Seniors encounter many challenges, from loneliness and loss to managing chronic illnesses and mental health issues. 80 percent of older adults have at least one chronic health condition, and 50 percent have more than one, according to the Centers for Disease Control. Substance use issues can complicate the problem.
In the sections that follow, we will discuss: the unique mental health needs of seniors; specialized services that can address these needs; the benefits of seeking care in one’s older years; and how stigma can keep older adults from accessing treatment. We’ll also provide a list of resources that may be of help for older adults and their families.
Understanding the Unique Needs of Older Adults
Geriatric mental health needs can be easier to miss because of the aging process itself. Growing older can present new challenges:
- More physical health issues can trigger mental health symptoms and mask them at the same time. These issues can often go undiagnosed, be misdiagnosed, or increase the risk of medication interactions.
- Changes in cognition or sensory perception can complicate the mental health assessment and diagnosis process.
- Isolation and loneliness can occur with retirement, the loss of loved ones, less mobility, or still other aging-related experiences.
- A higher risk of alcohol, opioid, and substance use disorders can hasten memory loss and worsen mental health and other health issues.
“Anxiety, cognitive impairment and mood disorders (such as depression or bipolar disorder) tend to be the most common treatment needs among older patients. Often these conditions coincide with the physical effects of aging and higher rates of chronic illness in older patients.” – Dr. Beau A. Nelson, DBH, LCSW, Chief Clinical Officer, FHE Health
Services Tailored for the Needs of Seniors
A more effective treatment plan will address these multi-faceted needs and their interconnectedness. Services tailored for seniors should therefore include:
- Awareness of aging-related physiological changes such as decreased metabolism of medications and higher susceptibility to side effects
- Appropriate adjustment in communication methods and treatment styles due to cognitive decline and sensory impairments
- Consideration of social factors such as social support networks or access to transportation and housing stability, which may be barriers to treatment
- Recognition of the unique challenges older adults face in accessing and engaging with geriatric mental health services
- Integration of comprehensive substance use disorder assessments into routine geriatric evaluations to ensure timely identification and intervention
If a substance use disorder is diagnosed, the American Society of Addiction Medicine (ASAM) recommends the following treatment services:
- Group therapy with other seniors
- Family involvement and support
- Case management
- Cognitive-behavioral approach
- Motivational interviewing
Services that take a person-centered approach, addressing the whole older person and their various needs, are optimal for improving well-being and quality of life.
Benefits of Seeking Care for Seniors
Treatment can have multiple benefits for seniors who seek care for challenges with mental health or substance use. The right care can improve an older person’s quality of life, increase their life expectancy, and decrease the likelihood (or length) of long-term care in a nursing home.
Treatment has also helped many seniors with addiction and mental health issues find recovery and learn to manage their condition in healthy ways. Some research has found that outcomes for this population are better than those for other demographics, because seniors are more likely to adhere to a plan of care.
“What many people don’t know is that older men have the highest suicide rate of any age group. Yet 80 percent of the time depression among seniors is treatable, according to the CDC.” – Dr. Beau A. Nelson, DBH, LCSW Chief Clinical Officer, FHE Health
Addressing Stigma and Barriers to Treatment
The same stigma that affects the larger population can keep older adults from seeking care or sharing their struggles with friends or family, but the stereotyping of older adults, “ageism,” can increase this stigma.
Ageism can be many things. One of them is the notion that someone is too old to change or too old to have to worry about their health. When 80-year-old Aunt Betty is nursing her third cocktail at noon and slurring her words, it can be tempting to excuse the behavior with the rationale, “Oh, that’s just Aunt Betty.” But every Aunt Betty out there deserves a chance at better health and quality of life. – Dr. Beau A. Nelson, DBH, LCSW Chief Clinical Officer, FHE Health
Other issues that can pose barriers to treatment include:
- Transportation issues or financial constraints
- Lack of awareness about available services
- Societal attitudes and misconceptions surrounding mental illness in older adults
- Lack of specialized counseling approaches
- Limited accessibility to culturally sensitive mental health services
- Access to providers impeded by location, such as living in a rural or underserved community
- Unfamiliarity with symptoms that indicate a mental health issue
- Mobility issues that make it difficult to make it to mental health appointments
- Fear of institutionalization or loss of independence
The cognitive decline that often increases with age may also make it harder for some seniors to remember to take their medications and stick with a medication routine.
Addressing these and other barriers to geriatric mental health care is crucial to helping ensure access to the support seniors need. Actively combating the stigma surrounding mental health services is also necessary to normalize this care.
Senior-Specific Resources
It can be hard to know where to turn when you or an older adult whom you love is struggling. These resources may help:
- NAMI FAQs and support groups – The National Alliance on Mental Illness (NAMI) has many resources for older adults, including these answers to frequently asked questions and support group options.
- Community Resource Finder offers access to numerous supports, from homecare, daycare programs, and associations for those in retirement or with Alzheimer’s, to housing options, community services, and legal services for seniors.
- Dialing the “988” Helpline can aid in a mental health crisis when you need immediate referrals to care. Dial “988” for emergency assistance.
- An intervention, led and facilitated by an outside professional, can be instrumental in helping an older loved one choose care. At FHE Health, we have trained interventionists on staff who can serve as resources in this process.
Symptoms and Aging Transitions to Be Aware of
A mental health or substance use challenge may not be obvious, especially in an older adult with other health issues. The following symptoms may be signs of a mental health or substance use problem:
- Issues with memory
- Disrupted sleep patterns
- Changes in eating habits
- Decline in hygiene
- Lack of interest
- Unexplained bruises or contusions
If one or more of these symptoms occur with problem drinking or drug use, a substance use disorder may be the problem. In that case, it may also help to consider whether any of these aging-related circumstances describes your loved one’s current situation:
- Retirement and a sense of losing one’s identity
- Financial pressure
- Death of family members and close friends
- Transition to an assisted living facility
- Physical or mental health decline
These events and transitions are known risk factors for substance use disorders.
If problem drinking or drug use has persisted for at least two weeks and seems to be a regular pattern, an intervention with the help of a trained professional may be a good next step. With older adults, an intervention usually requires the participation of at least one or two close loved ones.
Prioritizing Mental Health for Older Adults
As the nation’s older population continues to grow, ensuring seniors have the mental health services they need will only become more critical. At FHE Health, we’re here to guide you to treatment services that address the personalized needs of you or an older loved one. Our integrated care approach enables us to care for the whole person and their specific needs, including the older adult who may be struggling with mental health or substance use.
Have questions about an intervention for an older adult or wondering about specialized care for a senior you love? We are here to help 24/7. Contact FHE Health at 1-844-423-3574.
