Mental Health in Ageing Populations
According to the World Health Organization’s estimates, the number of people aged 60 and above will reach 1.4 billion by the year 2030, “representing one in six people globally.” As we get older, a host of health complications may arise, ranging from frailty to dementia, that can have an impact on our wellbeing. In spite of improving healthcare provisions, these impacts can have resounding adverse effects on our mental health.
It can be difficult to make changes to your lifestyle when health complications arise, and it’s what becomes a risk factor for a decline in one’s mental health. The danger of it is that we might not immediately realise how much of an impact it would have on our loved ones. As a result, mental illnesses such as depression and anxiety can occur and lead to a further decline in not just their mental and emotional wellbeing, but also their physical health.
As a caregiver, it’s very critical that you pay attention to your loved ones’ mental health and find ways to help them through their health journey.
Common Conditions That Affect Seniors
Delirium is a temporary change in a person’s mental state that may occur very quickly and unexpectedly. It commonly occurs during long stays at the hospital or in a nursing home setting, which is usually referred to as “hospital delirium.” It may start within hours or a few days, though some episodes can last for more than a month.
Common symptoms usually involve difficulties in remembering people or events, a lack of awareness of your surroundings, and difficulty speaking or understanding what you’re told. Other symptoms of delirium may vary based on the type of delirium it is. There are three categories of delirium:
- Hyperactive delirium: characterised by restlessness, agitation, confusion, or a sudden change of mood; they may also have vivid hallucinations and cannot distinguish what is real and what isn’t
- Hypoactive delirium: the polar opposite of hyperactive delirium, characterised by inactivity or reduced motor activity, sluggishness, abnormal drowsiness, and constant sleepiness
- Mixed delirium: a combination of hyperactive and hypoactive delirium, where either state may take precedence over the other
A challenge to treating delirium is that it exhibits similar symptoms as dementia, making it easy to confuse it for early warning signs of dementia. However, delirium is a condition that “waxes and wanes” over time, making it tricky to properly diagnose and treat. It still requires prompt treatment, as long-term complications to normal brain functions can lead to new-onset dementia or a gradual/complete loss of independence.
Depression is a mental health issue that causes a mixture of feelings, including sadness, bitterness, anger, and resentment. Depression is a serious condition that needs to be addressed immediately as it can cause long-term health complications and affect how you think and behave. If left untreated, depression can significantly interfere with your daily life.
Depression may be common but it’s not something that should be taken lightly. It’s considered a mental health disorder, caused by a multitude of factors. These factors can arise due to any number of changes you may experience throughout your life, such as moving away from your hometown or the loss of a loved one.
Depression among senior citizens is a major concern, given how they are more prone to the risks of poor health outcomes. Depression can arise from health complications your loved one may be going through; if they feel that they’re not getting better, their worries and fears can eventually transform into depression. Other symptoms such as fatigue, appetite loss, and even difficulty sleeping may either be overlooked or misdiagnosed, further exacerbating their condition.
While it’s normal to feel some anxiety at times, having an anxiety disorder is something else entirely. An anxiety disorder is a mental health condition where you’re constantly feeling afraid or anxious over nearly anything, to the point that it interferes with your daily life. You might also go through physical symptoms of anxiety, like feeling as if your heart is rapidly pounding.
Anxiety happens any time we feel anxious or nervous about particular things in life, such as going for a job interview or making important decisions. It also keeps us safe by making us be cautious before doing certain things, such as when you’re unsure about an email being a possible scam. However, when you have an anxiety disorder, these feelings of fear, dread, or worry are elevated to near-extreme levels, making you feel helpless or even pushing you to avoid certain scenarios at all costs.
There are a number of different types of anxiety disorders, such as generalised anxiety disorder (GAD) – where you constantly feel worried or afraid, even if there’s no reason to be – and social anxiety disorder – where you feel very anxious or self-conscious in social situations.
