Bradley Cooper, Oscar winning Hollywood Actor
As the global population ages, the mental health of older adults has become an increasingly important focus for caregivers. Geriatric mental health involves the psychological and emotional well-being of individuals aged 65 and older. Caregivers, whether professionals or family members, play a critical role in identifying, managing, and supporting the mental health needs of the elderly.
The act of caregiving touches the lives of individuals globally, with over 63 million caregivers identified by the International Alliance of Carer Organizations (IACO). The economic significance of unpaid caregiving, estimated at approximately $600 billion by the American Association of Retired Persons (AARP), underscores its pervasive impact. With the elderly population projected to increase steadily, as evidenced in the ‘India Ageing Report 2023’ jointly released by the UN Population Fund and the International Institute for Population Sciences, it is imperative to address the challenges posed by ageing, not only for the elderly themselves but also for their caregivers.
Several factors are held accountable for deteriorating mental health among older adults. Conditions such as heart disease, diabetes, and chronic pain can contribute to mental health problems. Reduced social interaction and feelings of loneliness are significant risk factors for depression and anxiety. Natural aging processes and neurodegenerative diseases can lead to cognitive decline, impacting mental health. The loss of spouses, friends, and family members can lead to prolonged grief and depression. Concerns about financial security can cause significant stress and anxiety in older adults.
As populations age, many professionals find themselves assuming the role of caregivers for their ageing parents while balancing career responsibilities. A notable study in the United States reveals that 73% of employees also serve as caregivers. This article endeavors to provide evidence-based guidelines for ensuring the mental well-being of ageing parents within this context.
The multifaceted challenges of caregiving
Caring for elderly parents presents myriad challenges, yet there exists no singular handbook to prepare caregivers for this role. However, it is observed that elderly individuals may experience common mental health conditions.
A significant challenge arises from the gradual role reversal as parents age, necessitating children to transition from dependence to becoming primary caregivers.
This transition poses challenges for both parties involved.
The burden of caregiving is particularly pronounced for the ‘sandwich generation,’ individuals responsible for both young children and ageing parents. This unpaid and often unrecognized task can harbor toxic undertones, encompassing physical, psychological, and social challenges.
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These difficulties are compounded within nuclear family structures, where pressure from spouses or relatives unwilling to care for elderly parents may arise. Such attitudes, when perceived by the elderly, exacerbate mental health issues, including loneliness, social isolation, and depression, leading to decreased mobility and physical inactivity.
According to the World Health Organization (WHO), approximately 14% of adults aged 60 years and above live with specific mental health conditions. Loneliness and social isolation, affecting approximately 25% of the elderly population, are identified as prime risk factors for mental health issues later in life. Moreover, many older adults act as caregivers for spouses with chronic conditions, further impacting their mental well-being.
Common geriatric mental health conditions
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Some common geriatric mental health conditions are:
Anxiety: Among the elderly, anxiety disorders are common. This includes generalised anxiety disorder and phobias, which can be triggered by life changes, health concerns or worries regarding the future. Financial stress, bereavement (loss of spouse) and lack of purpose after retirement could also cause such conditions.
Depression: Elderly people could experience depression differently from young adults. Usually, it is manifested in elders through symptoms such as fatigue, aches and pains or sleep disturbances, unlike the feelings of sadness that younger adults undergo. Isolation and a prolonged sense of loneliness may be one of the main causes of depression.
Psychosis: Schizophrenia, delusional disorder and other psychotic conditions can occur in older adults, presenting unique challenges during diagnosis and treatment. Such conditions could be triggered by an accident, personal loss or some major life event.
Cognitive decline: Be it dementia or mild cognitive impairment, cognitive decline could be a major concern in geriatric groups. The WHO states that one out of six older adults suffer abuse, often at the hands of their own caregivers , which may be one reason behind cognitive decline. It’s no surprise that cognitive decline is associated with inadequate mental stimulation and lack of socialization.
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Sensitive elderly care
As the population ages, more individuals find themselves part of the ‘sandwich generation,’ simultaneously caring for their aging parents and their own children. This dual responsibility can be emotionally and physically taxing, necessitating a proactive approach to ensure the well-being of elderly parents while managing personal and familial obligations. Key to this approach is vigilance for signs of cognitive decline and mental health conditions, providing consistent emotional support, and considering professional caregiving services.
