Supporting mental health in older adults

Supporting mental health in older adults

Anyone can experience mental health struggles, and our ability to develop conditions such as depression or anxiety does not diminish as we get older. Here, we are taking a closer look at the most common mental health concerns of older adults, the other health conditions that could be a contributing factor, and how the role of the caregiver is so crucial in prioritising the mental health of older adults. We will also explore how to effectively promote mental wellbeing in older age groups, tips for managing the most common mental health issues, and where to seek professional support if a loved one is struggling with their mental health. At Home Instead, our aim is to help people age positively and in place by bringing expert care to their home. For nearly 20 years, we have been providing the highest standard of care, and creating industry-leading training programmes for our Care Professionals that are accredited by nursing and medical professionals. Today, we are the world’s largest global domiciliary care network, supporting over 100,000 older adults with personalised, tailored care at home. So whatever questions you have about mental health in older adults, we can help.

What are the most common mental health issues in older adults?

Older adults typically face a number of mental health issues that can significantly impact their quality of life. The most common include:

Depression 

Depression is prevalent among this age group. According to Independent Age, around 1 in 5 older people experience symptoms due to factors such as losing loved ones, dealing with the symptoms of chronic illness, or experiencing reduced mobility in older age. Older people may experience depression symptoms such as:

• Feeling a consistent sadness or low mood
• Losing interest in things they once enjoyed
• Struggling to focus 
• Feeling helpless or hopeless
• Becoming easily irritated 
• Having trouble sleeping or sleeping for too long 
• Fatigue or unexplained tiredness 
• Eating more or less than usual 

Anxiety 

Anxiety is common in older people due to stressful life events, limited mobility, loss of independence, and more. According to Independent Age, this affects around 3 in 10 older people, and can manifest as anything from persistent worry and rumination, to panic attacks and refusal to socialise or leave the home. Anxiety is also known to exacerbate physical health problems, causing issues such as gastrointestinal problems, frequent urination, and shortness of breath, to name a few. Anxiety can take the form of generalised anxiety, social anxiety, specific phobias, panic attacks and more. Some symptoms that may indicate anxiety in an older person include:

• Feelings of nervousness or tension 
• A sense of impending danger
• An increased heart rate
• Rapid breathing 
• Excessive perspiration 
• Shaking or trembling
• Trouble thinking about anything other than the worry
• Trouble sleeping

Cognitive decline

Certain cognitive issues are very common in older adults, such as types of dementia, which includes Alzheimer’s disease. This affects cognitive function which can lead to life-changing symptoms like memory loss, confusion and difficulties carrying out daily activities. Eventually a person with dementia will require constant care. Cognitive decline is a concern as people age, with around 982,000 people estimated to be living with dementia in the UK, and 1.4 million estimated to be living with dementia by 2040. According to studies, this may have been worsened due to the pandemic. You may find more useful information on this in our guide to caring for someone with dementia at home,

Loneliness

While loneliness may not be considered a mental health condition in itself, the results of extended periods of loneliness and social isolation are usually increased depression. This is common in older people for several reasons. For example: 

• Retirement – They may have retired from their regular job and no longer see as many people every day 
• Loss – They may have lost friends or family members of a similar age
• Mobility issues – They may have reduced mobility, which can lead to less trips out of the house where they can meet people
• Busy families – As families grow and take on additional responsibilities, they may be unable to visit as often as they once could 
• Living alone – Many older people live alone, either due to their children growing up and leaving home, or their partner passing away

You can learn more about what to look for in older adults in our guide to the signs of loneliness in older people.

What steps can older people take to maintain their mental health? 

Despite the importance of involving healthcare professionals in mental health issues, older people can also take steps on their own or within their community to enhance their wellbeing and mental health where possible. There are a number of ways to do this, and depending on the person’s mental health diagnosis and personal preferences, the following strategies can be selected as and when needed, or could be incorporated into a daily routine as a preventive measure against poor mental health. 

Stay physically active

Where possible, getting regular exercise or movement has incredible benefits for both physical and mental health, and has been proven to boost memory and thinking skills, reduce feelings of anxiety, and potentially reduce the risk of depression by 20-30%. You can find examples of exercises for older adults in our guide to fitness and exercise for older adults.

Engage the mind

Doing regular activities to engage the brain, such as jigsaw puzzles, reading books, doing games with others, learning new skills, and taking part in arts and crafts, can all help to improve mood and keep the mind sharp as we age. This is particularly helpful for those suffering from cognitive decline. You can find some examples of games and activities for those with dementia in our guide to great games for dementia patients.

Develop social connections

Seeing friends and family can help to boost mental health when we are feeling low, as well as getting involved in local events, volunteering, or joining clubs. Doing this regularly can become a preventive measure by facilitating connections within the local community and preventing isolation. As a caregiver, you may also find it helpful to utilise technology, like age-friendly mobile phones, to help an older person maintain long-distance connections with any family or friends who live far away.

Maintain a healthy diet

A balanced diet that incorporates plenty of proteins, fruits, vegetables, and foods rich in vitamins can support brain health. Studies have found excess amounts of processed or refined foods can affect the brain, as well as causing inflammation, oxidative stress, and impacting the body’s regulation of insulin, which is important to manage in older age as this can affect the risk of diabetes.These studies have also discovered a poor diet could worsen symptoms of mood disorders like depression. For this reason, although eating a healthy meal will not stop an older person from feeling low, doing this over a prolonged period of time could. 

