Aging adds plenty of health concerns to your life and can alter how you feel about yourself and the world around you. This is made even more difficult for seniors with mental illnesses. With increasing chronic health conditions, loss of loved ones, and losing independence, depression rates rise for those over 65. “More than two million of the 34 million Americans age 65 and older suffer from some form of depression.” (Mental Health America)
Angelo Pananas is the director of Behavioral Health at West Florida Hospital where they have a psychiatric unit dedicated to seniors at the Pavilion. The Pavilion is a 56-bed inpatient psychiatric program with 18 beds in their geriatric unit. The program is certified through the Alzheimer’s Association’s Institute for Healthcare Improvement Age Friendly Initiative, a assessment based on fair and equitable treatment of patients living with Alzheimer’s disease. “This includes mentation—a psychiatric evaluation and cranial nerve assessment, medication, physical therapy, and working with patients’ goals,” Pananas said. Most patients are suffering from depression or are in agitated states of dementia that can be difficult for family to deal with without a plan.
Dr. Shabana Jaffri is one of the psychiatrics at the Pavilion and says that they often get patients who have hit a critical care point in their mental health that they did not have to reach. “I think the most common thing is they have to watch when they retire is if they don’t have a proper plan because they have had very busy lives, and suddenly, they’re just staying at home.”
One thing that retirement without any plans can uncover is bipolar disorder. Found in an estimated 2 percent of the population, bipolar disorder is characterized by alternating depression and manic or hypomanic states. Hypomania can go undetected as it may manifest in some individuals as hyper-productivity. Retirement may uncover this as a person becomes irritable and agitated without an outlet for their hypomania.
Preparing for retirement doesn’t just mean having a plan for something fun to do. A plan isn’t just for retirement. Dr. Jaffri suggests that patients have plans for their care teams, such as advance directives, power of attorney and living wills. This allows family members to make care decisions while you may be hospitalized that are in your best interest in the case of placement after hospital care.
Having a plan also includes looping your loved ones and caregivers in on your mental health journey. They need to know what medications you are on, as many may have adverse reactions with medications for physical ailments. Your family should know signs of psychosis or depression and examples of when you may need to be hospitalized.
Pananas and Dr. Jaffri recommend that above all else, do not wait until rock bottom for your mental health to go to a mental health facility or simply to talk to your doctor. Dr. Jaffri says that getting dementia patients in the last stage is common and difficult to help with as a provider. She wishes she could see patients earlier to help them and their families with care plans.
Aging can go hand-in-hand with hardships such as loneliness and new aches and pains. But aging does not naturally include depression. “Depression and dementia are not in everybody, but we have to watch some of the cognitive impairment of that,” Dr. Jaffri said. Signs that depression might be at play with your loved one:
Many are emotions that can come and go with life. Seek additional help if they are consistent for one to two weeks. Talk to your doctor to receive a screening for depression and other mental health concerns to start the process of assistance.
In children and older adults, depression and anxiety may have physical components. This means that the body and organs start to become affected, and aches and pains pop up. Anxiety can cause gastrointestinal problems and depression may cause physical aches and pains. Work with your doctor to rule out any causes. If you are unable to make a diagnosis, your mental health may be the culprit—and a treatable one at that!
This can go the opposite way, with physical ailments causing agitation and irritability—even signs of psychosis. Dr. Jaffri says that the first thing they do with geriatric psych patients is treat constipation and urinary tract infections to rule this out.
Pananas adds that it is more important than ever to have faith in your doctor. People are coming in long after physical and mental health issues become a problem. This spike in late interventions recently is caused by a fear of hospitals during COVID-19. Pananas stresses that hospitals are experts and infectious control and urges the public to take care of themselves and talk to their doctor as issues arise.
You can ask your loved one about their mental health directly. Don’t stop at, “Hey, how are you?” because we have programmed ourselves to say, “I’m great!” even when that is far from the case. Especially when you add in our southern mannerisms!
Ask them if they are depressed, are having thoughts of hurting themselves, or thinking about suicide. There is a myth that asking about suicidal thoughts can then plant the idea. This is not the case; in fact, asking about this reduces the risk of suicide because that person knows someone cares and that they can talk about it. Despite being a small part of the population, individuals ages 65 and over account for 20 percent of all suicide deaths in the US and those ages 85 and older are six times more likely to commit suicide than the national average. This is not to say that your loved one is at risk, but rather that it is much more important to check in on them and create a warm space for open and genuine answers.
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