HOW CAN WE HELP PREVENT MENTAL ILLNESS AMONG OLDER ADULTS?
While most mental illnesses have their onset in childhood or adolescence, older adults are uniquely vulnerable to suffering from negative outcomes associated with mental illness. They are more likely to experience major life changes, such as deterioration in physical health moving into a long-term care or nursing home, or losing a loved one, and are less likely to be connected to others in the community. In fact, it is estimated that 19% to 24% of older Canadians are experiencing some degree of social isolation which can put them at increased risk of loneliness and mental health issues.
Some tips to prevent or manage mental illness are:
Remain socially connected and active in the community |
Engage in meaningful activities |
Manage your chronic health conditions |
Remain physically active |
Maintain a healthy diet |
Keep a regular sleep schedule |
If you are facing mental health issues, you should reach out to your primary care provider or a mental health professional for assistance.
WHAT ARE THE MOST COMMON MENTAL HEALTH CONDITIONS AMONG OLDER ADULTS?
Older adults are at risk for a variety of mental health conditions. However, some are more common amongst older adults than others. Common mental health conditions among older adults that are highlighted in this pamphlet are:
1. Depression |
2. Anxiety |
3. Delirium |
4. Addictive Disorders |
5. Suicide |
1. DEPRESSION
WHAT IS DEPRESSION?
Depression is more than feeling sad. It is a serious medical illness that causes persistently low mood and loss of interest in activities that were previously enjoyed, leading to emotional and physical problems that decrease a person’s ability to function in thier social and occupational life. While it can share many symptoms with sadness, depression is not something that people can get over on their own without treatment.
Depression can affect a person’s mood, behaviour and physical functioning. Some common symptoms of depression are:
- Feeling sad, lonely or anxious.
- Feelings of guilt or regret.
- Loss of pleasure from favourite things or activities.
- Sleeping problems.
- Difficulty thinking or focusing.
- Reduced energy and feeling tired more often.
- Changes in eating habits or weight.
- Feeling like a burden.
- Loss of meaning in life.
- Frequent complaints of pain and medical visits.
HOW DO YOU KNOW IF YOU HAVE DEPRESSION?
If you experience these symptoms for more than two weeks, you may have depression. This mood can result in behavioural changes, such as talking and moving slowly, withdrawal from people, giving up on hobbies, decreased self-care, or psychological changes, such as feeling hopeless and having negative thoughts.
Discussing your thoughts and feelings with your primary care provider can help them to understand what is happening in your life. They may do some tests to rule out other causes of the symptoms.
WHO IS LIKELY TO EXPERIENCE DEPRESSION?
Depression can affect anyone at any time. Older adults are particularly at risk because of physical and lifestyle changes that can cause some to feel anxious and a lost sense of independence. Some common risk factors for depression among older adults are:
- Are female.
- Have pain.
- Are widowed or divorced.
- Previous depression.
- Brain changes due to vascular problems.
- Major physical and chronic disabling illness.
- Taking more than five medications.
- Excessive alcohol use.
- Social disadvantage and low social support.
- Recent bereavement.
- Moving from home to another place, such as a retirement home or long-term care home.
- Adverse life events.
- Chronic stress caused by health, family or marital problems.
- Social isolation.
- Persistent sleep difficulties.
HOW DO YOU MANAGE DEPRESSION?
Depression requires ongoing management. It does not typically improve without support from a medical professional. Your primary care provider can run tests to rule out contributing medical causes, and recommend treatment may prescribe medication, recommend psychotherapy, or a combination. They may also help you seek the advice of a psychiatrist or other mental health professional.
Coping with depression is very difficult. In addition to medical treatment, you will benefit from breaking the stigma and seeking support from family and friends.
2. ANXIETY
WHAT IS ANXIETY?
As we age, we often go through many life changes in a relatively short period of time. It’s normal to feel anxious in these situations, but if your anxiety and fears are affecting your day-to-day life significantly, you may have anxiety and may benefit from the support of a mental health professional.
Generalized Anxiety Disorder
This is the most common type of anxiety disorder for older adults. It causes people to worry excessively about everyday situations and events. The condition usually lasts at least six months and can cause restlessness, fatigue, muscle tension and insomnia or trouble sleeping.
Phobias
Fear is a normal emotion, but when it interferes with leading our everyday lives, it can become a phobia and considered a condition. There are many different types of phobias, including social phobia, which causes people to fear social situations, as well as more specific phobias such as fear of flying, bugs and leaving the house. The most common phobia in older adults is the fear of falling.
