Assisted Living for People With Mental Health Disorders

Supporting Seniors with Mental Health Conditions

When thinking of age-related health issues, physical infirmity probably springs to most people's minds; however, seniors are also prone to mental health disorders. Another exciting transition is retirement, which many people anticipate with enthusiasm but might trigger or exacerbate mental health issues.

Although there are insufficient studies into seniors' mental health, those that do exist expose cause for concern. For example, almost one-fourth of seniors in the United States are believed to be socially isolated and approximately two-thirds don't get the mental health treatment they need. Assisted living facilities provide safe, secure and sociable homes with staff trained to care for residents with mental health issues. This guide provides an overview of the mental health conditions that seniors typically face and how assisted living can help.

Common Mental Health Conditions That Impact Seniors

Some mental health conditions are common among seniors. Given their general prevalence, however, there are often a variety of ways to treat them.

Anxiety Disorders

An anxiety disorder may make a senior become so anxious that dealing with everyday life becomes a challenge. Common symptoms you may notice include uncontrollable fear, obsessive thinking, insomnia, increased heartbeat and headaches. It is estimated that anywhere from 3% to 14% of America’s older adults have a diagnosable anxiety disorder. This could be due to one or more risk factors most relevant to the senior population, such as bereavement, reduced mobility and financial insecurity. Fortunately, anxiety can be effectively treated by medications and psychotherapy.

Bipolar Disorder

Most people with bipolar disorder experience severe mood swings that include manic highs and depressive lows. The precise cause for these swings isn’t known, but genetics, a chemical imbalance in the brain, childhood trauma and stressful life events are believed to be factors. Around 25% of people with bipolar disorder are aged 60+, and this figure is projected to exceed 50% by 2030. Seniors should visit their doctor if they think they’re experiencing symptoms of bipolar disorder.

Depression

Depression is a medical condition that can cause someone to continuously experience feelings such as sadness, hopelessness and apathy for lengthy periods — typically weeks or longer. Significant events, such as losing a loved one, can lead to depression in the elderly. Depression affects 1% to 5% of seniors, rising to 11.5% of those hospitalized and 13.5% in those receiving home care. It can be treated with psychotherapy and/or antidepressant drugs.

Eating Disorders

Eating disorders typically appear in early adulthood (age 18 for bulimia and anorexia and 21 for binge eating disorder) and may continue into the retirement years. As we age and our metabolism slows down and hormone levels decrease, it can become a challenge to lose weight, and seniors who aren't used tocarrying a few extra pounds may develop unhealthy habits with food. Healthrisks associated with eating disorders include heart disease, hypertension anddiabetes. Seniors should speak to a doctor if they’re concerned about theirrelationship to food, as common treatments include psychotherapy, nutritionalcounseling and medications.

Medication Misuse

Many people take prescription drugs to treat physical ailments, pain, mentaldisorders and chronic conditions, and some medications may contain addictiveand potentially dangerous controlled substances. Patients may, for example,take more than the recommended dose or use drugs prescribed for someoneelse. Misusing drugs may reduce their effectiveness, increase interactions withother drugs and cause serious side effects, including death.

Post-Traumatic Stress Disorder (PTSD)

PTSD is caused by a traumatic event, such as a near-death experience or anattack. It’s believed current data under-represents the problem, but somestudies reveal 1.5% to 4% of adults aged 60+ have PTSD, with 7% to 15%exhibiting subclinical level symptoms, which is not enough for a confident diagnosis. Symptoms include experiencing intrusive thoughts and nightmares,sleeping poorly and having angry outbursts. Cognitive and exposure therapiesare effective treatments, as is joining a support group. Seniors should contacttheir doctor if they show signs of PTSD.

