Representative image for mental health.
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The World Health Organisation has recognised the rising elderly population worldwide and declared 2021-2030 the United Nations Decade of Healthy Ageing. In India, the proportion of people aged 60+ is around 10%, projected to reach 20% by 2050. Ageing is associated with medical and mental health ailments, as well as social problems. Mental health in elderly people depends on physical health, support systems, financial security, and lifestyle. This article covers holistic issues impacting the overall mental health of older adults.
As people age, they experience slowing down in thinking, planning, and movements. Many in India may have long-term illnesses such as diabetes, hypertension, cardiac illness, and joint pains. There may be a decline in sensory functioning, mainly in vision and hearing. Some may suffer from long-term aches and pains, leading to frequent hospital visits and multiple medications. Healthcare providers are trying to make arrangements to assist senior citizens. The transport and clinic area need to be elder-friendly. Accompanying adult children could clarify and assist in treatment decisions. With the breaking of joint family systems and economic migration, adult children may not be with their elderly parents.
Elderly people are required to manage domestic and related issues independently. They may also experience pessimism and fear of death as they see their contemporaries, friends, and siblings becoming ill, hospitalised, and many dying. Due to reduced physical mobility, many may not meet friends and families and so become isolated. Loneliness is becoming an epidemic despite the advancing technology allowing us to connect. Some may experience financial issues. Dwelling in the negative past can lead to sadness or anger emotions.
Depression in older people is hidden, which not only impairs their function but also impacts relationships and, in turn, affects emotions. It may worsen some of the physical health or interfere with treatment. There is a vicious circle of depression, leading to isolating oneself, that further worsens the condition. Depression must be detected early and treated to reduce the complications.
Another commonly identified illness with ageing is loss of memory and related functions. Within a few years, this nerve cell-damaging illness affects different functions of the brain, leading to elderly persons losing many functions and becoming dependent on basic daily routine care at home. The caregiving role of an elderly person with ailments, particularly dementia, is very stressful due to a lack of knowledge and understanding. Later stages of dementia require a lot of personal, supportive care and sometimes nursing care in addition.
One must adopt a good lifestyle with an unwavering attitude. Regularly socialise by attending gatherings and communicating with friends and family. Social media involvement within limits helps in getting connected. Getting involved in active senior citizen forums to stay active. Travelling with friends and family is another way. There is no harm in continuing to work. Hobbies can reduce stress. Morning walks and chatting with contemporaries will keep them engaged. Lifestyle must include healthy eating, yoga or exercise, and maintaining sleep hygiene. Some show interest in spirituality also.
An active lifestyle helps prevent or delay the onset of dementia. Once the person loses memory but has never discussed assets and finances with anyone in the family, they can become vulnerable to exploitation or unutilised. Many unclaimed deposits in the bank could be seen as an example. Therefore, there is a need to help spouses learn to manage finances and be aware of plans. Making a will is considered part of good planning. Family members noticing consistent forgetfulness must meet a psychiatrist or neurologist early. Early detection helps in managing better and better prepared to reduce stress for all concerned.
With the ups and downs of life and a goal usually related to the future of their children in mind, the ‘baby boomers’ have become senior citizens, which should call for celebration. The optimistic thought pattern and active, healthier lifestyle would promote mental health. There is a need to create more health awareness amongst older people to work on all the different factors around them to improve their mental well-being. Adults closer to becoming old must bear these issues in mind and start preparing financially and for their overall lifestyle.
(The writer is an assistant professor in geriatric psychiatry, NIMHANS, Bengaluru. This is the seventh of a DH-NIMHANS series on mental health.)