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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.
Some mental health conditions are common among seniors. Given their general prevalence, however, there are often a variety of ways to treat them.
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.
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 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 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.
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.
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.
The World Health Organization (WHO) states 15% of adults aged 60 and older have a mental disorder. Many factors can trigger these disorders:
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:
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 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 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 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 |
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:
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:
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 Department | Services | Phone | |
---|---|---|---|
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 |