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Introduction
What do you think contributes to good mental health in later life? Think of older people you know, for example, relatives, neighbours and friends. Now consider which of the following you think demonstrate good mental health:
- A sense of well-being
- Adjustment to living circumstances
- The capacity to make and sustain relationships
- The ability to meet the challenges which life brings
- Absence of mental disorders
(Well-being: Our sense of well-being is essentially our own subjective assessment of our life, whether or not we feel satisfied with it and whether our feelings about it are generally postive or negative. Well-being incorporates both physical and mental health. The term is often used interchangeably with ‘happiness’, although happiness is generally regarded as having too wide a range of meanings and is used in too many different ways to be as useful.)
When you are finished, click on ‘Next’.
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Introduction
- A sense of well-being
- Adjustment to living circumstances
- The capacity to make and sustain relationships
- The ability to meet the challenges which life brings
- Absence of mental disorders
Did you think any of the first four options were a good indicator of mental health? These are indicators of good mental health at any age, including the later years.
A good state of mental health in later life depends, however, on older people being provided with a reasonable standard of living and opportunities to participate in, and contribute to, family life and society.
Mental health is difficult to define at any life stage, but it certainly amounts to more than merely the absence of mental disorder or illness. It involves well-being and personal fulfillment and meaning.
Although some mental disorders most typically present themselves in later life (e.g. dementia) mental health in old age is in part a consequence of successful ageing through a lifetime.
Click on ‘Next’ to meet Jean.
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Jean
“When we first moved into this quiet village thirty-five years ago it was such a change from the life I’d known in London. I had my two young grandchildren at the time, John, my husband, was away at work all day, and I knew no one. There wasn’t much transport and I felt trapped in this isolated village with no one to talk to and nowhere to go. It was then that my depression started.
For about a year things were fairly grim, but eventually, through the help of my doctor and my family, I began to feel more myself again. I forced myself to join the Women’s Institute, something I would never have dreamt of doing at one time; I gradually got to know people round here and found we had more in common than I imagined. There is always some event that needs organising in the village and to my surprise I found that I was quite good at this. I’m a person that needs to feel needed so I think it satisfies something in me. There have still been times over the years when I have got a bit low, not always for any obvious reason - my doctor says that I am vulnerable to depression - but I was usually able to recognise the early warning signs and seek some support.
The real second crisis in my life came when John died suddenly a couple of years ago. I felt totally bereft and for months didn’t want to see anyone or do anything. But gradually and with a lot of support from my family and friends I’ve picked up the pieces again. My daughter has talked to me about moving into town to be near them. But I think that would be a mistake whilst I am still so active and involved with things in the village. I feel my life is here now and overall it’s a full and satisfying one.”
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What undermines mental health
Although becoming mentally ill is not an inevitable part of old age there are a number of issues that are more likely to affect older people and which compromise mental health. These include: chronic physical illness, disability, loss and bereavement, and retirement.
It is important to recognise that those issues which most ‘ordinary’ older people face are inherently difficult. They are challenging at any age but only tend to attract public interest if they affect younger people.
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Problems affecting people in later life?
What undermines mental health in later life?
A range of different mental health problems affect older people. The next exercise asks you to think about this and to identify, from a list, which you think are most relevant to later life.
Look at the list below and think about those you think are the main mental health problems affecting older people. Then click on ‘Next’.
- Depression (Whilst we all feel low from time to time, depression can be distinguised from this everyday experience in terms of the time it lasts (in that depressions persists over time), the severity of symptoms such as sleep and/or appetite disturbances, and the intensity of feelings such as hopelessness and worthlessness.)
- Dementia (The term dementia is an umbrella term that covers a wide range of disorders of the brain. These disorders are almost always progressive and lead to symptoms such as memory loss and confusion. The most common forms of dementia are Alzheimer's Disease and Vascular Dementia.)
- Alcohol abuse
- Problems caused by medication
- Other mental health problems (such as anxiety, delirium, late onset schizophrenia)
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What problems affect people in later life?
- Depression
- Dementia
- Alcohol abuse
- Problems caused by medication
- Other mental health problems (such as anxiety, delirium, late onset schizophrenia)
Older people can experience all of these mental health problems. Depression, for example, is relatively prevalent among all older age groups. As you probably know, dementia is an illness which predominates among very old people.
Although most mental health problems that affect older people can affect people of any age, the nature of the illness, what triggers it, the range and severity of symptoms and the way it needs to be treated tends to be particular to later life.
The role of the loss of a lifelong spouse in causing depression is one example. The risk of isolation is another. Of course the way any mental illness is experienced is highly individualised; it is just useful to recognise that some of the features of later life compromise mental health in specific, and sometimes, powerful ways.
Ref: Victor (2005).