Aging is an inevitable part of life’s journey, a path usually represented by wisdom, experience and a rich accumulation of cherished memories. Yet this voyage through the years can also bring a host of unique scenarios. One such scenario is the aging-mental health nexus, which underscores the delicate link between our mental wellbeing and age.
The complex relationship between age and mental health has been a topic of discourse for a long time, and while there has been significant research and progress, it is still not fully understood. Nonetheless, the known influence of age on mental health demands our understanding, empathy and, most importantly, specialized care.
This post explores this link and the often-subtle signs of mental distress among the aging population. Furthermore, we highlight how nurses can serve as beacons of support to improve their mental and emotional wellbeing.
Understanding the aging-mental health nexus
Older adults, typically aged 60 and above, play a significant role in society through their contribution as family members, volunteers and active participants in the workforce. The global population is also aging rapidly – it is projected to almost double from 12% to 22% between 2015 and 2050. However, while most of this population has good mental health, many older adults are at risk of developing several mental conditions, from mental and neurological disorders to potential substance use problems. But what makes them a more vulnerable population?
The explanation lies in the aging process. A complex combination of biological, psychological and social variables determine how we get old and our health outcomes. However, it’s crucial to acknowledge that this progress is unique and varies from person to person. Diverse factors including genetics, lifestyle, environmental factors and cognitive aspects also shape it.
Numerous researchers have established connections between the aging process and alterations in brain structure and function. These changes can detrimentally impact cognitive ability, memory, emotions and behavioral patterns. Yet while they may be part of the natural aging process, these changes could also result from brain diseases and traumatic brain injuries.
The aging process is also intertwined with psychological elements and the social environment in which elderly individuals reside. Psychological aspects impact their self-perception, stress-coping mechanisms and pursuit of personal goals. The predominant adverse effect of this factor is a heightened susceptibility to conditions such as depression and anxiety.
Likewise, social connections, support systems and exposure to social challenges can positively and negatively affect an elder’s mental health. On the one hand, a feeling of social inclusion and supportive relationships can elevate mental wellbeing and functioning. Conversely, unfavorable social circumstances such as isolation, conflicts and abuse can undermine their mental health.
The dynamics of aging and mental health are significantly interrelated, influencing each other in bidirectional ways. This is perhaps why approximately 15% of adults aged 60 and over have a mental disorder. With such numbers, it’s essential to completely grasp how these factors influence and interact with each other over time and develop better strategies to promote healthy aging.
Most prevalent mental conditions among older adults
Based on available data, anxiety disorders are the most prevalent mental disorders among older adults, affecting many people aged 60 years or older. Anxiety among older adults could result from external factors such as stress, chronic illnesses and disability, or internal factors associated with vulnerability and personality traits.
This condition is also associated with reduced physical activities among older adults, as well as lower functional status, decreased life satisfaction, loneliness and reduced quality of life. If left untreated, anxiety disorders are also a risk factor for Alzheimer’s disease and vascular dementia.
Despite this prevalence and the potential to cause more severe complications, anxiety disorders are hardly recognized among older adults. Therefore, healthcare professionals must identify the physical symptoms associated with mental conditions and develop preventive or treatment plans.
Challenges in recognizing mental health issues in the elderly
It is crucial to improve the mental wellbeing of older individuals. However, addressing these concerns within the elderly population is a complex process marked by distinctive challenges. To begin with, mental health issues tend to surface in often unexpected ways, making them difficult to identify and address.
Below, we explore some of the barriers that nurses must recognize to provide crucial mental health support and care among older people.
Masked symptoms and co-occurring conditions
Older adults experience changes to their physical health, mental health and cognition as a normal aging process. These similarities sometimes make it difficult to distinguish between normal aging processes and signs of mental illnesses.
Older adults could have symptoms masked by other medical conditions or medications. For instance, symptoms such as depression might remain hidden behind chronic pains, heart disease, diabetes or dementia. This scenario could lead to treatments that target the apparent physical condition without addressing the underlying mental issue.
Additionally, there are instances where co-occurring conditions coincide with mental illnesses. These circumstances can complicate the detection and treatment of mental disorders, potentially increasing the severity and longevity of mental health symptoms. Over time, these symptoms may develop into severe conditions that significantly impact the overall quality of life for elderly individuals.
The stigma surrounding mental health
Stigma is a significant barrier to recognizing and managing mental health issues in elderly patients. Although mental health awareness has significantly increased recently, many older adults grew up at a time when there was substantial stigma attached to discussions concerning mental health. As such, they may feel embarrassed or guilty about their condition.
Other factors such as generational attitudes, religious biases, limited access to care, and fear of institutionalization contribute to the likelihood of older adults receiving treatment for their conditions.
