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1. Mental Health In Older
Adults: Lunch and Learn
Hosted by: The Center for Volunteer Caregiving
Presented by: Robert H. Pollock MSW, LCSW

2. Objectives of Presentation
 Review of the human life cycle stages
 Definition of Mental Illness, Personality Disorder
 Older Adult Facts
 Elder Abuse
 Elder Competency
 Risk Factors for Mental Illness, and Symptoms of Mental Illness
 Mental Health Goals / Interventions – Individual & Community
 Integrated Care Model
 Attitudes Towards the Elderly

3. The Human Life Cycle Stages
 Pre-birth
 Birth
 Infancy (0-3)
 Early Childhood (3-6)
 Middle Childhood (6-8)
 Late Childhood (9-11)
 Adolescence (12-20)
 Early Adulthood (20-35)
 Midlife (35-50)

4. The Human Life Cycle Stages-continued
 Mature Adulthood (50-80)
 Late Adulthood (80+)
 Death and Dying

5. One Definition of Mental Illness
 A mental illness is a condition that affects a person’s thinking, feeling or mood.
Such conditions may affect someone’s ability to relate to others and function each
day. Each person will have different experiences, even people with the same
diagnosis.

6. One Definition of a Personality Disorder
 A personality disorder is a type of mental disorder in which you have a rigid and
unhealthy pattern of thinking, functioning and behaving. A person with a
personality disorder has trouble perceiving and relating to situations and people.
Personality disorders usually begin in the teenage years or early adulthood, and
usually persist throughout life.

7. Older Adults: Facts
 Older adults are more likely than any other age group to have complex health
conditions, substance use disorders and cognitive impairments
 Loss is common: loss of – spouse, friends, physical functioning, independence,
purpose
 Purpose affects overall health, including mental health, physical health and
substance use
 Healthcare providers and older adults often mistake depression for a natural
response to aging. This can lead providers to not screen for or treat depression
 Older adults do not seek help
 Older adults go to see their Primary Care Physician, to get all of their medications
and help for their physical illnesses

8. Elder Abuse
 Physical abuse
 Sexual abuse
 Domestic violence
 Psychological abuse
 Financial abuse
 Neglect
 Self-neglect
 Elder abuse is a serious problem, with an estimated 8-10% of older adults
experiencing abuse
 Only 27% of hospital emergency departments have elder abuse protocalls

9. Pediatrics and Eldercare
 As some adults age, they may begin to rely more on spouses, adult children,
grandchildren and other loved ones for assistance with daily living activities and
navigating the health care system
 Unlike the pediatric population, where parents legally and functionally act as
caregiver and decision maker for their child, caregiver relationships for older adults
are much less straightforward and obvious
 In conditions like dementia, capacities are slowly lost and there is often not a clear
point at which older adults require surrogate decision-makers
 Advance Directives are very important
 Wills and Living Wills are very important

10. Some Basics About Geriatrics
 Changes of the brain
 Changes of the body
 Changes of many levels of functioning
 Changes of tolerance in medication, alcohol, foods

11. Causes and Risk Factors for Senior Mental
Illness
 Physical disability
 Long-term illness (e.g., heart disease, cancer)
 Dementia-causing illness (e.g., Alzheimer’s disease)
 Physical illnesses that can affect thought, memory, and emotion (e.g., thyroid or
adrenal disease)
 Change of environment, like moving into assisted living
 Illness or loss of a loved one
 Medication interactions
 Alcohol or substance use
 Poor diet or malnutrition

12. 10 Symptoms of Mental Illness
 1. Sad or depressed mood lasting longer than two weeks
 2. Social withdrawal; loss of interest in things that used to be enjoyable
 3. Unexplained fatigue, energy loss, or sleep changes
 4. Confusion, disorientation, problems with concentration or decision-making
 5. Increase or decrease in appetite; changes in weight
 6. Memory loss, especially recent or short-term memory problems
 7. Feelings of worthlessness, inappropriate guilt, helplessness; thoughts of suicide
 8. Physical symptoms that can’t otherwise be explained: aches, constipation, etc.

13. 10 Symptoms Continued
 9. Changes in appearance or dress, or problems maintaining the home or yard
 10. Trouble handling finances or working with numbers

14. Mental Health Goals / Interventions
 Healthy adjustment to stage of life
 Acceptance of loss – letting go
 Explore for and treat “Survivor Guilt”, which is often present when the elderly
person has survived one of their children
 Explore for and treat a deep sense of guilt wishing a loved one would die
 Involvement in life activities as fully as possible
 Reminiscence therapy – discussion of past activities, events, experiences with
another person or group, usually with the aid of tangible prompts such as
photographs, household and other familiar items from the past such as music, old
movies

15. More Interventions
 Explore spirituality
 All preparations for death are completed to a satisfactory level
 Acceptance of how a person has lived their life
 What is their legacy
 What are they proud about in their life
 What are they not proud about in their life, and acceptance of this
 The bucket list
 Do they want to talk about death / the after life? Do they have an opinion about
this
 What is their meaning of life

16. Integrated Care Model
 One person to act in the role of “Case Manager”
 A team approach in which all relevant providers share information about the
elderly person
 The team also provides for the caregiver and other important people (family,
friends), so the entire team does not disappear when the elderly person dies
 Making sure nothing is “slipping through the cracks” about the over all care and
well-being of the elderly person
 Exercise needs to be included – it is not only healthy for the body, but for the
emotional well-being of every person

17. More Interventions
 Healthy Ideas – is a national model with measurable results and demonstrated
benefits for older adults, service providers and community mental/behavioral
health practitioners
 Senior Reach – is an award winning, innovative collaborative between Jefferson
Center for Mental Health, Seniors’ Resource Center, and Mental Health Partners,
and is having a profound impact in the community and has proven highly
successful in decreasing depression, anxiety, feelings of hopelessness and social
isolation among seniors. Their mission is to support the well-being, independence
and dignity of older adults by educating the community, providing care
management and mental health services, and connecting older adults to
community resources

18. More Interventions
 Enhance Wellness – Seniors looking for assistance in managing needs such as
physical activity, weight management, mental stimulation, nutrition, medication
management or depression/anxiety have a resource in the Enhance Wellness
program.

19. Attitudes Towards the Elderly
 America – present-day attitudes
about the elderly is very poor, and
treated with little respect
 Some Cultures Respect Their Elders
 Aging isn’t just a biological process –
it’s also very much a cultural one
 The Elderly are treated with high
respect among the Native American
elders, in China, Greece, Korea, and
Romans

20. Something to work Towards
Good Mental Health is Ageless
Questions?