Navigating Mental Health Challenges in Seniors
According to the World Health Organization’s 2023 data, around 14% of adults aged 60 and over live with a mental health disorder, with the most common mental health conditions for this group being depression and anxiety.1
There are many factors that can negatively impact a senior’s mental health. For example, reduced mobility, age-related cognitive decline, the onset of multiple chronic conditions, dementia and Alzheimer's disease, and social isolation and loneliness can all lead to or escalate a senior’s mental health conditions. They may face the challenge of experiencing several health problems at the same time and are also more likely to experience grief and bereavement in old age. Remember that some seniors might act as caregivers of their spouses with chronic diseases, which in the long term could add to the risk of feeling stressed and burnt out. All the above situations could put senior adults at greater risk of depression and anxiety. When these conditions are left untreated, a senior’s mental health can worsen and, in some cases, result in suicide. Older adults have one of the highest suicide rates as compared to other age groups—with white men over the age of 65 having the highest rate.
How to Improve Mental Health Wellness for Seniors
There are many opportunities to improve how we treat senior mental health, as this population tends to avoid talking about what they are experiencing and/or downplays the seriousness. This population may feel that sadness and isolation are a normal part of the aging process. They also may be embarrassed to discuss mental health concerns for fear of appearing weak or dramatic. With a condition like dementia, admitting there may be a cognitive problem can be scary, and avoiding it is sometimes easier.
To help older patients get the care they need, primary care physicians must be proactive about spotting mental health issues and taking action. Here are three ways you can make a difference.
1. Proactive Screening for Mental Health Risk Factors in Seniors
Screening can help identify patients at risk, who aren’t able to recognize or articulate their feelings. Nationally published tools can help screen patients for the presence of common behavioral health issues like depression. Annual physicals present the perfect opportunity to conduct screenings for mental health risk factors. In addition, watch for red flags that may come up organically during a visit. For instance:
- Does the patient have trouble sleeping?
- Do they seem to be worried about many things?
- Have they recently lost a spouse or close friend?
- Are they suffering from a terminal illness or a condition that has recently gotten worse?
- Are they difficult to engage?
- Do they discuss any unusual ideas or disturbing thoughts they have had recently?
- Do they anger easily?
Should you notice anything that makes you suspect a mental health issue in your senior patients, take further action—whether that’s providing education, referring the patient to a specialist, scheduling a follow-up call, or talking about treatment options such as mental health therapy.
2. Fostering Meaningful Conversations About Mental Health
Primary care physicians are in a good position to change seniors’ minds about the importance of good mental health and how to achieve it. Listen to their concerns, repeat what they’ve said, provide education on mental health, and listen to how they respond. This is especially important for older patients who might not have the vocabulary to express their feelings. You should approach mental health discussions with the same care and attention as physical health discussions. When dealing with difficult conversations, apply empathy and show them that you understand the complexity of their struggles and situations. Some of the topics on mental health may include self-care tips, therapy options, possible medications, and caregiver support. When making specialist or therapy referrals, consider connecting patients with physicians who are experienced in the treatment of mental health conditions (and associated neurological and substance use conditions) in senior adults. Sharing information about the Suicide and Crisis Lifeline (the three-digit crisis number, 988) may also be beneficial, although be mindful that discussions around death and suicide can be particularly delicate for senior adults.
3. Extending Support Beyond Clinical Visits for Seniors
Although engaging senior patients during appointments is important, you should also stay in touch between visits to ensure they receive mental support from family and communities. This may include conducting follow-up calls, scheduling telehealth check-ins, and connecting them with local community resources, such as stable transportation, companionship, meal delivery services, or support groups. For senior adults, meaningful social connection is important to help reduce the feeling of isolation and loneliness, which can lead to more positive mental health and increased quality of life. Physicians who participate in alternative payment models such as value-based care may have more flexibility to think creatively about how to connect with them outside of traditional visits.
Conclusion
By 2030, one in six people in the world will be aged 60 years or over.
Consequently, the prevalence of mental health issues for seniors, including mental health issues that can lead to an increased risk of suicide, is expected to increase as well. As an industry, health care professionals, need to take the necessary steps to proactively identify older patients with potential mental health challenges and intervene early before they escalate.
CareAllies is an industry leader with more than two decades of experience in value-based care. We help physicians like you succeed in value-based care models so you can improve the health and wellness of your patients.
Explore more expert insights in our resources or contact us today to learn more about how we can help with your practice.