Changing the conversation about health

How can we promote better mental health in the older generation?

Depression in the older generation is on the rise, with illness and reduced quality of life factors impacting the over 65s. Here, Merisha Williams chats to Dr Simon Chowdhury, Consultant Medical Oncologist at the London Clinic, about the key issues affecting the mental health of older people – and how we can help...

World Mental Health Day, first marked on October 10th 1992, is one of the many initiatives that’s helped to break down the stigma around mental health issues. People are being encouraged to more and be honest about their feelings.

Campaigns such as the Mental Health Foundation’s ‘I’m Fine’ and ITV’s ‘Britain Get Talking’ continue to help banish stigma and an increasing number of younger people use social media as an effective medium to talk about their problems.

Mental health’s missing generation? Older people often find it harder to share their feelings, after decades of living in a society that favoured a stoic approach to mental health

However, elderly people have the potential to be left behind. In the last 30 years, the population of people aged 65+ grew by nearly half. Statistics show that depression affects 22 per cent of men and 28 per cent of women who are aged 65 and over. More shockingly, 85 per cent of these people will receive no help for their mental health.

For elderly people, especially those who get illnesses such as dementia, physical disabilities or cancer they are at a higher risk of mental illness, especially since their generation have been discouraged from talking about it in the past.

Older people are less likely to use growing technology, making avenues such as social media much less open to them. Amongst young people and children, mental health is a topic that is encouraged to be spoken about, but for elderly people, this is not always the case.

ARE ELDERLY PEOPLE MORE LIKELY TO BE AFFECTED BY MENTAL HEALTH ISSUES?

It’s common for a lot of people to think that mental health problems are something we develop naturally as we get older, but in fact, this isn’t true. As with anyone at any age, mental health can be affected by different factors such as recent events or genes.

Lifestyle changes, especially in elderly people who have gotten used to a specific routine for years, can impact their mental health. They could be something that bring elderly people out of their comfort zone and then elderly people may feel they don’t have time to adjust to these changes.

PRESSURES OF RETIREMENT

Retirement is something that is completely new for all of those that haven’t reached that point in their lives. For elderly people, it’s a case of planning first and ensuring that they are ready for it whilst for younger people, it’s wondering what it will be like and wondering if they will ever get there. Retirement can be a big change for elderly people, especially for those who have spent the majority of their lives working.

The current generation of older people lived in an era where there’s a high probability that they’ve been working since they were young teenagers. When retirement is near, it can cause anxiety as there are a lot of factors to take into account: future costs without any employment income, financial security, maintaining friendships that were made at work and keeping self-esteem, especially if they were someone who felt valued in their place of employment by their peers.

In some cases, an early retirement may have been forced on some elderly people by their place of employment –  especially if people are being made redundant or if the company is closing. If older people aren’t ready for this change just yet, it can really affect their mental health, especially if early retirement was never part of a plan. For some, this will help towards depression and anxiety as they may feel it’s too late for them to try and get another job.

POST-WAR STIFF UPPER LIP

Loneliness and failing health can severely impact mental health in older generations

For a lot of elderly people, they are very likely to have lived through at least one war – whether they’ve been caught up in one or taken part and witnessed it. Those who survived World War 2 are more likely to suffer from depression by 6%. Furthermore, thousands of soldiers suffered from PTSD (post traumatic stress disorder) which led to a lot of them self-medicating with alcohol and abusing other substances to cope.

After WW2, some of the hospitals were full of people that had mental health problems, but at the time, as there was a lot of negativity around the subject, people did not speak about it. Even in some cases, it would bring shame to have someone in the family with a mental illness. 

This would have been a bigger possibility in countries such as the UK where people are taught to have a ‘stiff upper lip’. This mentality has stopped people from being honest about how they feel and is now affecting the older generation as they didn’t get the treatment they needed in the beginning.

LET’S TALK ABOUT DYING

Death will affect everyone at some point, but no matter what age, it doesn’t necessarily mean you’ll be ready for it. As death becomes more frequent as we get older, it can lead to depression and suicide depending on how much a person is affected.

Loneliness is one of the biggest problems facing older people today, especially for those who have had a spouse for most of their lives or who are used to being around people.

Each generation is different and the current elderly generation came from a time where marrying young as common and a sense of community was encouraged. When these normalities start disappearing from elderly people’s lives, it can cause anxiety and depression as what they have been used to, has now gone.

‘Broken heart syndrome’ or Takotsubo syndrome is a very real phenomenon. It consists of a temporary disruption of the heart’s pumping function which increases the risk of death for the sufferer. As the heart weakens during  a traumatic event, this syndrome has similar symptoms to a heart attack and due to this, it’s common for elderly couples to die within a short amount of time of each other.

DECLINING HEALTH

Other health issues that tend to be more common as we get older, such as arthritis, dementia or cancer can really have an affect, especially on those who have enjoyed an active lifestyle throughout their life.

Physical disabilities can prevent elderly people from leaving their homes and this also leaves elderly people feeling lonely. Medication tends to come with these health issues and a common side effect of medication is changes to mental health. Since older people will be more likely to be taking more than one type of medication at any one time, their changes of having mental health problems increase.

To combat these issues, a lot of elderly people will be placed into care homes, rely on a home care agency or have a local home carer, especially if their families feel they are unable to look after them anymore or give them the help they need. Personal care assistants are trained to help with specific problems and they also tackle the problem of loneliness in elderly people.

HOW CAN OLDER PEOPLE TAKE CARE OF THEIR MENTAL HEALTH?

To help with mental health, it’s always suggested to plan retiring, wills and funeral costs early. This will help to lessen anxiety within elderly people and will also help their families to put their minds at ease.

Medical professionals such as doctors always suggest having a healthy and active lifestyle where possible. Diet aids in mental health and physical activity will help to keep the body and brain active. This can also help with self-esteem and to regulate sleeping patterns.

Social groups – such as art classes – can make a huge difference to mental health

To combat loneliness, it’s good advice to try and volunteer somewhere if unemployed or retired and join social groups to form new friendships. It’s so important to have someone to talk to in case any issues do arise – whether it’s a family member, friend or specialist and remember to write things down if it’s needed.

LOOKING FORWARD

Of course, this advice isn’t just for elderly people, it’s for everyone and it’s important to know that mental health is never the same for everyone. Some people will be ready to talk about it and others won’t be ready – it’s up to others to be patient and understanding. Even though talking is a good idea, some mental health illnesses will also require medication, so it’s best to visit a doctor first.

Hopefully, mental health will continue to be spoken about on a larger scale with all labels of taboo erased. The more the younger generation continues to talk about it openly and fights for proper, decent mental health care, it will be easier for future older generations to get the treatment and the help that they need.

For more information on Caremark care homes, visit https://www.caremark.co.uk/

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