Schizophrenia is a serious mental disorder where your loved one may suffer from delusions and hallucinations, as well as impaired cognition and even slurred speech. When schizophrenia is “active,” a person is said to be undergoing an episode of psychosis. It can become difficult for them to perceive what is real and what isn’t, and it becomes difficult to communicate with them to help them.
Misconceptions surrounding schizophrenia have only served to deny those with the condition to proper medical treatment that can help ameliorate their condition. There may be no known cure, but modern medicine is able to help those with schizophrenia to live normal lives. While the incidence of “severe psychotic symptoms” does weaken as we get older, symptoms can still occur if you don’t take care of yourself.
Relocation Stress Syndrome
When caregiving arrangements are shared between family members, or if they need to be placed in a nursing home for a periodic duration, some seniors may experience relocation stress syndrome. House-to-house care arrangements can be needed due to various reasons, such as everyone being busy with work and other commitments, but frequently moving your loved one can make it difficult for them to adjust to the constant change of their surroundings.
When your loved one develops relocation stress syndrome, they may start to exhibit signs of stress, anxiety, confusion, and depression, all of which contribute to a decline in their physical, mental and emotional well-being. Loved ones who have existing health complications, such as dementia, are also at greater risk of developing RSS.
Signs to Look Out For
Mental health complications can arise without warning, and could even be written off as a temporary “down” or blue period. However, these signs should not be written off so quickly, since they can still be early warning signs of the onset of mental health illness.
Things to look out for include:
- A sudden change in your loved one’s mood (including mood swings)
- An unexpected change or loss of appetite (they may be eating a lot less than usual)
- A gradual, or sudden, loss of interest in hobbies or daily activities your loved one enjoys
- A gradual, or sudden, avoidance of social situations (or even going out)
- Persistent feelings of guilt, worry, doubt, and so on
- Difficulty sleeping, or not getting enough sleep
- Difficulty staying focused on something, or frequently daydreaming/drifting off
Signs you should definitely pay attention to include:
- Self-harming behaviours
- A desire to run away
- Sudden health complications that arise and are difficult to treat
What Affects Seniors’ Mental Health?
There can be any number of reasons why seniors also see a dip in their mental health, even though they’ve reached the age where there’s less to worry about. Stress can come about from a variety of circumstances, including chronic loneliness. If your loved one is cooped up at home for the most part, with no friends to spend time with, they can be at a much higher risk of becoming depressed.
But what else adversely affects your loved one’s mental wellbeing?
- Health concerns: As we age, our body slowly becomes weaker. At the same time, we also may go through various health complications, some of which may have profound effects on our body. Your loved ones may be unable to cope with these sudden changes in their wellbeing, especially if it has a major impact on their daily life
- Loss of independence: As a result of health complications or other reasons (such as reaching the age where driving becomes a concern), your loved ones will find it hard to do things they’d normally do, let alone find joy in them, further leading to a decline in their mental health
- Grief: The loss of a close friend, a loved one, or a loyal pet can contribute to feelings of loneliness, guilt, and depression
- Retirement: Routines change once your loved one retires and they might find it difficult to transition to a life spent at home for the most part. If they enjoy their job, that can exacerbate their feelings of loneliness or regret
- Social stigma: Your loved one may hide how they really feel from others, including yourself, especially since depression is still considered a stigma within society. They may think hiding their emotions, doubts, and anxieties will be a better idea so as to not seem like a burden, but bottling up their feelings only worsens their mental health
- Elder abuse: Any form of elder abuse will inevitably lead to a worsening of an elderly person’s mental wellbeing
Note that there may be other aspects that affect a senior’s mental health.
Impact on Seniors’ Wellbeing
It’s normal to feel depressed occasionally, especially if you’ve had a bad day. But if it persists for a long period of time (at least two weeks), that is considered an early warning sign of depression or some other mental health condition. Be it grief, a loss of independence, or any of the aforementioned risk factors, all these can leave lasting effects if left untreated.
