When is it time to consider a mental health screening for seniors?
The two most under-diagnosed and under-treated mental illnesses among the elderly population are depression and anxiety. There are particular signs and symptoms of these disorders that are important to monitor, according to Dr. Jennifer Stelter, PsyD and Director of Operations of Clinical Programs for The Alden Network.
If your loved one is no longer engaging in the day-to-day activities that they used to enjoy, you should probably be concerned about possible depression. Other symptoms include sad facial expressions, tearfulness, increases or decreases in appetite, increases or decreases in the amount of sleep they get, irritability, loss of energy, feelings of guilt and difficulties with concentration that appear to cause forgetfulness and may mimic dementia.
In addition, if they begin to express the notion that they no longer have anything to live for or would rather join their deceased loved ones, there is certainly a need for a mental health evaluation, Dr. Stelter stated.
Anxiety is another often-missed mental malady among the elderly. Those suffering from anxiety may appear irritable, frustrated or angry. They may start pacing or, when seated, rocking. Their level of worry, especially about their own health, may increase, even causing intestinal distress like diarrhea or constipation. They may also become hyper-verbal.
“Depression and anxiety among the elderly is not normal. No matter their age, everyone should be able to have the highest quality of life possible,” Dr. Stelter emphasized, hypothesizing that there is still an unfortunate stigma about mental illness that prevents people from seeking help, especially among older adults.
That is why The Alden Network's rehabilitation and health care centers and other providers of senior housing and healthcare assess new patients' mental wellness upon admission, she explained.
But if your loved one is not soon going to a post-acute rehabilitation center like Alden for short-term therapy or moving to a long-term care facility and you detect changes in their attitude and social interaction, Dr. Stelter recommends talking to their physician, mentioning the issues you notice and asking them to rule out medical causes for the changes.
“Certain medications and medical/physical conditions can cause different types of personality changes. So, ask for a thorough physical, including blood and urine work, to rule out any physical problem that may be contributing to what you are observing,” she suggested. “And if nothing in the testing can explain the changes in your loved one, ask the physician to refer your loved one for a mental health screening.
“The screening process is very important because some older adults with depression issues can appear to have dementia. We call it pseudo-dementia and it is vital that these individuals be thoroughly assessed in order to receive the help they need,” Dr. Stelter stated.
“As we age, our brain chemistry changes and, therefore, a chemical imbalance may be the cause of depression,” said Dr. Stelter. “Depression or anxiety in someone who has never experienced it in the past can also be situational. It may be caused by losses of their mate, other family members and friends, or by the transition to retirement after a busy career or the transition to a new housing situation.”
When this type of situational depression or anxiety is diagnosed, Dr. Stelter said that she usually first suggests one-on-one therapy, group counseling or support groups. If those interventions do not work or are not a viable alternative for some reason, individuals may want to speak with their physician about a more formal psychiatric management program.