Mental Health

MENTAL HEALTH IN ELDERLY

Introduction

  • In the Indian context, we now have a larger section of the population that can be classified as being ‘elderly’. The average life span has gone up from 32 years in 1947 to 54 years in 1980 and from there, to 63 years (presently).
  • The absence of any useful, directed and purposeful goal leads to a progressive deterioration of a person’s mental capacity and health. Such situations are most often characterized by personality and mood changes, increased irritability, self-centeredness, social withdrawal and feelings of insecurity and guilt.
  • In the present day and age, owing to factors such as urbanization, the breakdown of the joint family system, migration of youth to cities in search of a means of livelihood and so on, the elderly have now been marginalized and neglected, resulting in many of them falling prey to mental illnesses.

Psychosocial variables leading to mental/emotional problems in the elderly:

  • Recent death of a spouse and consequent loss of companionship
  • Lowering of income caused due to retirement
  • Unemployment
  • Elders living alone due to the increasing incidence of nuclear families
  • Physical illness or disability
  • Impaired sight and/or hearing

Diminishing self-esteem

  • This can occur due to inferiority complex issues, economic uncertainty, failing health and failure to adapt to external changes.
  • It can be overcome by drawing wisdom from- life experiences, past accomplishments, cultivating independent living skills, planning for financial self-sufficiency and reaching out to the less fortunate.

Bereavement

  • It refers to the scenario wherein the person has lost a close relative or friend.
  • It can manifest itself in the form of psychiatric disorders such as depression, psychosomatic illnesses or even the urge to commit suicide.

Coping with bereavement

  • Accept the emotions surging through you, be it anger, guilt or sadness.
  • Take time to grieve and mourn.
  • Don’t live in the past.
  • Handle your finances.
  • Don’t conform to outdated, stereotypical roles of widowhood.
  • Seek professional help if required.

Psychiatric disorders in old age
Depression:

  • The common symptoms of depression are sadness, disturbed sleep, anxiety, excessive preoccupation with one’s body/health, feeling of unworthiness, loss of purpose in life, suicidal ideation, loss of energy, poor appetite and so on.
  • At times, depression in the elderly is associated with serious physical illness.

Treatment

  • By routinely undergoing a physical exam.
  • Consumption of anti-depressant drugs, as prescribed by the psychiatrist.
  • Undergoing psychotherapy.

Anxiety disorders:

  • This is usually associated with depression and hopelessness about the future, especially related to death.
  • Feelings of guilt can also arouse anxiety.
  • The suitable treatment prescribed for this condition includes anti-anxiety drugs and supportive psychotherapy.

Paranoid disorders:

  • Nearly 10% of psychiatric patients, over the age of 60, suffer from such issues.
  • It is more prevalent among elderly women than elderly men.
  • Some of the prominent features include- intense feelings of jealousy, bizarre complaints regarding organs/parts of the body (like insects crawling all over the body), hearing hallucinatory voices and so on.
  • Many of these issues are cause due to factors such as- stressful circumstances, breakdown of the family and isolation/loneliness.
  • Such patients are prescribed antipsychotic drugs and have to be carefully monitored.

Organic Mental Syndrome:

  • Some conditions present themselves when there is any form of injury to the head or due to infections or metabolic changes in the brain.
  • Two such important conditions are:
  • Delirium: It is characterized by confusion, attention issues, restlessness, disorientation, hallucinations and speech impairments of various forms.
  • Dementia: This is characterized by the loss of intellectual or cognitive functions, resulting in a gradual decline in social and occupational functioning.
  • The main features of this condition are- forgetfulness, difficulty in carrying out a simple conversation, errors in judgement and disorientation.

Treatment
For both conditions mentioned above, a thorough medical investigation is a must, under the supervision of a neurologist. Medication is then provided based on the severity of the conditions progress.

There are many positive ways to avoid becoming sad and depressed

Overcoming loneliness

  • Renew social contacts.
  • Join senior citizen forums/clubs.
  • Organize reunions with former colleagues.
  • Reach out to younger people.
  • Keep pets and care for them.
  • Develop new interests and hobbies.

Some mental activities that can boost brain power:

  • Reading
  • Refresher courses
  • Learning a foreign language
  • Learning computer skills
  • Mental calculations
  • Memorizing poems/couplets
  • Learning music, how to paint, calligraphy etc
  • Debating, story-telling
  • Games like Chess, Chinese Checkers, Bridge etc