- Adversity changes us, but sometimes it changes us for the worse. Without any support from caregivers or medical providers, the mental health of your loved ones will only continue to worsen over time, making it harder to treat them
- There’s still a lack of awareness of the importance of treating mental health conditions, given the persistent social stigma towards depression and anxiety as “excuses” or signs of weakness. This only complicates the provision of necessary therapies and treatments to help those with mental health conditions
- Mental health conditions will not go away over time and a lack (or denial) of access to treatment will only make things worse in the long term
- Growing social isolation is one key factor that contributes to mental health conditions, even for seniors. As we humans are social beings by nature, being deprived of any social connections – accidental or otherwise – will have lasting impacts that can negatively affect your loved one’s physical and mental wellbeing
- In fact, when there’s an imbalance in your mental wellbeing, it also causes an equivalent reaction in your physical wellbeing; depression can cause insomnia, and frequent headaches, and can even lead to chronic diseases if left untreated
As such, we need to take measures in order to help our elderly loved ones by promoting positive mental health and getting them the treatment they deserve so that they may enjoy the rest of their lives with dignity, joy, and compassion.
Medical therapies are an effective way to help your loved one get back on their feet, but not everyone may be open to that avenue. Communication from loved ones such as yourself can go a long way toward making them feel that they are not insignificant or undeserving of help and care. Thus, practical solutions can be as simple as opening up to one another or making suggestions that will help alleviate their feelings of loneliness, guilt, anxiety, or whatever it may be in a more productive and empathetic manner.
Have a Heart-to-Heart
One of the best ways to help someone with a mental health condition is to provide emotional support. Set time aside for you and your loved ones (and keep any distractions away) and create an open and non-judgemental space for them to speak about the issues they face. Listen closely to what they have to say about how they feel about where their life is currently headed, whatever doubts they may have, and be respectful if there may be topics they don’t want to discuss at the moment.
Actions also speak louder than words: show your loved ones that you’re doing your best to care for them in accordance with their wishes. Be mindful of their wants and needs, and be patient with them. Caregiving can be a handful sometimes, and it can take a great deal of time and effort, but as long as you have empathy for your loved one and understand their needs, you’ll eventually get through to them.
Try not to put off having a chat about how things are going and how your loved ones feel. At the same time, remember to put them first, especially if they aren’t ready to discuss a particular topic.
Spend Quality Time Together
It’s always a good idea to spend as much time as possible with your loved one to counter the effects of loneliness or social isolation. It helps by being a constant reminder to your loved one that they are loved and deserving of respect. Plus, it also adds the benefit of keeping them out of the house for a period of time so they don’t feel cooped up every day.
Take them to places they’d like to go or have never been to to make for some fun and new experiences to be shared. Be sure to take their overall health into account before you plan certain trips. It also helps to involve them in the planning process so they feel included; they might even have suggestions of sights and sounds to see that might not have been considered initially.
Do Things Together
It also helps to do fun activities together at home or when you’re outdoors. This is most beneficial if your loved one doesn’t have any hobbies or interests, or if their mental health prevents them from enjoying what they would normally do. Make suggestions to them about what you can do together and see what sticks; if they don’t feel like it, don’t try to force them into doing something they don’t like.
Any kind of activity can be helpful to your loved one in the long run. Whether it’s through painting to express their creative side, regular exercise to keep their body in shape, or even reading to keep their brain active, you’ll be sure to have some great bonding moments together.
Plan a Daily/Weekly Routine
Having a daily or weekly routine is also a good idea to keep one’s mental health in check. It helps keep you and your loved one’s day organised with plenty of things to do, such as exercise in the mornings, a reading session on weekend afternoons, and regular family movie nights. All this can help strengthen familial bonds and keep everyone in good spirits.
That being said, it may also be fruitful to start planning for the future, be it in terms of getting financial support, or even preparing for when your loved one may reach the end-of-life stage. Morbid though it may be, it can give you and your loved ones a deeper connection in where to go from here. It may even provide some form of closure for your loved ones, especially if they may feel clueless at first as to how the future will look like.