WHO IS LIKELY TO EXPERIENCE ANXIETY?
You are at increased risk of developing an anxiety disorder if you:
- Are female.
- Lack social supports.
- Have had a previous diagnosis of anxiety.
- Have a medical or psychiatric condition.
- Have poor health.
- Have suffered a recent trauma.
WHAT CAN ANXIETY LOOK LIKE?
A person with anxiety may show some of the following symptoms:
- Irritability.
- Fatigue.
- Poor sleep.
- Preoccupation with health problems.
- Excessive worrying.
- Seeking reassurance repeatedly.
- Low self-confidence and avoidance of situations.
- Intense states of fear and panic.
- On edge or unsettles.
- Headaches, upset stomach, insomnia, palpitations an chest pain, sweating.
HOW DO YOU MANAGE ANXIETY?
If you believe that you or a loved one has anxiety, the first thing you should do is talk to your primary care provider who can run tests to rule out contributing medical causes, and recommend treatment. Treatment can include talk therapy, stress reduction, coping skills, family and social support, as well as medication.
Aside from medication, changing certain behaviours can help you to manage the symptoms of anxiety: cutting down on caffeine, smoking, over-eating, alcohol and news intake, as well as getting regular exercise.
It can also be helpful to discuss your fears with friends and family members. Discuss what you’re worried about and set specific goals to help you manage the symptoms of anxiety.
You can learn skills such as deep breathing, progressive muscle relaxation, meditation, and setting aside worry time.
3. DELIRIUM
WHAT IS DELIRIUM?
Delirium is a sudden and temporary disturbance in the brain leading to fluctuating problems with attention and alertness, thinking, and behaviour. It is caused by medical conditions and drugs that affect the brain.
The following factors can contribute to delirium:
- Infections.
- Medication side effects.
- Dehydration or malnutrition and changes in salt and water balance in the body.
- Constipation or diarrhea.
- Heavy alcohol or tobacco use or withdrawal.
- Poor fitting hearing aids or glasses.
- Being in a new or unfamiliar environment.
WHO IS LIKELY TO EXPERIENCE DELIRIUM?
People are more likely to suffer from delirium if they have:
- Dementia.
- Depression.
- Had recent heart, hip or other major surgery.
- Had previous episodes of delirium.
- Poor vision or problems hearing.
- Or are 65 years or older.
WHAT CAN DELIRIUM LOOK LIKE?
There are three types of delirium: hyperactive, hypoactive and mixed. A person with hypoactive delirium may show some of the following symptoms:
- Move very slowly or not be Active.
- Not want to spend time with others.
- Pause when speaking or not speak at all.
- Look sleepy.
- A person with hyperactive delirium may show some of the following symptoms:
- Be worried or afraid.
- Be restless.
- Repeat the same movements many times.
- Experience hallucinations.
- Experience delusions.
With a mixed delirium, a person can have symptoms of both hyperactive and hypoactive delirium during the same overall episode.
HOW CAN YOU MANAGE DELIRIUM?
Delirium is treated by treating the underlying cause and managing the symptoms with or without the use of additional medications.
In most people, delirium can clear in a few days or weeks and in others it may take longer.
It is easier and quicker to treat delirium when the signs and symptoms are recognized early, but remember that everyone is different.
Delirium is a sign that the body and brain are sick. If delirium is suspected, immediate medical attention is recommended.
4. ADDICTIVE DISORDERS
WHAT ARE ADDICTIVE DISORDERS?
Addictive disorders can lead to problematic patterns of substance use or behaviours, such as the excessive use of alcohol or drugs, and gambling that interfere with a person’s life. If an individual engages compulsively with a substance or behaviour, despite negative consequences, they may have an addictive disorder.
WHAT CAN AN ADDICTIVE DISORDER LOOK LIKE?
There are physical, psychiatric, social and cognitive signs that an older adult may be misusing substances. These include:
Psychiatric
- Sleep disturbances
- Mood swings
- Persistent irritability
- Anxiety
- Depression
Physical
- Tremors
- Poor coordination
- Unexplained injuries or bruising
- Malnutrition
- Poor hygiene and self-neglect
- Dependence
Cognitive
- Confusion and disorientation
- Memory impairment
- Daytime drowsiness
Social/Behavioural
- Withdrawal from usual activities
- Family difficulties
- Early requests for medication renewals
WHAT ADDICTIONS ISSUES DO OLDER ADULTS COMMONLY FACE?
