Lesson 8: Older Adults and Mental Health

Attention

Who needs you when you are "old?"
Who wants you when you have limited resources and are older?
The gift of maturity could be earned wisdom and heritage.
Depression and despair can alternatively be experienced in maturity.
Declining health, transportation issues, housing, diet and nutrition, and finances all come into play.

Erik Erikson, and his wife, Joan, are/were widely published figures in the field of developmental psychology. Personality theory, therapeutic intervention, training and supervision for clinical practice.

Erik pre-deceased his wife by four years. His loss resulted in Joan re-thinking the final parts of Erikson's lifespan schematic. She concluded that there may well be a ninth stage, beyond the traditionl eight that everyone is trained to.
A kind of review and re-interpretation of all that hs come before can take place. It is not over until it is over. Final edit goes to the experiencing individual.

Final edit. The meaning is in the eye of the beholder!

Learning Outcomes

Upon completion of this lesson's material, students will be able to:

• Describe the normal milestones of the aging process
  
• Describe the challenges associated with diagnosing and treating mental illness among older adults.
  
• Describe contributing factors to mental health problems among older adults.

Teaching

Interview of Erik Erikson by Richard Evans - Part 1

Interview of Erik Erikson by Richard Evans - Part 2

Interview of Erik Erikson by Richard Evans - Part 3

Erikson's Eight Stages of Development

By the way, Erikson did talk about a stage beyond the eigth. It was what he called transcendance. Death is not necessaily the end of a life. The children you leave behind, the people whose life you touched, your ideas and life's wok all leave a heritage. Ideas can outlast earthly existence.

Lecture

When I was writing this, I anticipate visiting with my friend "Edna," who lives just down the road. In a few days, it will her 89th birthday. As she says, she is a farm-girl by nature. This has determined her values and perspective.
We befriended through her 35 years of work with senior citizens. Her mother before her, and her mother before her, did the same.

"Edna" has tough decisions EVERY day. She needs physical therapy. This will maintain her ability to care for herself. House care, shopping driving, all are physical-motor events. Her sister, who is 91, chops her own wood, carts it, and helps neighbors with firewood, etc. "Edna"by comparison is fragile, not frail. She needs to use her energy and time thoughtfully.

Actually, we all do!! Acting as if we will live forever is disproven again, and again. Painfully, we were reminded back in October. A fatal automobile crash took a former relative through marriage of "Edna's." We had planned on getting together later that day to have dinner by my wife and I's home. It was not to be.
"Edna" now has some important decisions to make. She always has to budget her finances, they are fixed, and very limited. She is considering moving into senior housing. She wants more social activity than occurs when her son and daughter-in-law return at the end of day from work.
She wants her OWN space!

Currently, there is a great deal of research going on concerning the roots of depression in childhood and adolecence. While systemic and biologic factors can play a role, so too can sociial-emotional issues. Bullying comes dramatically to center stage. Suicides, and homicides have been the documented outcomes of un-managed, mis-managed bullying! Self-esteem, body-image, emotional reactivity, all come into play. And. loneliness. Stand-alone sense for children, and/or adolescence can be very difficult to deal with.

Elder abuse, and/or neglect are now on the behvioral radar. It may mean missed doctor appointments, failure to renew prescriptions, delays or interception of personal mail, and so on. But, loneliness is very high on the list of non-abuse, non-neglect mental health risks.
I visit "Edna" for both my and her mental health. Sometimes, when I am there, her son, who is two years younger than I, is visiting too. He is divorced, and lives alone. "Edna" has had two marriages, one ending in divorce, the other death of spouse.

Companionship can be very important component of caring relationships. Robert Sternberg has done much research here. When his first marriage ended in divorce, I believe he was caught unawares. It turned his research and professional focus from cognition and intelligence, to personal relationships: liking, love, luminence.

Feelings are real. They are governed by the brain, the nervous system, and endocrine glands. A healthy life-style can maintain a healthy brain. Physical exercise, while good for the body, is even better for the brain. The brain creates and receives "feel-good" neurotransmitters and hormones secretions.

Assessment

Lesson 8 Quiz

1. What are some contributing factors to mental health wellbeing for mature adults?
2. What are the symptoms of some of the common mental health challenges in maturity?

Lesson 8 Discussion A

If affordable housing is an issue throughout one's lifetime, so is affordable healthcare. Can you imagine what happens when these "collide" in old age? What should we as a community understand about the risks here? Would could/should be done? Remember, this is YOUR future!

Lesson 8 Discussion B

Review the content of the GDS app. How does this particular depression scale address the risk factors for the elderly? How might you use such information to shape your interventions? (Be sure to focus on the types of interventions a Case Manager would do...not therapy or medication - though you may refer to these - what other types of interventions might be indicated?)