Socialise With Others
Having your loved ones connect with others their age, or sharing similar interests can also do a lot of good in curbing mental health issues. There are various support groups and communities that cater to providing a healthy social experience for seniors, be it in providing activities that everyone can participate in or simple meetup sessions over meals. If distance may be an issue, technology can help to bridge that gap through video calls.
Studies have shown that socialising is very beneficial to not only your loved one’s mental wellbeing, but also helps keep their physical wellbeing in check as well.
Need a Helping Hand?
Caregiving for your elderly loved ones is a noble cause, but it can be fraught with challenges. If you need help or just want a short break to recharge, Homage’s Care Pros can help you out. Our highly trained and certified Care Pros can come to your home to provide your loved one with companionship and security, from feeding your loved one during meals to taking them out for walks or medical appointments. Rest assured, our Care Pros will be able to deliver excellent caregiving whenever it’s needed while respecting the dignity and privacy that your loved one needs.
Let us help you with affordable home care and companionship whenever you need it. Download our app now to find out more and start booking personalised, quality care for your loved one.
- American Psychiatric Association. (2020). What is Schizophrenia? Retrieved 6th November 2023 from https://www.psychiatry.org/patients-families/schizophrenia/what-is-schizophrenia
- Centers for Disease Control and Prevention. (2023). Depression and Aging. Retrieved 6th November 2023 from https://www.cdc.gov/aging/olderadultsandhealthyaging/depression-and-aging.html
- Cleveland Clinic. (2023). Anxiety Disorders. Retrieved 6th November 2023 from https://my.clevelandclinic.org/health/diseases/9536-anxiety-disorders
- Cleveland Clinic. (2023). Delirium. Retrieved 6th November 2023 from https://my.clevelandclinic.org/health/diseases/15252-delirium
- Cleveland Clinic. (2023). Older Adults and Mental Health: What To Watch for and How To Help. Retrieved 6th November 2023 from https://health.clevelandclinic.org/depression-in-elderly/
- de Mendonça Lima, C. A., & Ivbijaro, G. (2013). Mental health and wellbeing of older people: opportunities and challenges. Mental health in family medicine, 10(3), 125–127. Retrieved 6th November 2023 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3822658/
- Family Caregiver Alliance. (n.d.). Depression and Caregiving. Retrieved 6th November 2023 from https://www.caregiver.org/resource/depression-and-caregiving/
- HealthDirect. (2021). Older people and mental health. Retrieved 6th November 2023 from https://www.healthdirect.gov.au/older-people-and-mental-health
- Kentucky Counseling Center. (2021). 8 Mental Health Tips for Seniors or the Elderly. Retrieved 6th November 2023 from https://kentuckycounselingcenter.com/8-mental-health-tips-for-seniors-or-the-elderly/
- Mayo Clinic. (2018). Anxiety disorders – Symptoms & causes. Retrieved 6th November 2023 from https://www.mayoclinic.org/diseases-conditions/anxiety/symptoms-causes/syc-20350961
- Mayo Clinic. (2022). Delirium – Symptoms & causes. Retrieved 6th November 2023 from https://www.mayoclinic.org/diseases-conditions/delirium/symptoms-causes/syc-20371386
- Mayo Clinic. (2022). Schizophrenia – Symptoms & causes. Retrieved 6th November 2023 from https://www.mayoclinic.org/diseases-conditions/schizophrenia/symptoms-causes/syc-20354443
- McCoy, K. (2022). 8 Tips to Keep Your Brain Sharp and Healthy as You Age. Retrieved 6th November 2023 from https://www.everydayhealth.com/senior-health/staying-sharp.aspx
- McLean Hospital. (2023). Everything You Need To Know About Older Adult Mental Health. Retrieved 6th November 2023 from https://www.mcleanhospital.org/essential/older-adult
