23 Aug How to Better Serve the Underserved: Special Considerations for Older Adults

Part Six in a Series

Within the United States, it’s an undeniable reality that within two decades, older adults will outnumber young children for the first time in our nation’s recorded history. As of 2018, there were more than 52 million adults aged 65 and over. By 2060, that number will double.

Although ongoing advancements in technology and medicine have significant positive impacts on quality of life, older American adults still face challenges as they age. This has far-reaching consequences for almost every aspect of American life. Without special consideration, it is difficult to offer older Americans the behavioral and mental health care that they deserve.

With more than 20% of Americans aged 55 and older experiencing at least one mental health concern, we cannot wait to implement new procedures and policies that will help increase access and improve services for them. To serve this population effectively, we must begin by understanding the unique challenges they face.   

Unique Behavioral and Mental Health Challenges Faced by Older Americans

As we age, our risk factors for special mental health issues like dementia, Alzheimer’s disease, anxiety, bipolar disorder, and schizophrenia begin to rise, with depression being the most common. Statistics suggest that roughly 50% of elderly clients report “significant depressive and anxiety symptoms”, in addition to the following challenges:

Physical Disability or Loss of Mobility: Our physical health is inextricably linked to our mental health. As our bodies change, coping with the loss of mobility or additional restrictions to movement can be difficult for some people to bear.

Long-Term Illness: Chronic illness is a significant risk factor for serious mental and behavioral health issues. For example, 25% of people living with diabetes experience depression. Clinicians must thoroughly assess each client, and determine the best course of action to help them cope with symptoms of both physical and mental illness.

Alzheimer’s Disease and Dementia: A diagnosis of Alzheimer’s disease or dementia is life-changing. It’s estimated that up to 50% of people who are diagnosed with these conditions experience serious symptoms of depression, especially in the early stages. However, if clinicians are able to offer accurate diagnoses and effective treatment, it can significantly improve cognitive function.   

Illness or Loss of a Loved One: Even if the client isn’t the person directly affected by illness, the burden of caretaking or grief due to a loss can have a significant impact on their mental health. In some individuals, a sudden loss can trigger psychiatric disorders, even if they had no prior history of mental illness.

Many other changes occur as individuals move into retirement and beyond, which can negatively affect mental health. These include, but are not limited to:

• Chronic pain
• Major life changes like selling the family home
• Medication interactions
• Loneliness
• Alcohol or substance abuse 

 
Successfully Addressing the Challenges that Face Older Clients

Developing an effective treatment plan for older adults requires a thoughtful and holistic approach. With intentional effort, clinicians can address the challenges they face, using some of the following tips.

Be aware of warning signs that are unique to geriatric depression: The warning signs of later-onset depression are easy to categorize as simply a hallmark of aging. It’s normal for people to feel frustrated by changes in their lives, or grief at the death of a loved one. However, when these behaviors become all-consuming, they might be a sign of depression. Some of the most common warning signs are:

• Fatigue and decreased energy
• Irritability or restlessness
• Difficulty concentrating
• Loss of interest in hobbies
• Feelings of hopelessness or pessimism

 
Monitoring these symptoms and providing an accurate diagnosis is a huge help in providing effective treatment.

• Ensure the client is being supported socially: Social interaction and engagement with others is a key component of living a healthy life as we age. If your client is showing symptoms of poor mental health due to isolation, there are many social services that you can connect them with to ensure adequate social support. This is instrumental in lowering risks for both mental and physical illness.
• Organize all their clinical information in one place: Treating a patient effectively requires full knowledge of all their ongoing physical and mental health conditions. A behavioral health EHR can help ensure these details are always accessible to clinicians and available for reference without tedious searching.
• Understand how their demographic background will influence their approach to treatment: Older adults can often be biased towards or against treatment options depending on their history. Many older adults also find it challenging to communicate their emotions clearly, and may have a negative perception of mental health conditions like depression or anxiety, due to internal and external stigma stemming from their social history, race, ethnic background, or even just familial upbringing. Regardless of their history, clinicians must be careful to work within their client’s comfort zone to ensure they are receptive to the treatment options provided. 

 
Additional Resources

Working with older adults requires clinicians to think about each client as a whole, including their physical health, social life, and so much more. To learn more, you can find additional resources here: 

National Council on Aging: Behavioral Health Programs for Older Adults

Eldercare Locator for Behavioral Health

National Institute of Aging: Depression and Older Adults

Geriatric Mental Health Foundation: Resources for Clinicians