The role of nurses in geriatric mental health
The significance of promoting healthy aging cannot be emphasized enough. As such, the role of nurses in caring for older individuals holds immense importance. This pivotal responsibility demands profound sensitivity, mindfulness and awareness to ensure the best outcomes.
Geropsychiatry represents a unique convergence of superior clinical expertise and societal compassion. Here are some of the roles that nurses can play to help older adults attain enduring mental care.
Continuing education for nurses
While mental health among older people continues to be a substantial and growing concern, the processes for identifying and treating these conditions are poorly understood or ineffectively managed. This barrier highlights the need for geriatric mental health training in long-term care settings and for versatile healthcare professionals such as nurses.
Nurses are in an advantageous position to address the current mental health challenges among the older population. One way that this can be achieved is through developing, implementing and evaluating geriatric mental health education and training programs. Nurses can engage in advanced nursing specializations such as AGNP programs online or other programs that prepare them for the healthcare needs of older adults by studying at the reputable Wilkes University.
Comprehensive assessment and screening
Nurses are often the first point of contact for older adults seeking help for any medical problem. As such, they have the opportunity to identify and assess mental health symptoms early. In this context, nurses can screen for common mental health problems such as depression, anxiety, dementia or substance abuse. Through screenings, nurses can detect symptoms that may otherwise go unnoticed and suggest specialized services.
Along with physical health, nurses can also assess older adults’ functional ability, cognition and psychosocial situation with a Comprehensive Geriatric Assessment (CGA). By performing these roles, nurses can contribute to preventing, detecting, diagnosing and treating mental health problems in older adults.
Identifying and addressing patients’ unique needs
Through comprehensive evaluation and screening, nurses specializing in geropsychiatry can apply evidence-based interventions designed to address the physical and mental health of older adults. Such interventions have demonstrated effectiveness in enhancing various mental health conditions and can be customized to align with each patient’s unique needs.
Alternatively, nurses can refer patients to specialized health professionals who can provide holistic and patient-centered care. It’s also good practice to monitor how effective and safe these interventions are for patients. Some common evidence-based mental health interventions include psychotherapy, pharmacotherapy, psychosocial interventions or lifestyle modifications.
Collaborative care approaches
The nursing practice emphasizes collaboration among different professionals. This healthcare model aims to improve patient outcomes through interprofessional cooperation. This model commonly includes a primary or tertiary team collaborating with allied health professionals, such as mental health specialists.
Nurses possess unique training that prepares them to understand the responsibilities of various healthcare professionals, making them exceptional collaborators. Moreover, their capacity to grasp and evaluate a patient’s clinical, emotional and social requirements positions them as valuable contributors in developing tailored treatment plans, irrespective of their specific expertise.
As such, it’s common for nurses to engage in collaborative efforts with fellow healthcare professionals to provide comprehensive and patient-centered mental healthcare.
Preventive measures to promote mental wellness
Preventive healthcare has continued to gather widespread appreciation across the medical scene for its ability to focus on root causes and enhance quality of life. Nurses can also apply this strategy effectively in promoting mental wellness among the older populations.
Our lifestyles are significant risk factors for mental health. Many individuals struggling with mental illness frequently report disrupted sleep patterns, poor dietary choices, reduced engagement in physical activities and potential substance misuse. There is also the ripple effect of substance addiction on family dynamics, which, in most cases, is more consequential to a person’s mental health than substance abuse.
Nurses can educate and counsel older adults on the impacts that specific lifestyles could have on their mental health and provide support in altering these behaviors. These professionals are also aware of the benefits of social engagement on the mental health of elderly individuals. As such, they facilitate and encourage such meetings.
Holistic nursing care
A holistic approach to healthcare considers the whole person rather than just focusing on a specific illness or symptom. This strategy is a crucial aspect of gerontology and mental healthcare that recognizes all the factors influencing overall health.
As part of holistic care, nurses can develop individualized care plans, manage patient medications, and incorporate therapeutic interventions and social engagements to combat loneliness and isolation. Nurses could also include activities that stimulate cognitive function and help older adults maintain mental acuity.
Furthermore, holistic nurses empower patients for self-care by providing them with education, support and the resources to manage their conditions and improve their wellbeing. Ultimately, holistic care improves mental health in older individuals by providing a comprehensive and personalized approach that considers multiple dimensions of their experiences.
Conclusion
Prioritizing the holistic wellbeing and social support of older individuals is vital in promoting their physical and mental health. To achieve this, we must gain a deep understanding of the complexities they encounter in preserving their emotional and mental wellbeing.
To address the distinctive challenges and disorders linked to the aging process, comprehensive training for healthcare providers, particularly nurses, is required. Such efforts should extend to establishing accessible primary healthcare services within underserved communities tailored to the unique needs of older adults. Alongside providing caregivers with the requisite training and support, equal attention should be placed on ensuring sustained mental healthcare for older individuals who grapple with mental disorders.