Aging parents are at risk of developing cognitive impairments such as dementia and Alzheimer’s disease, as well as mental health conditions like depression and anxiety. Early detection is crucial for effective management and improved quality of life.
Signs of cognitive decline include memory loss, confusion, difficulty with language, and changes in behavior. Regular cognitive assessments and monitoring daily activities can help in early detection. Engaging aging parents in cognitive activities like puzzles, reading, and memory exercises can also help maintain cognitive functions.
Symptoms of depression and anxiety in elderly parents may manifest as persistent sadness, loss of interest in activities, sleep disturbances, and excessive worry. Maintaining open communication and encouraging them to express their feelings can help identify these issues early. It is important to be empathetic and validate their experiences, reducing the stigma often associated with mental health.
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Emotional support plays a critical role in the well-being of aging parents. It involves being present, listening, and engaging them in meaningful conversations and activities.
Spending quality time with aging parents can alleviate feelings of loneliness and isolation. Activities such as shared meals, walks, or simply talking about their day can enhance their emotional well-being.
Encourage social interaction through community centers, clubs, or religious organizations. Social engagement helps maintain a sense of purpose and belonging, which is vital for mental health.
Balancing care for elderly parents with personal and familial responsibilities can be overwhelming for the sandwich generation. The demands of caregiving, coupled with career and parenting duties, can lead to stress, burnout, and strained relationships.
Effective time management is essential. Prioritizing tasks, delegating responsibilities, and setting realistic goals can help manage the multiple demands placed on caregivers.
Caregivers must also prioritize their own health and well-being. Regular exercise, healthy eating, sufficient rest, and seeking social support are crucial to prevent caregiver burnout.
In situations where balancing responsibilities becomes too challenging, hiring professional caregivers can provide significant relief. Professional caregivers offer specialized care that ensures the safety and well-being of elderly parents while allowing family caregivers to manage their other obligations.
Professional caregivers are trained to handle various aspects of elder care, including personal hygiene, medication management, and mobility assistance. They can provide companionship and engage in activities that promote cognitive and emotional health.
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Knowing that a professional is caring for their aging parents can alleviate stress for family caregivers. It ensures that parents receive consistent, high-quality care, which can be particularly reassuring when caregivers are unable to be present.
Professional caregiving services often offer customized care plans tailored to the specific needs of the elderly. This can include part-time or full-time care, depending on the level of assistance required.
Preventing cognitive decline
Caregivers should facilitate physical activity, purposeful engagement through hobbies and social interaction, including participation in spiritual and group activities. Additionally, combating social stigma surrounding mental health issues among the elderly is crucial, necessitating pharmacological interventions alongside psychosocial efforts such as counselling and community-based programmes to promote mental well-being and social connectedness.
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How to ease into the caregiving process?
Caregivers should receive training to recognize the signs and symptoms of mental health issues. Understanding the unique presentation of these conditions in older adults is crucial. Utilize resources from organizations and local health departments to stay informed about geriatric mental health. Encourage open and non-judgmental communication. Older adults may be reluctant to discuss their mental health issues due to stigma or fear of being a burden. Practice active listening, showing empathy and understanding. Validate their feelings and concerns. Encourage participation in social activities and hobbies. Group activities, volunteer work, and community events can reduce feelings of isolation. Help them stay connected with family and friends through technology, such as video calls and social media.
Encourage professional mental health support, including therapy and counseling. Cognitive-behavioral therapy (CBT) is effective for both depression and anxiety in older adults. Ensure proper management of medications. Regularly review their prescriptions with healthcare providers to avoid interactions and overmedication.
Promote regular physical activity, which has been shown to improve mood and overall well-being. Encourage a balanced diet rich in fruits, vegetables, lean proteins, and whole grains to support physical and mental health. Caregivers should also prioritize their own mental health. This includes taking breaks, seeking support, and maintaining their own social connections. Joining caregiver support groups can provide emotional support and practical advice from others in similar situations.
In conclusion
The promotion of geriatric mental health is paramount, requiring caregivers to encourage the elderly to seek or accept assistance while providing comprehensive support. Through these efforts, elderly individuals can navigate their later years with dignity and grace, fostering a reality of healthy ageing.
(By Sama Bég, Chief Product Officer – Emoha Eldercare)
