May is Mental Health Awareness Month, established in 1949 by Mental Health America to raise awareness of the importance of mental health and wellness for Americans. Older adults, in particular, may suffer from poor mental health due to unique life circumstances such as grieving the loss of a loved one, a serious medical diagnosis, or the loss of physical function. While many believe that depression is a normal part of aging, according to the CDC, this is not true. While older adults are at an increased risk, they are often misdiagnosed and undertreated.
Our most recent educational video covers spotting and addressing warning signs in your residents for declining mental health. It is important to recognize that the signs and symptoms of emotional or psychiatric disturbances in older adults may be different from those in younger individuals. Older adults are less likely to experience affective symptoms such as worthlessness and dysphoria, a state of feeling very unhappy, uneasy, or dissatisfied and more likely to experience cognitive changes, changes in the body, and loss of interest.
Signs of Declining Mental Health in Older Adults
Both caregivers and seniors themselves may not recognize the changes pointing to a decline in mental health. Older adults often view their symptoms as a normal result of illness or life changes and not a sign of depression to be treated. They may also not understand how treatment could alleviate these symptoms.
Sleep Disturbance: Disrupted sleep can be both a cause and consequence of mental health problems. Although a majority of older adults complain about sleep problems, changes in their sleep patterns may be a warning sign of further issues. If your resident has changes in their sleeping patterns, be on the lookout for additional signs of declining mental health.
Appetite Changes: Both an increase or decrease in appetite, as well as sudden weight gain or loss, can be signs of poor mental health, but a decrease often points to depression. Appetite changes can also be attributed to reduced physical activity, medication changes, and digestive or dental problems, so it is important to evaluate all changes when assessing your residents.
Cognitive Changes: Normal aging can include some forgetfulness, such as occasionally forgetting names and words, misplacing things, or a subtle decline in thinking speed. However, changes in intelligence, long-term memory, or ability to perform daily tasks are cause for concern. Watch for repetitive questioning, odd or inappropriate behaviors, getting lost in familiar places, and changes in language abilities, including comprehension.
Changes in Hygiene: Indifference to hygiene tasks is a common symptom of mental health conditions. If your resident has a sudden or unexplained change in hygiene or refuses their normal assistance with personal care, this typically indicates an underlying issue.
Unexplained Physical Symptoms: Your resident may complain of aches and pains such as headaches, arthritis pain, back pain, or digestive distress without a medical cause. Physical complaints are often the predominant symptom of depression in the elderly.
Social Isolation: A loss of interest in activities or relationships a person once enjoyed is a sign of depression in all adults. Cognition can play a large role in social engagement so older adults may socially isolate due to a decline in cognitive abilities. Residents who withdraw from their regular social activities should be assessed for mental health issues.
Refusal of Care: While noncompliance may be some resident’s normal behavior, if a resident suddenly refuses care, an evaluation may be necessary. Suddenly refusing care may be a sign of the onset of dementia or other mental health issues; conversely, urinary tract infections may cause uncooperation.
Changes in Mood: Residents may seem sad, lethargic, hopeless, or lose self-worth when their mental health is declining. Listen for thoughts of emptiness, guilt, and suicide if you sense a prolonged change in mood.
Dangerous Behavior: Increased substance use or abuse and thoughts of death or suicide are clear signs of mental health concerns. Seek a psychiatric evaluation for residents exhibiting sudden, dangerous behavior.
It is important for caregivers to pay close attention to the signs of declining mental health in their residents and know that this decline is not an inevitable part of aging. Getting older adults the help they need when treating mental health conditions can alleviate pain and suffering, reducing the risk of comorbidities.
