For many, the "golden years" are a time for greater freedom and new beginnings.
But later life can be a difficult time too--one that, for many, is marked by loss, said University of Arizona psychiatrist Ole Thienhaus.
“Loss in the sense of losing people you care about is a major issue,” said Thienhaus, who heads the UA College of Medicine’s Department of Psychiatry. “But then loss in the wider sense involves loss of autonomy.”
Whether it’s losing a loved one, one’s health or one’s independence, many elders struggle, and this struggle can lead to serious mental health issues.
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According to the National Institute of Mental Health, older adults have the nation’s highest suicide rate, and as many as 20 percent suffer from depression and other mental disorders.
Thienhaus specializes in geropsychiatry, which studies mental health in older people.
He said far too many elders go undiagnosed and untreated.
“Often younger clinicians don’t realize how active a healthy older person can be,” he said. “There’s a tendency to jump to the conclusion that they’re old [and] who wouldn’t be depressed if they were old and didn’t have anything to do?”
When doctors and family members miss the symptoms of mental distress, there can be physical and potentially life threatening consequences, Thienhaus explained.
“A typical example would be an elderly person with diabetes—and after age 85, virtually everyone has diabetes—who will not take care of their diabetes because they’re so depressed they don’t really pay attention,” he said. “They end up in the hospital in a diabetic coma or with other complications ... and so we have a real, very direct connection between a mental health condition and a chronic medical condition that would be much more manageable if somebody had taken care of the depression first.”
Thienhaus said helping elders recover takes a multi-pronged approach, one that cares for the body and mind together.
That’s the kind of care a new program at Carondelet St. Mary’s Hospital aims to provide. The recently opened Bridges Geropsychiatric Program serves adults over age 55 experiencing a mental health crisis.
That population has, until recently, had very few options, said Randy Claxton, a behavioral health therapist in the Bridges program. He has worked in Southern Arizona’s mental health system for more than 20 years.
“In the last 15, 20 years there’ve been 10 geropsychiatric beds for all of Southern Arizona,” Claxton said. “Because of the lack of services and specifically inpatient beds for this group or individuals with special medical needs, they would be seen in the emergency room, they would be assessed as needing that bed, and then they would be there for days.”
Bridges adds 14 beds to the mix, and is licensed to treat as many as 23 patients. Patients see a geriatric psychiatrist and a medical doctor, so both their physical and mental health issues are addressed. The program also provides family education and counseling, so loved ones are better equipped to understand what their elders are going through.
For software engineer Andy Ruhl, education proved critical when his mother’s failing health triggered a severe bout of depression.
“She is in a situation where she can’t really take care of herself ... and that’s a big drain on her, to the point where she attempted her own life,” Ruhl said.
At Bridges, Ruhl’s mother found daily care from physicians and therapists who have helped her begin to cope with the feelings of loss kindled by her frail health.
Ruhl said Bridges also helped his family, by providing a deeper understanding of the toll mental health issues can take.
“When somebody’s physically sick it’s easy, everyone has kind of dealt with that,” Ruhl said. “But mentally, (it) is not something the rest of us know much about. But by experience in this program, I have an idea that if she gets in that place again, I’ll know it and I’ll be able to talk to someone about it.”
Claxton said the program is only a beginning, and more mental health services for older adults and their families are still needed in Southern Arizona, where demand will continue to grow as the population ages.
Awareness about elders’ mental health has to grow too, Thienhaus said.
“The typical questions that should be asked of an older person is, 'How do you do you spend your day? What do you do? Are you getting bored? Do you feel lonely?' Again, the assumption too often is that this is all part of old age, and it isn’t,” he said.
Armed with that awareness, Thienhaus said elders, their care providers and their families can all find the help they need to live healthier, happier lives.