Mental health aging

“the life cycle weaves back on itself”

Human Life Cycle Stages :

https://www.simplypsychology.org/Erik-Erikson.html
Ego integrity VS Ego Despair
• Self management of health
• Self-management activity for older adults who believe that a change
in their environment will improve their living situations
• Self-management is a dynamic learning process that relies upon a
number of skills, including:
• problem solving,
• implementing solutions, and evaluating outcomes;
• decision making;
• researching;
• forming partnerships with health care providers; and taking action, which
involves devising a plan and carrying it out
Wisdom
• In facing declines in health status, older adults faced threats to the
independence, essentially revisiting the crisis of autonomy versus
shame and doubt that they experienced as children
• actively working
• trusting and making visible their capabilities, by using them to organize their
activities
• Exhibiting autonomy, as they are not allowing others to become more
powerful in self-management activities
Older Adult Facts :
• Older adults are more likely than any other age group to have complex
health conditions, substance use disorders and cognitive impairments
• Loss is common: loss of – spouse, friends, physical functioning,
independence, purpose
• Purpose affects overall health, including mental health, physical health and
substance use
• Healthcare providers and older adults often mistake depression for a
natural response to aging. This can lead providers to not screen for or treat
depression
• Older adults do not seek help
• Older adults go to see their Primary Care Physician, to get all of their
medications and help for their physical illnesses
Elder Abuse
• Physical abuse
• Sexual abuse
• Domestic violence
• Psychological abuse
• Financial abuse
• Neglect
• Self-neglect
• Elder abuse is a serious problem, with an estimated 8-10% of older
adults experiencing abuse
Some Basic of Geriatric
• Changes of the brain
• Changes of the body
• Changes of many levels of functioning
• Changes of tolerance in medication, alcohol, foods,etc
Causes and Risk Factors for Senior Mental
Illness
• Physical disability
• Long-term illness (e.g., heart disease, cancer)
• Dementia-causing illness (e.g., Alzheimer’s disease)
• Physical illnesses that can affect thought, memory, and emotion (e.g.,
thyroid or adrenal disease)
• Change of environment, like moving into assisted living
• Illness or loss of a loved one
• Medication interactions
• Alcohol or substance use
• Poor diet or malnutrition
Challenges in Assessment and Diagnosis
• Clinical presentation of older adults with mental disorders may be
different from that of other adults, making detection of treatable
illness more difficult.
• Many older adults present with somatic complaints and experience
symptoms of depression and anxiety that do not meet the full criteria
for depressive or anxiety disorders
• Detection of mental disorders in older adults is further complicated
by high co-morbidity with other medical disorders
• The symptoms of somatic disorders may mimic or mask psychopathology,
making diagnosis more taxing.
• Older individuals are more likely to report somatic symptoms than
psychological ones, leading to further under identification of mental
disorders.
• Primary care providers carry much of the burden for diagnosis of mental
disorders in older adults
• However, the rates at which they recognize and properly identify disorders
often are low.
• With respect to depression, a significant number of depressed adults are
neither diagnosed nor treated in primary care.
Depression in Late Life
• Depression is strikingly prevalent in older adults
• With 8 to 20% of older adults in the community and up to 37% in
primary care settings experiencing symptoms of depression.
• Depression is a foremost risk factor for suicide in older adults
• Undiagnosed and untreated depression in the primary care setting
plays a significant role in suicide.
• Depression training for general practitioners reduces suicide.
General picture disorder in elderly

depression

psychosis
dementia

movement
disorders
Terima Kasih