Ageing: A Very Short Introduction by Nancy A. Pachana

Author:Nancy A. Pachana
Language: eng
Format: azw3, epub
Tags: Developmental, Gerontology, Social Science, General, Adulthood & Aging, Psychology
ISBN: 9780191038464
Publisher: Oxford University Press
Published: 2016-11-17T18:38:27.503867+00:00

Treatment of mental disorders in later life

Generational influences can impact older adults in whether they choose to seek help from mental health services—older adults from earlier generations are often perceived as stoic and unwilling to ask for such services. One barrier to seeking mental health services that crosses age and cultural barriers is the sense among some sectors of society of there being a great stigma attached to such services. Another barrier to seeking this sort of help can occur when health issues begin to overwhelm an individual, their family, and/or health care providers, such that mental health issues are missed or deemed to be a lower priority. Nonetheless, many cross-national studies have shown that older adults are in fact generally willing to seek help for mental distress, and indeed often prefer talking therapies to medication. However, they are often stymied by health professionals with inadequate knowledge and skills in terms of working with older persons.

This is unfortunate. Older adults definitely benefit greatly from receiving a variety of interventions. Psychosocial approaches, medication treatments, and combinations of the two have been shown to be effective with older adults. Although some research and meta-analyses of the psychotherapy data with older adults have shown less robust responses and/or higher relapse rates than in younger groups, in general the psychotherapy literature reflects the efficacy of talking therapies with older adults. Also, as many older adults already take numerous medications for illness, in surveys they often express a preference for psychosocial approaches to tackle mental health concerns.

A wide range of psychotherapies have amassed data on their efficacy with older persons. Although cognitive behavioural therapy approaches have been most intensively researched with older adults, data exist for the efficacy of such intervention approaches as brief psychodynamic therapy, reminiscence approaches, interpersonal therapy, and acceptance and commitment therapy. Combining psychologically informed approaches with adjunct approaches, such as exercise regimes or music therapy, has also been researched and found to have some support. The latter may be especially effective with persons experiencing cognitive declines, when more behaviourally focused, less verbal approaches may be most suitable.

Many have embraced meditation and mindfulness as the purported benefits of such activities infiltrate the mainstream. Mindfulness-based interventions to address a range of mental health coping issues have been trialled in a range of older adult populations, spanning caregivers to persons with neurological disorders such as Parkinson’s disease, with mixed findings. The potential benefits of meditation and mindfulness on cognition and brain health are an exciting new area of research, if only just beginning. Researchers in this area must grapple with a host of measurement and methodological issues as this field of exploration matures.

The consequences of untreated psychiatric disorders in later life are substantial. Untreated depression and anxiety may result in increased illness or morbidity, as well as increased mortality, particularly in the case of depression. Suicide rates, particularly in older males, are of specific concern. Suicidal ideation is more prevalent in older frail persons, those experiencing chronic pain, and those with depressive symptoms or

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