Risks Factors for Mental Health Conditions in Seniors

The World Health Organization (WHO) states 15% of adults aged 60 and older have a mental disorder. Many factors can trigger these disorders:

  • Alzheimer’s: Alzheimer’s is a type of dementia affecting more than 6 millionAmericans as of 2022. Changes in the brain resulting from age, as well asenvironmental, lifestyle and genetic factors, are believed to play a part.
  • Chronic Pain: Chronic pain is pain that lasts longer than expected as part ofthe healing process (usually pain lasting over 3 months). Persistent paincan cause mental health conditions such as depression and anxiety.
  • Chronic Stress: Chronic stress is persistently feeling overwhelmed orpressured. Factors such as worrying about developing dementia, personalfinances and losing independence are known contributors.
  • Elder Abuse: Around 1 in 10 adults aged 60 and older have suffered elderabuse in their community. Based on self-reports from residents, the mostcommon type in residential care is psychological abuse (33.4%) and theleast common is sexual abuse (1.9%).
  • Physical Health: Deteriorating physical health is known to affect seniors’psychological health. Arthritis is a common condition that may impactmental health, with 49.6% of adults aged 65+ reporting a diagnosis.

Warning Signs of Mental Health Disordersin Seniors

Loved ones and caregivers are often the first people to notice that a senior maybe struggling with a psychological condition. Signs to look out for include:

  • Loss of temper and argumentative behavior
  • Appears unusually angry, scared or upset
  • Feelings of desperation or helplessness
  • Loss of sleep or sleep pattern changes
  • Loss of appetite
  • Experiences pains that can’t be explained
  • A lack of emotion
  • Extended depression
  • Substance misuse
  • Thoughts of self-harm, suicide or hurting others

Housing Options for Seniors Living WithMental Health Conditions

Seniors living with mental health conditions don’t need to suffer alone. There areseveral types of care available, and the best option depends on the individual.Here are three of the most common housing options for seniors in need ofmental health treatment.

Assisted Living for People With Mental HealthConditions

Assisted living is nonmedical care delivered in a homelike community. Residentslive in private or shared rooms, typically with kitchenettes and bathrooms.Trained caregivers assist with activities of daily living (ADLs), which may includebathing, dressing, toileting and eating. Structured social and wellness programshelp residents stay mentally and physically active and encourage them todevelop friendships with other residents. Most people live reasonably close to anassisted living facility.

Pros: Cons:
Memory care units are often on-site, many with trained staff Staff may not be trained to handlespecific conditions, such aspsychosis
Sharing a home with residentslessens feelings of isolation Not all states have regulations forassisted living facilities caring forseniors with & mental healthproblems
Staff will call medicalprofessionals in a medicalemergency There may be less medicalsupport on-site than needed forsome seniors

Nursing Homes for People With Mental HealthConditions

Nursing homes deliver 24/7 medical care to seniors requiring short-term help torecover from illness or surgery and those with enduring conditions needinglong-term support. The environment is more homelike than a hospital. Residentslive in private or shared rooms with fresh meals served daily. An estimated 65%to 91% of nursing home residents have a significant mental healthdisorder. Residents may be able to receive therapy and medication managementto treat mental health conditions in nursing homes.

Pros: Cons:
Mental health professionals maybe on-site or visit regularly Being away from home may causea mental health issue, such asdepression
Staff is trained in medicationmanagement Facility may not have staff on-site24/7 with experience in a specificcondition
24/7 access to medical care Seniors may experience less socialinteraction

In-Home Care for People With Mental HealthConditions

In-home care can be nonmedical or medical. Nonmedical care can range fromsimple companionship to helping with activities of daily living (ADLs), such asbathing. Medical care is typically delivered by registered nurses and therapists,including injections and physical therapies. Caregivers aren’t typically on-site24/7 but can become available for an additional cost. In-home care can providesupportive companionship for seniors with mental health conditions.

Pros: Cons:
Seniors live in familiarsurroundings Caregivers may not beimmediately available in anemergency
Agency may have staff to helpwith common conditions, such asdementia Agency may not have staff trainedin some conditions, such as PTSD
Seniors can still access mentalhealth support out of their home Senior may struggle to bond witha caregiver if staff changes are frequent

The Benefits of Senior Living for Seniors With Mental Health Disorders

Studies have shown that quality housing can support recovery from and management of mental health conditions. Assisted living facilities must maintain high standards or they risk losing their licenses. With appropriate support,seniors can benefit from care at an assisted living community in the following ways:

  • Feeling accepted: Assisted living creates opportunities to socialize withother residents who also have various mental health conditions.
  • Getting a new lease on life: Assisted living offers opportunities to build newfriendships and learn new skills.
  • Feeling safe: A problem such as a fall isn’t as frightening because anassisted living caregiver is always near and ready to help.
  • On-site mental health support: Assisted living facilities may have staff trained to recognize warning signs and deal with them.