Older adults most often face addiction issues related to their use of alcohol, smoking, and prescription medications. Alcohol use is the most common issue among older adults, and 14% of those aged 65 and over smoke tobacco. However, women typically misuse prescription medications, and men typically misuse alcohol.
HOW ARE ADDICTIVE DISORDERS TREATED?
There is no one-size-fits-all treatment for addictive disorders. However, counselling in individual, group or family settings can help individuals manage their addiction. Counselling typically focuses on using a harm reduction approach, which emphasises reducing risks and harms associated with substance use over reducing substance use itself. Telling someone who has substance use issues to stop using is usually not an effective approach.
If you are taking care of someone who may be struggling with addiction, you can take a harm reduction approach to ensure they are as safe as possible. This can include:
- Ensuring their basic needs, such as food and shelter, are met.
- Helping them learn safer ways to use the substance.
- Focusing on what would make life better for your friend or family member, based on what their own goals are.
- Respecting the autonomy and choices of the older adult who is capable to make their own decisions.
5. SUICIDE
WHAT IS SUICIDE?
Suicide is the act of intentionally causing one’s own death. Suicide can happen to anyone. Suicidal behaviour can be impulsive or planned.
WHY DO PEOPLE DIE BY SUICIDE?
People turn to suicide when they have lost hope or feel helpless. They often see no other way to relieve their pain. This is more likely to happen when one has depression, when one is in crisis or facing major life stressors, when one lost a sense of purpose or meaning in life, or when one feels disconnected from others.
WHAT ARE SOME SIGNS THAT SOMEONE MAY CONSIDER SUICIDE?
Before someone turns to suicide, they usually show warning signs. People who are feeling suicidal may:
- Show signs of agitation, high anxiety, anger, or paranoid behaviour.
- Show a sudden change in mood or behaviour.
- Show a sense of hopelessness and helplessness.
- Express the wish to die or end their life.
- Increase substance use.
- Withdraw from engaging with people and activities that they previously enjoyed.
- Experience changes in sleeping patterns.
- Have a decreased appetite.
- Give away prized possessions or make preparations for their death.
WHAT SHOULD YOU DO IF SOMEONE SHOWS WARNING SIGNS FOR SUICIDE?
Asking about suicidal thoughts will not cause someone to have thoughts of suicide, or cause them to attempt suicide. Listen to and validate their pain, and offer your support.
If someone you know is showing signs that they may be thinking of suicide, you should take them to the nearest hospital emergency department.
If the person will not go to the hospital, or if you are not sure if this is the right thing to do, get help from a health care provider as quickly as possible.
If your loved one is attempting or about to attempt suicide, and you are not at risk, do not leave them alone and call 911.
HOW CAN YOU HELP PREVENT SUICIDE IN OLDER ADULTS?
Ensuring that the physical and mental health of older adults are well cared for and supported can be a powerful protective factor against suicide. Additionally, ensuring they remain socially connected and are prepared to cope with and adapt to changes can help prevent suicide among older adults.
If you or someone you know is experiencing depression or other mental health issues, seek treatment as well as programs that teach coping skills for stressors and for overwhelming emotions.
WHERE CAN I FIND MORE INFORMATION?
CANADIAN COALITION FOR SENIORS’ MENTAL HEALTH
Canadian Coalition for Seniors’ Mental Health shares information, resources and links to other organizations to promote mental health among older adults.
CONNEX ONTARIO
ConnexOntario provides free and confidential health services information for people experiencing problems with alcohol and drugs, mental illness and/or gambling.
TORONTO SENIORS HELPLINE
The Toronto Seniors Helpline offers supportive counselling over the phone, risk assessments, crisis de-escalation and triage to mobile crisis teams including Crisis Outreach Service for Seniors (COSS)
THE CENTRE FOR ADDICTION AND MENTAL HEALTH
The Centre for Addiction and Mental Health provides services and education to support individuals with mental health and addiction challenges.
GERSTEIN CRISIS CENTRE
The Gerstein Crisis Centre offers a crisis hotline that is available 24 hours a day, 7 days a week to support individuals experiencing a mental health crisis.
Modified: 2024-02
We would like to thank the following for their support of our Education Resources to Support Healthy Ageing Initiative
- Mon Sheong Foundation and the Ben and Hilda Katz Foundation have generously provided funding to support printing and translation of our Education Resources to Support Healthy Ageing.
- The Ministry for Seniors and Accessibility supported this initiative with funding through its Seniors Community Grant Program.