Top Questions About Geriatric Mental Health Answered

As families help older loved ones manage physical health conditions, they shouldn’t overlook mental health changes. Depression, anxiety and other mental health disorders are quite common among the older population. Estimates are that one in four older adults will experience a mental disorder.

Here are questions families often ask:

Q: Are changes in my loved one’s personality and behaviour just a normal part of ageing? Health problems, the loss of a spouse, disability, and even one’s changing role after retirement can lead to personality changes. But it’s important to discern between normal changes of ageing and mental health disorders. Experts caution that left untreated, these disorders can lead to fatigue, illness, and even suicide.

Q: What are the signs that my loved one might have a mental health condition that should be addressed? The changes can be gradual and subtle. A consultation with their doctor would be wise if your loved one is …

• Sleeping much more or much less than usual.
• Feeling unusually confused, on edge, worried or afraid.
• Exhibiting low or no energy.
• Eating much more or less than usual.
• Experiencing prolonged grief that does not subside.
• Losing interest in things they once enjoyed.
• Feeling helpless or hopeless.
• Smoking, drinking, or using drugs more than usual.
• Expressing thoughts of suicide.

Q: How are my loved one’s physical health and mental health problems related? Life-changing conditions such as hearing and vision loss or stroke can lead to depression and anxiety. Sometimes the relationship is what mental health specialists call “bidirectional cause and effect”: A health condition such as heart disease, stroke, memory loss or diabetes can raise the risk of mental health problems. In turn, mental health conditions affect not only the brain but also the whole body, and can hasten memory loss, raise blood pressure and cholesterol, and worsen digestive disorders, diabetes and heart disease. Side effects of medications also may play a role. An integrated medical assessment is necessary.

Q: Can these mental health disorders be treated? Yes. Your loved one’s doctor might recommend cognitive behavioural therapy, psychotherapy, interventions for substance misuse or other negative habits, and instruction about lifestyle changes that promote positive mental health. Geriatric mental health professionals also may prescribe medications, taking into account a patient’s ability to manage medications, the other medications they take, and how their age affects the way their body processes substances.

Q: What if a loved one resists seeking help? Even older adults who are conscientious about healthcare might avoid seeking treatment for depression and anxiety. Fearing stigma, they might try to “go it alone”, thinking that seeking help is a sign of weakness. Reassure your loved one that, on the contrary, it’s a sign of strength to take charge in this way. Substance misuse, gambling or other behavioural health problems may be especially hard to discuss. If possible, talk to your loved one’s healthcare provider about options.

Q: If my loved one talks of suicide, what should I do? Never discount statements such as “Everyone would be better off without me” or “Life’s not worth living”. Other warning signs include buying a firearm, stockpiling pills and giving away possessions. Experts say that the rate of suicide increases with age, and depression is a top risk factor. Any family member who believes their loved one is in crisis should contact their local suicide prevention number.

Q: As a family caregiver, should I worry about my own mental health? While it is a labour of love, serving as a family carer for an ill loved one or a loved one with disabilities can be very stressful and can raise the carer’s own risk of mental health problems—so much so that experts consider caregiving a risk factor for depression and anxiety. If you are a family carer and you’re feeling symptoms of distress, discuss your situation with your healthcare provider and your family. Seek help from other family members and professionals.

The Role of Professional In-Home Care

Professional in-home caregivers support the health of older clients—and that includes mental health. Here are ways they can help:

Coordinating care. Most older patients see a number of healthcare providers, and they often have a complicated care mroutine to follow. Professional in-home caregivers help keep track of appointments, accompany clients to the doctor and pharmacy, and provide health reminders.

A home environment that’s conducive to good mental health. Professional caregivers help clients with bathing, dressing, grooming, meal preparation and housekeeping. They provide companionship that wards off social isolation and loneliness, and mental stimulation that lifts the spirits.

Partnering with family. In our experience, family carer distress is greatly reduced when a family partners with professional caregivers. In-home caregivers keep the family up to date about their loved one’s condition, even when the family lives at a distance—a situation that can be very distressing as an older relative’s needs change. The resulting peace of mind allows the family to focus on their jobs, their other responsibilities, and their own health.