The Older Adult and Mental Health
One clinical area in which I specialize is helping older adult clients deal with emotional and psychological issues commonly associated with aging. I am reminded of something several of my older adult clients have articulated (in their own words, but with the same general content): “I’m 70 years old (or whatever age 65 and over). I didn’t expect to live this long. Now what?”
Of course, everyone’s details are different, but in general we know several things about a person’s physical, cognitive, and social development in the Late Adulthood stage of life (65 years to death.) Usually these developmental variables are normal and most older adults handle them, not without challenges of course, but usually with competence and with little outside help.
At this age, wrinkles begin to develop. Hair grays and thins. We get shorter because cartilage in small discs thins. Osteoporosis can begin to appear, not only in women, but especially in women. The brain shrinks; the heart pumps less blood. Reactions slow and senses become less acute. Cataracts and glaucoma may affect the eyes, and hearing loss is common. Chronic diseases, such as heart disease, diabetes, and strokes become more common.
Cognition refers to all the mental processes that allow us and help us to think. Cognition tends not to decline until we reach our 80’s. However, learning remains possible throughout the human life span, and thinking can remain sharp with training, brain exercises, and practice. Short-term memory and memory of specific events may decline naturally with age, but other types of memory are largely unaffected.
Significant life transitions occur during older adulthood and can be problematic for seniors unprepared or without social supports. Basic personality traits remain stable during older adulthood. As an older person reviews his or her life, for example, that can be fulfilling, or it can be unsatisfactory and create some issues that might be addressed with a counselor/therapist. Retirement, no matter how well planned, can cause some introspection and change in self-image and self-esteem. Activities, hobbies, and interests may change, and change can always become a challenge. Losses routinely experienced in old age (loss of daily work schedule, loss of friends to relocation or death, loss of familiar surroundings, loss of usual income levels) inevitably cause stress. Each of these losses is normal, but a therapist can assist with coping strategies, planning appropriate responses, and processing these feelings.
What is "Not Normal" Aging?
So, what about mental health and mental illness as we age? Is it different, worse than other stages of the life span? And what can we do to maintain and improve our mental health status?
Of course, older adults, quite apart from being older, can experience the array of mental health issues to which persons of all ages can be susceptible (except perhaps some specific childhood disorders.) This includes schizophrenia; bipolar illnesses; depression; anxiety, obsessive-compulsive, somatic symptom, impulse control, or substance abuse disorders; eating disorders; and
Alzheimer’s (dementia, debilitating memory loss,) and may also occur as a person ages. These diagnosable mental disorders can and should be addressed with a therapist and the physician, as appropriate.
On a less acute level, any of the physical, cognitive, or social/personality developmental changes can become a focus of clinical mental health attention if they begin to affect an older adult’s or their significant others’ ability to function in their community. Some areas that come readily to mind as issues affecting the aging population, and that may be assisted by meeting with a therapist, are most often dealt with successfully by older adults and their families/friends. But, these may become a focus of clinical attention if the older adult lacks the support, information, or other resources to deal with such issues effectively:
- Substance use/abuse;
- Maltreatment (of self or others);
- [Chronic] pain;
- Sleep patterns;
- Emotional effects of low or insufficient income;
- Effects of legal issues such as divorce, estates, lawsuits;
- Experiencing a natural disaster; and
- Other experiences such as discrimination, being a crime victim, or various types of fraud.
As a therapist, though I am not a physician, I do have an interest in and some clinical tools that can help a client to address the psychosocial aspects of medical conditions, as well as access to medical care, and issues of compliance/non-compliance with medical care and treatment.
Optimizing Mental Health Throughout Aging
Can we do anything to optimize cognitive functioning? Yes, we can, and I will use some examples from the Alzheimer’s/dementia field:
- Learn a foreign language. The listening and hearing involved stimulates the brain. What’s more, a rich vocabulary has been linked to a reduced risk for cognitive decline.
- Draw a map from memory. After returning home from visiting a new place, try to draw a map of the area; repeat this exercise each time you visit a new location.
- Take a cooking class. Learn how to cook a new cuisine. Cooking uses a number of senses: smell, touch, sight, and taste, which all involve different parts of the brain. (This would also help with maintaining social and personality functioning levels (below)).
Socially and personality-wise, one can do several things improve one’s odds of success in the social arena. Keep involved. Go back to or join those groups that share your interest --- alumni clubs, retirement association activities, hobby clubs, senior centers, residential community activities, etc. Develop a new hobby, for example, I am researching bonsai gardening as a containable, doable, locally-available new activity. Recognize the relationship between physical, mental, and emotional health. Keep fit. Exercise with mall walkers or chair yoga classes. Join Silver Sneakers or Silver and Fit if your health insurance or Medicare senior health plan covers it.
Maybe I Can Help?
Does any of this sound familiar? Could any of it be you? If you think so, why don’t you contact me. We can confidentially discuss your concerns and whether I might be able to help. Check out other pages on my website here: “About Me,” “Another Word About Therapy via Video Conferencing…,” and then, hopefully “Appointment Request.” I would very much like to be your “en-courager” you, to instill the courage for you to make the decisions and take the steps you want in order to maintain mental health and improve the relationships you have with yourself and the world around you. I look forward to your call or email. Thanks!
Ellin, A. (2018). Change Artists. Psychology Today, 51(1). 52-88.
Feldman, R. S. Development Across the Life Span. Pearson Education, Inc. Upper Saddle River, NJ: 2008.
https://www.nimh.nih.gov/topics/topic-page-older-adults.shtml This is a website of the National Institute of Mental Health (NIMH). NIMH has a treasure trove of information and web pages on aging and mental health, and this site is probably a good web address at which to start your review, search, and learning.
Winch, G. (2017). Solutions for the Solitary. Psychology Today, 50(4). 32-34.
Stephen M. Harmon, LMFT ♦ Licensed Marriage & Family Therapist ♦ Calif. Lic. # 49365