GREY IS BEAUTIFUL: thinking about mental

wellness in the elderly

I remember her like it was yesterday. Her face sagged and wrinkled here and there by the wear and
tear thats comes with the rushing by of youthful years. Crows feet, firmly stamped around her
piercing eyes, lips that appeared a bit crooked yet smiled all the time and parted readily in peals of
hearty laughter. She was old but she was also filled with life and wisdom. She was our grandmother
and we loved her to pieces.
Very early in life, we all come face to face with the grey reality of ageing. Sometimes in the face of a
loving grandmother like I did, or that of a stern and very scary solitary old man who lives across the
street and grumbles incessantly about everything. As we grow older, we begin to realise the old age
is an inescapable side effect of life. Knowing we cant avoid it, we have no choice but prepare to live
it as happy and as healthy as possible.
Aging could be defined as the process of becoming older, a process that is genetically determined
and environmentally modulated. It is multidimensional, characterised by physical, psychological and
social changes. These changes are crucial and define the very process of ageing and are losses in
some aspects and gains in some other regard. Losses include decreases in ability to handle stress,
increased homeostatic imbalance and increased disease risk. There is also loss of agility, physical
frailty which makes the elderly person more vulnerable in times of emergency. Financial losses could
occur with retirement and there could be an associated loss of influence in social circles. The later
however may not always be the case and may depend on a host of other factors such as good
retirement planning and the extent of ones social circle and influence in youth. The picture probably
seems very bleak but it should be noted that old age is not just about losses. An important gain in
the older individual is that of wisdom. This was well recognised in traditional African societies as
evidenced by the fact that in many families, the oldest living member was the family head and
villages had a council of elders who led the people, settled disputes and took major decisions
affecting the people. Society draws from the wealth of experience and wisdom of its older persons
to further its advancement and growth.
As regards health, the changes are mostly depreciative in nature. This becomes hugely significant in
the light of recent projections regarding increases in the population of the elderly in most countries
of the world. Currently the number of people above 60 is put at 800 million. It is estimated that this
would increase to over 2 billion in 2050. This growth has been brought about by better health care
services which have led to increased life expectancy. Such an increase would obviously put a strain
on health resources in countries and hence the need to plan how to effectively cater for this teeming
population.
The world health organization defines health is a state of complete physical, mental and social well-
being and not merely the absence of disease or infirmity. Mental health is an important aspect of
health. It is estimated that neuropsychiatric conditions are responsible for 14% of the global burden
of disease. As high as 20% of persons above the age of 55 are said to suffer from some form of
mental disorder. Statistics from around the world show that mental health issues are becoming a
major problem. Mental health problems of older adults are said to be under-identified by health
care professionals and older people themselves, and older people are often reluctant to seek help. It
is for this reason that the world mental health day of 2013 chose to focus on this emerging problem
in order to raise awareness about it and seek for possible solutions.
Mental disorder can occur at virtually any stage of life but there are some that are commoner
among the elderly. The commonest ones are highlighted below.
DEMENTIA
Dementia is a set of symptoms, which affect the way people think and interact with each other. Very
often, term memory, mind, speech and motor skills are affected. Certain forms of dementia cause a
change in the personality of the sufferer. A person suffering from dementia may lose certain skills
and knowledge they already had. This is the main difference to other conditions affecting the mind.
People who suffer from learning problems, or lower intelligence will never acquire certain skills,
people suffering from dementia will lose skills they have acquired. Dementia is more common in
older people. Certain forms of dementia can be treated, to some extent. The most common form of
dementia is Alzheimer's disease, which accounts for between 50 and 60 per cent of all cases.
DEPRESSION
Depression is a mental illness or mood disorder which makes people feel sad and pessimistic. Most
people feel sad, discouraged, or "down" sometimes, but that is not depression. In clinical
depression, these feelings last for a long time and are combined with other symptoms. Someone
with depression might have these symptoms: strong sad feelings or no strong feelings at all, feeling
guilty, feeling helpless or hopeless, anxiety, fear, low self-esteem or a loss of interest in life. These
are symptoms of depression when they last for a long time (usually for more than two weeks). Many
people with depression commit suicide; today, it is thought that over half the people who
committed suicide had suffered from depression at least once. Depression is one of the commonest
mental disorders among the elderly and can sometimes be confused with dementia. Antidepressants
are effective in treating this condition in the elderly.