When Should Someone With a Mental Health Condition Consider Senior Living?

Determining when to consider senior living can be difficult for loved ones,particularly if the senior is resistant. Families should look for warning signs theirloved one can no longer handle their condition without regular support. Thefollowing covers some things you should watch for:

  • Deteriorating personal care standards, such as not bathing
  • Weight loss
  • Expressing thoughts of self-harm, suicide or violence
  • Refusal to take prescribed medications
  • Social isolation, which can be triggered by losing a spouse

Who May Not Be a Good Fit for Senior Living?

Seniors with mental health conditions that a facility can’t manage aren’t a goodfit for senior living. Some facilities may not have proper staffing, while othersmay not have safe housing options, depending on the senior’s behavior. If thesenior is already in senior living but has refused care, it may be a sign the facilitycan no longer meet their individual needs.

State Resources for Mental Health Assistance

State Department Services Phone Email
Alabama Department of Mental Health Supports community-based mental health care services  (334) 242-3642 nicole.walden@mh.alabama.gov
Alaska Department of Health & Social Services Provides a continuum of statewide behavioral health services (907) 269-4804 gennifer.moreau-johnson@alaska.gov
Arizona Health Care Cost Containment System (AHCCCS) Manages community-based mental health care services (602) 417-4000 sara.salek@azahcccs.gov
Arkansas Department of Human Services Funds treatments for state residents with mental illnesses (501) 686-9981 jay.hill@dhs.arkansas.gov
California Department of Health Care Services Coordinates systems that treat people with diagnosed mental health issues (916) 440-7400 michelle.bass@dhcs.ca.gov
Colorado Department of Human Services Provides a continuum of mental health care via public programs (303) 866-7400 morgan.medlock@state.co.us
Connecticut Department of Mental Health & Addiction Services Provides a continuum of statewide behavioral health services (860) 418-6952 nancy.navarretta@ct.gov
Delaware Health and Social Services Supports community-based mental health care services  (302) 255-9657 joanna.champney@delaware.gov
District of Columbia Department of Behavioral Health Funds treatments for state residents with mental illnesses (202) 671-3180 barbara.bazron@dc.gov
Florida Department of Children and Families Collaborates with mental health care providers statewide (904) 515-8064 maggie.cveticanin@myflfamilies.com
Georgia Department of Behavioral Health and Developmental Disabilities Contracts services from mental health care agencies  (404) 651-8520 monica.johnson@dbhdd.ga.gov
Hawaii State Department of Health Provides a continuum of statewide behavioral health services (808) 586-4770 amy.curtis@doh.hawaii.gov
Idaho Department of Health and Welfare Supports community-based mental health care services  (208) 334-5726 ross.edmunds@dhw.idaho.gov
Illinois Department of Human Services Manages community-based mental health care services (312) 793-1326 david.albert@illinois.gov
Indiana Family and Social Services Administration Collaborates with mental health care providers statewide (317) 232-7860 jay.chaudhary@fssa.in.gov
Iowa Department of Human Services Provides a continuum of statewide behavioral health services (515) 256-4662 meyanso@dhs.state.ia.us
Kansas Department for Aging and Disability Services (KDADS) Funds treatments for state residents with mental illnesses (785) 291-3359 andrew.brown@ks.gov
Kentucky Cabinet for Health and Family Services Partners with mental health care providers statewide  (502) 564-4527 wendy.morris@ky.gov
Louisiana Department of Health Supports community-based mental health care services  (225) 342-1562 karen.stubbs@la.gov
Maine Department of Health and Human Services Manages community-based mental health care services (207) 592-6406 sarah.squirrel@maine.gov
Maryland Department of Health Funds and collaborates with mental health care agencies (410) 767-6492 lisaa.burgess@maryland.gov
Massachusetts Executive Office of Health and Human Services Provides a continuum of statewide behavioral health services (617) 626-8097 brooke.doyle@mass.gov
