
Ensuring that geriatric patients have safe and secure housing, as well as freedom to come and go at will, already makes a massive positive difference in a patient's sense of self and confidence. Regular visits with family and friends, as well as engaging in community events, can be crucial. Policies and programs that provide support for housing and care professionals are incredibly helpful in maintaining a patient's mental health.
Ways You Can Help
If you have begun to suspect that your loved one's mental health is declining or are concerned about significant changes in their behavior, there are several ways you can approach the issue. The first and most important way that you can confront your concerns is by speaking to the loved one you are worried about.
Try to learn more from them about how they are feeling, whether they are dealing with any undue stress or anxiety, or even exhaustion and depression. This can often ease your mind in cases where underlying mental health disorders are not at play and can also help you quickly identify cases where they are.
If your loved one is taking medications, especially ones that have been recently prescribed, do some research about the medications and potential interactions. Ask a geriatric pharmacist, as they specialize in providing medications for older adults and would likely have helpful information for you. Sudden changes in energy and mood can often be related to newly prescribed medications.
If you have spoken with your loved one and are concerned about their mental health, the best thing you can do is bring up the issues to your loved one's doctor or psychiatrist, or seek out evaluations and tests that can help to determine or rule out problems. These professionals will often have the best information available to you, and can help you make difficult decisions in providing adequate care.
Managing Geriatric Mental Illness
Ensuring proper care is available for geriatric patients can be incredibly difficult and cost-prohibitive. Once you have a diagnosis, it is crucial to examine how much care you and other family members may be able to provide, and what areas you may need additional support for.
Geriatric care facilities may be better equipped to handle the intricate issues that come up when managing mental and neurological issues in older adults. If possible, providing in-home care is preferable as being in a familiar environment in which the patient feels like more of an authority figure can make a major difference in the progression of their illness.
Keystone Health specializes in geriatric care for patients in Idaho. In addition to primary care options, Keystone offers treatment and support for patients with dementia and Alzheimer's, and chronic care management for patients with multiple chronic or permanent conditions. In-home health care options are available for patients who need it. Click here to learn more about how Keystone can help your loved one.