- MedlinePlus. (2022). Depression in older adults. Retrieved 6th November 2023 from https://medlineplus.gov/ency/article/001521.htm
- Mental Health Foundation. (n.d.). How to look after your mental health in later life. Retrieved 6th November 2023 from https://www.mentalhealth.org.uk/explore-mental-health/publications/how-look-after-your-mental-health-later-life
- Miller, J. (2022). How to Improve Access to Mental Health and Substance Use Care for Older Adults. Retrieved 6th November 2023 from https://www.ncoa.org/article/how-to-improve-access-to-mental-health-and-substance-use-care-for-older-adults
- Milne-Tyte. (2023). Call it ‘stealth mental health’ — some care for elders helps more without the label. Retrieved 6th November 2023 from https://www.npr.org/sections/health-shots/2023/08/14/1193738304/mental-health-older-adults
- Mohanraj, A. (2022). Depression may present differently in older adults. Retrieved 6th November 2023 from https://www.thestar.com.my/lifestyle/health/2022/09/06/depression-may-present-differently-in-older-adults
- National Institute on Aging. (2020). Cognitive Health and Older Adults. Retrieved 6th November 2023 from https://www.nia.nih.gov/health/cognitive-health-and-older-adults
- National Institute on Aging. (2020). Depression and Older Adults. Retrieved 6th November 2023 from https://www.nia.nih.gov/health/depression-and-older-adults
- National Institute of Mental Health. (2023). Depression. Retrieved 6th November 2023 from https://www.nimh.nih.gov/health/topics/depression
- National Institute of Mental Health. (2023). Older Adults and Mental Health. Retrieved 6th November 2023 from https://www.nimh.nih.gov/health/topics/older-adults-and-mental-health
- National Institute of Mental Health. (2023). Schizophrenia. Retrieved 6th November 2023 from https://www.nimh.nih.gov/health/topics/schizophrenia
- New Straits Times. (2023). Managing elderly care. Retrieved 6th November 2023 from https://www.nst.com.my/opinion/letters/2023/07/934921/managing-elderly-care
- NHS England. (n.d.). Older people’s mental health. Retrieved 6th November 2023 from https://www.england.nhs.uk/mental-health/adults/older-people/
- Paul, S. (2023). Mental Health In Older Adults: Common Conditions And How To Treat Them. Retrieved 6th November 2023 from https://www.forbes.com/health/senior-living/mental-health-in-older-adults/
Relojo-Howell, D. (2023). Why it’s crucial to look after your mental health in your old age. Retrieved 6th November 2023 from https://www.freemalaysiatoday.com/category/leisure/health/2023/01/17/why-its-crucial-to-look-after-your-mental-health-in-your-old-age/
- Texas Health and Human Services. (n.d.). Behavioral and Mental Health Needs in Older Adults. Retrieved 6th November 2023 from https://www.hhs.texas.gov/sites/default/files/documents/about-hhs/community-engagement/atw/atw-issue-brief-behavioral-health.pdf
- UCSF Department of Psychiatry and Behavioral Sciences. (n.d.). Maintaining Wellness for Older Adults and Caregivers. Retrieved 6th November 2023 from https://psychiatry.ucsf.edu/copingresources/olderadults
- UPMC HealthBeat. (2022). The Importance of Mental Health Care for Seniors. Retrieved 6th November 2023 from https://share.upmc.com/2022/01/mental-health-for-seniors/
- WebMD. (2021). What to Know About Mental Health in Older Adults. Retrieved 6th November 2023 from https://www.webmd.com/healthy-aging/mental-health-in-older-adults
- World Health Organization. (2023). Dementia. Retrieved 6th November 2023 from https://www.who.int/news-room/fact-sheets/detail/dementia
- World Health Organization. (2023). Mental health of older adults. Retrieved 6th November 2023 from https://www.who.int/news-room/fact-sheets/detail/mental-health-of-older-adults