Michigan Department of Health and Human Services Collaborates with mental health care providers statewide (517) 335-0499 wieferichj@michigan.gov
Minnesota Department of Human Services Funds treatments for state residents with mental illnesses (651) 431-6408 commissioner.dhs@state.mn.us
Mississippi Department of Mental Health Funds and collaborates with mental health care agencies (601) 359-1288 wendy.bailey@dmh.ms.gov
Missouri Department of Mental Health Partners with mental health care providers statewide (573) 751-9499 nora.bock@dmh.mo.gov
Department of Public Health and Human Services Supports community-based mental health care services  (406) 444-6951 rdecamara@mt.gov
Nebraska Department of Health and Human Services Manages community-based mental health care services (402) 471-7856 sheri.dawson@nebraska.gov
Nevada Division of Public Health and Human Services Collaborates with mental health care providers statewide (775) 684-2211 swoodard@health.nv.gov
New Hampshire Health and Human Services Provides a continuum of statewide behavioral health services (603) 271-8378 julianne.carbin@dhhs.nh.gov
New Jersey Division of Mental Health and Addiction Services Funds treatments for state residents with mental illnesses (609) 438-4352 valerie.mielke@dhs.nj.gov
New Mexico Human Services Department Supports community-based mental health care services  (505) 660-2788 neal.bowen@state.nm.us
New York State Office of Mental Health Partners with mental health care providers statewide  (518) 474-4403 ann.sullivan@omh.ny.gov
North Carolina Department of Health and Human Services Manages community-based mental health care services (919) 733-7013 dave.richard@dhhs.nc.gov
North Dakota Department of Health and Human Services Collaborates with mental health care providers statewide (701) 328-8824 psagness@nd.gov
Ohio Department of Mental Health and Addiction Services Supports community-based mental health care services  (614) 466-2337 lori.criss@mha.ohio.gov
Oklahoma Department of Mental Health and Substance Abuse Services Provides a continuum of statewide behavioral health services (405) 248-9281 chodges@odmhsas.org
Oregon Health Authority Funds and collaborates with mental health care agencies (503) 449-7643 steven.j.allen@dhsoha.state.or.us
Pennsylvania Department of Human Services Funds treatments for state residents with mental illnesses (717) 705-8167 krhouser@pa.gov
Rhode Island Department of Behavioral Healthcare,
Developmental Disabilities and Hospitals (BHDDH)
Collaborates with mental health care providers statewide (401) 462-2339 richard.charest@bhddh.ri.gov
South Carolina Department of Mental Health Provides a continuum of statewide behavioral health services (803) 898-8319 robert.bank@scdmh.org
South Dakota Department of Social Services Supports community-based mental health care services  (605) 367-5236 melanie.boetel@state.sd.us
Tennessee Department of Mental Health and Substance Abuse Services Manages community-based mental health care services (615) 253-3049 marie.williams@tn.gov
Texas Health and Human Services Commission Partners with mental health care providers statewide (512) 838-2054 trina.ita01@hhsc.state.tx.us
Utah Department of Health & Human Services Funds and collaborates with mental health care agencies (801) 540-5242 bkelsey@utah.gov
Vermont Department of Health Funds treatments for state residents with mental illnesses (802) 241-0122 emily.hawes@vermont.gov
Virginia Department of Behavioral Health and Developmental Services Provides a continuum of statewide behavioral health services (804) 786-5682 nelson.smith@dbhds.virginia.gov
Washington State Health Care Authority Collaborates with mental health care providers statewide (360) 725-5252 keri.waterland@hca.wa.gov
West Virginia Department of Health and Human Services Supports community-based mental health care services  (304) 352-5837 christina.r.mullins@wv.gov
Wisconsin Department of Health Services Manages community-based mental health care services (608) 266-2861 teresaj.steinmetz@dhs.wisconsin.gov
Wyoming Department of Health Provides a continuum of statewide behavioral health services (307) 777-8763 matt.petry1@wyo.gov