When should an older person reach out for help if they have poor mental health? 

By incorporating the above practices into their daily life, you may begin to notice positive changes in the mental health of your loved one so they can start to enjoy a fulfilling and active lifestyle. However, if they continue to suffer from mental health issues such as a low mood or anxiety, do not hesitate to speak to their doctor about this so they can recommend treatment options. These might include: 

Depression treatment

Talking therapies such as cognitive behavioural therapy (CBT) or certain antidepressant medications could help to manage depression, and a doctor can prescribe this if necessary, or refer an older adult to the appropriate therapist. Their GP can also recommend local resources such as support groups that may give them a place to talk about how they are feeling, address the underlying cause, and increase their emotional resilience. For example, if loneliness is the root cause of their depression, this can be rectified by attending local groups or classes as suggested by their doctor. 

Anxiety treatment options

Many older adults suffer from anxiety, with one study finding 33% of older people said they feel more anxious post-pandemic. However, there are effective ways to manage this in daily life.Mindfulness exercises such as meditation, breathwork or progressive muscle relaxation can be great activities to incorporate into an older person’s day if they enjoy these, and they can also seek help from a professional counsellor who can discuss their feelings of anxiety and help them to learn coping strategies they can employ in daily life, and that you can support them with. Your loved one can access this counselling through their GP, but you can also help them do this if they are hesitant to start the process. 

Dementia treatment options

While dementia has no cure, certain medications and treatments can help to reduce the severity of symptoms. A doctor may be able to help an older person and their caregiver by referring them to a memory clinic, suggesting ways to create a supportive environment through home adaptations, recommending helpful memory activities to maintain their abilities and stimulate cognitive function, or helping them to access specialised care with someone who has extensive experience managing their type of symptoms.

How can you support the mental health of an older loved one? 

Family caregivers play a crucial role in supporting the mental health of older loved ones, and there are many ways to support them in this. When caring for a loved one, it is important to provide ample emotional support, particularly if they are experiencing mental health issues. You can do this by:

• Being attentive and responsive to their needs, and addressing any issues they have in order to minimise feelings of distress or anxiety.
• Providing emotional support by offering empathy, companionship, and positive encouragement.
• Taking the time to talk to them, and ask about what is important to them and what they value, so you can tailor actions to their specific needs.
• Listening actively and offering reassurance to help them feel valued and understood.
• Creating an environment that ensures their living space is comfortable, accessible, and supportive. This is especially important for those experiencing cognitive decline.
• Encouraging independence to help them maintain their sense of purpose and dignity, by supporting them in performing everyday tasks at their own pace.
• Addressing any loneliness or sadness they may be feeling as a result of something like a disability, a cognitive impairment, or a communication issue.
• Tailoring any interventions to suit their abilities. For example, if they have a hearing impairment or problems with their sight, think of creative activities and ways to encourage them to talk about how they feel.
• Encouraging autonomy by enabling them to make choices where possible and get involved in their own care.

These simple actions can foster a nurturing atmosphere and significantly enhance the mental health, wellbeing and quality of life of older adults. 

Where can an older person turn for mental health support? 

Loneliness is a major problem among older adults in the UK, and some older people may feel they have nowhere to turn when it comes to mental health issues, whether they want to seek treatment or simply to talk about how they are feeling. There are many options for professional help and resources that can offer assistance, such as seeking help from psychologists, psychiatrists, or counsellors in the local area (with the help of their GP) who can provide specialised care through therapy and medication, if required. Older adults can also utilise community support groups to talk about how they are feeling with others going through something similar, and resources to help them care for their own mental health. There may also be mental health services and social activities in the local area aimed at alleviating loneliness, and these initiatives can be extremely helpful. You will find advice and further reading in the following places:

• Mind.org.uk has general advice on looking after mental health 
• You can find out more about what resources the NHS may be able to offer older adults here
• Age UK have resources on their website for looking after your mental health in old age, as well as information on combating loneliness 
• Independent Age has advice on their website about looking after wellbeing in old age 

While it is important to take proactive steps in maintaining and managing the mental health of an older loved one, you should never feel that there is no one to turn to for help. Everyone–no matter their age–needs support sometimes to help get back on track and feel like themselves again. Remind your loved one that they should never be afraid to speak to someone about this, such as their GP, another community healthcare provider, a home care companion, or any of the above services.  At Home Instead, our companionship service is designed to help provide a friendly face within the home, whether that means for a few hours a week to talk over a cup of tea, or a live-in care arrangement to help with other things alongside supporting mental health issues in an older person. If you feel you or a loved one could benefit from support from a home care professional to help with loneliness issues or mental health difficulties, you can get in touch with your local Home Instead office to learn more.Our Care Professionals are the best of the best, and highly trained to deliver the services you need. No matter what type of home care you are looking for, we can provide a tailored service that suits you or your loved one. We’re an award-winning home care provider and part of a worldwide organisation devoted to providing the highest-quality relationship-led care for older people in their own homes. Arranging care for yourself or your loved one shouldn’t be stressful, so whatever questions you would like answered, feel free to reach out to the Home Instead team to discuss your needs.