How to Engage in Meaningful Conversations About Mental Health with Older Adults
As we age, a lot of loss occurs in the lives of our elders. As they start to deal with numerous health issues, it gets increasingly difficult for them to do the things they were once able to do with ease. Their acuity and certain parts of their cognition begin to decline, making you question whether or not they should still be driving, and whether or not they can properly use the stove. They begin to suffer several losses in their lifetime, whether it’s a close friend, partner, spouse, sibling, or even a child. All of these factors can be devastating as it is a painful reminder of all that they have endured throughout the aging process.
There is also a lot of financial burden associated with getting older, such as living on a fixed income, having to cover high costs for medications, insurance premiums, and co-pays with their various medical providers. What if you are a homeowner and you have to address needed repairs? All of these factors lead to a huge amount of stress which directly affects an older person’s overall mental health status.
Another important factor that we cannot lose sight of is the current trauma that is happening in our society and how triggering this must be for our elders. They’ve seen the impact of the great depression, lived through Jim Crow, have been victims of systemic and institutional racism, and have loved ones whom they worry about daily. They end up relieving previous trauma causing a significant decline in their emotional status which can result in depression, anxiety, and or PTSD.
Decades ago openly discussing mental health issues was very taboo and still is for many people especially older adults. We must recognize the signs that they may need help. Rather than asking questions like are you depressed, ask them how have they been eating, what did you have for dinner yesterday, when did you see your last doctor, I notice these pills here, how are you managing with taking your medications? To address any potential issues it is important to rule out any medical issues first and then build from there. This is where discussions with medical providers are essential. If your loved one is willing, explore whether or not they may be open to the idea of having you accompany them to their medical appointments.
If you have a loved one who is exhibiting potential signs of mental health-related issues, approach the conversation with caution. It may have to be an ongoing conversation. Lead with examples, say things like mom, I’m noticing you’ve been losing weight and I’m worried about you. How come you don’t go out with your friends all that much anymore? Is there something keeping you up at night? These are all different approaches to uncovering any underlying issues to the surface. As you do this if your loved one is somewhat open, you’d be surprised how much information you may be able to gather.
Now that you’ve gotten some understanding as to what they are feeling, now how do you suggest the possibility of them speaking to someone openly about what they are going through? Instead of saying you should see a therapist, validate what they are going through and ask, would you ever consider talking to someone about some of your stress and worries? Get a feel for it and if they are willing to consider it, build from there but don’t push because you have to be mindful that for an elder especially if they identify as black or a person of color it was forbidden for them to talk openly about their struggles growing up. Therefore you must be sensitive to that fact and broach the topic with sensitivity.
If they aren’t open to seeing someone, maybe there is a person in their lives who they identify closely with, such as a church community member, pastor, priest, etc? Sometimes even a private physician could be an ally in recognizing some of the symptoms and providing encouragement for your loved one to address some of their issues.
A lot of times older adults have this misconception that if they seek help they will be labeled as “crazy”. It’s important to validate those feelings and reinforce that as with any health-related issue there are people versed in dealing with matters associated with the aging process that can be a great way to address any issues that they may have worries about. For example, you can say, remember how you had the physical therapist help teach you exercises? This is a therapist who can help you find effective ways to cope with all of these losses and stress that you’ve had to endure throughout the aging process.
Do you know that there are therapists who work specifically with older adults? Do you know that there are also physician that specializes in working with older adults, referred to as “geriatricians”? If your loved one is having cognitive and or behavioral changes that you are concerned about it may be helpful to seek consultation from a geriatrician. Geriatricians are unique in that they look at all parts of an individual to address any underlying issues/concerns that may have a direct effect on a person’s psychosocial well being. They usually have an interdisciplinary approach and work with other professionals to address the needs of the older adult they are working with.
If you have a loved one who is older and open to seeing a therapist, explore potential resources in your area for a mental health professional that specializes in older adults. Not sure where to start? Check out Psychology Today which has listings of therapists based on the area you live in. I would highly recommend talking to your loved one’s physician for a referral and explore potential resources available through your local Department of Aging. They will be able to offer additional information and referrals to help an elder in your life.
It takes constant work to get older adults in the frame of mind that talking to someone can help them sort through their life transitions. If we promote the importance of emotional wellness and how it can help them develop healthy coping mechanisms to deal with stressors related to the aging process it can lead to less isolation and feelings of despair.