DiscoverCounselor Toolbox PodcastMental Health and the Elderly 12 Key Points
Mental Health and the Elderly 12 Key Points

Mental Health and the Elderly 12 Key Points

Update: 2019-09-08


421 -Mental Health & the Elderly

12 Key Points

Podcast is part of A La Carte Course:

Dr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC

Executive Director,

Podcast Host: Counselor Toolbox & Case Management Toolbox


– Review 12 key issues that either differ or often go overlooked in people over 65

Psychosocial Adjustment to Aging

– There are multiple psychosocial aspects to aging

– Integrity vs. Despair

– Loss of physical functioning

– Death of friends

– Changes in social relationships

– Frequent mental distress (FMD) may interfere with major life activities, such as eating well, maintaining a household, working, or sustaining personal relationships.

– Older adults with FMD were more likely to engage in behaviors that can contribute to poor health, such as smoking, not getting recommend amounts of exercise, or eating a diet with few fruits and vegetables (11)

Emotional Health

– Mood issues are not a consequence of normal aging

– Depression

– Situational (grief, life transitions)

– Vascular

– Bidirectional association between depression and cardiovascular diseases

– Elderly men have the highest rate of suicide of any age group

– When untreated, depression reduces life expectancy, worsens medical illnesses, enhances health care costs and is the primary cause of suicide among older people

– Both exercise and dietary interventions can promote mental health

– Almost half of older adults who are diagnosed with a major depression also meet the criteria for anxiety

Cognitive Decline

– It is often partly preventable

– Slowing or some loss of other cognitive functions takes place, most notably in:

– Information processing

– Selective attention

– Problem-solving ability

– Prevention and early intervention should focus on

– Encouraging different problem solving tasks (hobbies, puzzles etc.)

– Maintaining physical activity to improve blood flow

– Maintaining a good sleep routine (including addressing bladder issues)

Cognitive Health

– Dementia Risk Factors

– Smoking

– Alcohol use

– Hypertension

– Diabetes

– TBI from falls

– Dementia Interventions

– Physical activity

– Control of blood pressure

– Not smoking

– Social engagement

– Depression prevention/intervention

– Diabetes management

Chronic Health Conditions

– Medications

– Pain

– Increased injury risk

– Parkinson’s Disease

– Frailty Syndrome is a geriatric syndrome characterized by the clinical presentation of identifiable physical alterations such as loss of muscle mass and strength, energy and exercise tolerance, and decreased physiological reserve

– Malnutrition

– Lack of Exercise

– Depression

– Horticulture Therapy shows great potential in enhancing mental health, cognitive functioning and physical health in the elderly


– Age-related physiological changes that can impact drug effects include the following:

– absorption: increasing gastric pH, decreasing absorptive surface

– distribution: decreasing total body water, lean body mass, and serum albumin

– metabolism: decreasing hepatic mass and blood flow

– excretion: decreasing renal blood flow, glomerular filtration rate, and tubular secretion.

– Some of the most common medicines likely to have adverse effects include anticoagulants, antibiotics, diuretics, hypoglycemic agents, benzodiazepines, opioids, NSAIDs


– Hormonal changes and other physiological changes associated with aging affect sexual interest.

– Erectile dysfunction is a problem in men increasing with age.

– Diabetes, cardiovascular, cancerous, and chronic respiratory diseases and also some medications can reduce sexual capacity and desire

– The most common causes for male erectile dysfunction are vascular diseases.

– Age is not a barrier to sexually transmitted diseases.

– In women lack of emotional wellbeing and a sense of intimacy during sexual intercourse can lead to reduced sexual interest


– The causes of malnutrition can stem from other health problems

– Seniors suffering from dementia may forget to eat

– Depression

– Alcoholism

– Dietary restrictions

– Reduced social contact

– Limited income

– Reduced mobility

– Dental problems


– Sleep needs do not decrease with age.

– Short and long sleep duration groups had increased prevalence of mental health issues by 66% and 26%

– Poor quality insufficient sleep is associated with poorer physical function and cardiovascular issues

– With ageing less slow wave sleep (deep sleep) is expected, along with more awakenings, and a tendency toward earlier sleep times.


– Causes of Sleep Problems

– Bladder control

– Neurological conditions

– Lung diseases (asthma, COPD)

– Chronic pain

– Sleep apnea

– Anemia


– Rapid eye movement sleep behavior disorder often represents the earliest sign of a Lewy Body Dementia.

– In REM-SBD people act out vivid, often unpleasant dreams with vocal sounds and sudden, often violent arm and leg movements during REM sleep.


– Social support serves major functions, including

– Emotional support

– Informational support (e.g. advice and guidance)

– Instrumental support (e.g. providing rides or assisting with housekeeping)

– Adequate social support is associated with reduced risk of mental illness, physical illness, and mortality

– Retirement Blues


– Technology based interventions to reduce social isolation had a moderate, but short-term impact on reducing isolation.

– Social support interventions should focus on

– Connecting to the outside world

– Gaining social support

– Engaging in meaningful activities

– Boosting self-confidence

Life Satisfaction

– Life satisfaction is the self-evaluation of one’s life as a whole, and is influenced by socioeconomic, health, and environmental factors

– Life dissatisfaction is associated with obesity and risky health behaviors such as smoking, physical inactivity, and heavy drinking (all which increase risk of dementia)

Cultural Differences Impacting Treatment

– Different conceptualization of the problem

– Different idea of appropriate interventions

– Suspiciousness of strangers or “white coat syndrome”

– Different expressions of distress

– Limited resources

Treatment Principles

– Therapeutic interventions to encourage autonomy include

– Daily living skills

– Improving safety at home

– Provision of practical support and information including social and legal rights.


– Older people with mental illnesses (particularly depression or dementia) may take longer to respond to treatment

– Interactions between medication and comorbid physical illnesses (and their treatment) are also common.

– It is important to address coexistent physical and mental health issues

– Social engagement, physical activity, control of diabetes and hypertension, prevention of depression and developing a sense of life satisfaction are all associated with positive health outcomes and reduced risk of depression and dementia









Mental Health and the Elderly 12 Key Points

Mental Health and the Elderly 12 Key Points

Charles Snipes