ANXIETY DISORDERS
Anxiety can give people an added push, an extra bit of motivation, to accomplish difficult or
undesirable tasks. How many of us would continue to study for exams, if it werent for our
exaggerated fear of failure? However, sometimes people are beset by severe, crippling chronic
anxiety that does more than just give their mortal life its spice. This kind of anxiety takes over their
lives. This kind of anxiety is considered a disorder and is a characteristic of the anxiety disorders.
There are several kinds of anxiety disorders but the Phobic anxiety disorders which are characterised
by exaggerated fear of specific objects or situations are the commonest among the elderly. They are
treated using anxiolytic agents.
SUBSTANCE ABUSE
Though substance abuse problems are often thought of as young peoples problems, they should not
be neglected in older adults. Substance abuse problems among the elderly are often overlooked or
misdiagnosed. It has been reported that the number of elderly persons that abuse substance is on
the increase. Stressful life events such as retirement, marital breakdown or bereavement, social
isolation, financial problems, mental disorders and some chronic physical conditions are main
contributing factors to substance abuse. Physiological changes associated with ageing and increased
use of other medicines, especially sedatives, may make drinking in lower doses more harmful for
older adults through inducing more liver damage and causing more accidents and injuries.
PARKINSONS DISEASE
Parkinson's disease is a progressive disorder of the nervous system that affects your movement. It is
caused by loss of brain cells. It develops gradually, sometimes starting with a barely noticeable
tremor in just one hand. But while tremor may be the most well-known sign of Parkinson's disease,
the disorder also commonly causes stiffness or slowing of movement, unsteady balance and rigid
muscles. Although Parkinson's disease can't be cured, medications may markedly improve your
symptoms.
Virtually any psychiatric illness can occur in the elderly. In other to enrich and improve the quality of
life of the older population, it is important that mental disorders in them should be identified early
and treated as effectively as possible. The world mental health day has chosen to focus on the
mental health of older persons in other to raise awareness concerning problematic areas in this
regard.
On a general note, mental health of older adults can be improved through promoting active and
healthy ageing. To promote healthy ageing, the socio-economic determinants and inequalities in
health need to be dealt with and additional gender and minority disparities need to be tackled.
Stereotypes against active ageing are called ageism and need to be reversed. Ageist attitudes
consider older adults as frail, past their sell-by date, unable to work, physically weak, mentally
slow, disabled or helpless. Ageism serves as a social divider between young and old and prevents
participation in society. Age discrimination has a negative impact on the wellbeing of the elderly.
Ageing is a gradual process and there is much we can do to promote good mental health and well-
being in later life. Participation in meaningful activities, strong personal relationships and good
physical health are key factors. Poverty is a risk factor for the mental ill-health of older adults and
needs to be taken into consideration. Addressing elder maltreatment is a critically important
approach for the promotion of mental health among the elderly. Primary health and community care
and social service sectors need to be sensitized and supported to deal with elderly abuse.
Deinstitutionalization and close monitoring of the remaining institutions are important additional
strategies towards better service provision for the ageing population. Promoting healthy life styles
among the general population, starting from an earlier age with strategies such as increasing
physical and mental activity, avoiding smoking, preventing harmful use of alcohol and providing
early identification and treatment of non-communicable diseases (NCDs) can contribute to better
mental health among older adults. Involving civil society, non-governmental and non-profit
organizations, and public-private partnerships could facilitate the implementation of health
promotion strategies for older adults.
Many people are filled with horror with the discovery of that extra strand of grey hair on their heads
as the years go by. Youth is desired and has always been desired by people all through history. Many
have attempted to stop the ageing process or reverse it without success. It is about time we realised
that old age is not always a bad thing. If individuals and the society as a whole takes adequate steps
to ensure the health, comfort and social integration of the older population, it would soon be
obvious, like I see whenever I remember the smiling face of my grandmother, that grey is beautiful.