Introduction
This paper explores concerns about aging in the modern-day. It also examines the psychological problems that older people face. The paper sheds light on the social networks and the families within which the aging people operate. There is a spirited effort to explore the therapies and programs that can effectively handle the psychological challenges that relate to aging. Finally, the current paper delves into finding out any other necessary research that should be done to provide a clear direction on handling the problems related to aging more easily.
There is no doubt that the elderly, especially those at the age of 60and above, make significant contributions to society. They work as volunteers and even as active workforce teams. Although most elderly people possess steady faculties, others suffer from mental health disorders such as substance abuse issues and neurological complications. They are also widely prone to health conditions such as diabetes, osteoarthritis, and loss of hearing. Another fact is that people tend to experience simultaneous ailments as they grow old (WHO, 2017).
Indeed, the well-being of a human being tends to be compromised as they advance in age. These problems are linked to physiological changes that are triggered by age. Therefore, older adults are likely to encounter many challenges related to the aging process. The role of keeping good physical health cannot be overemphasized for the elderly. Engaging in physical health activities enhances the mobility and functioning of the elderly (Halaweh, Dahlin-Ivanoff, Svantesson&Willen, 2018).
Aging and Psychological Challenges Faced by the Older Adults
It has been noted that the population of the world is aging fast. It has been approximated that the population of aged people will double from 12% of the population in 2015 to 22% in 2022. In terms of figures, the percentages represent an increase from 900 million older adults to 2 billion, respectively. Older adults encounter special physical and mental problems that should be recognized. It has also been established that over 20% of adults aged above 60 years suffer from either a mental or psychological disorder or both. These exclude headaches.
It has also been established that 6.6% of disabilities among the elderly over 60 years is linked to neurological and mental disorders. The disorders that the elderly face account for 17% of the years lived with disability. The prevalent neurological and mental disorders of elderly people include depression, dementia. It has been noted that the two challenges affect between 7% and 5%, respectively, of the older population.
Anxiety is found to affect 3.8%; substance abuse is at 1%. It has also been found that approximately a quarter of the deaths that emanate from self-harm are by elderly people of 60 years and above. It has also been established that substance abuse issues among the elderly are either overlooked or misdiagnosed (WHO, 2017).
A fast increase in the numbers of elderly people will arise in middle and low-income countries. Indeed, these changes will far-reaching effects on such vulnerable economies. Many people live long and stay happy with no mental health complications noted, despite the common impression that the elderly lead a sad life. Sadness, slowness, and dementia are not inevitable consequences of aging.
However, one possible negative outcome of the global population’s aging is the rise in the number of elderly people with mental disorders. Such a scenario with have a pressuring effect on the health facilities in the countries where there is a sudden rise in the number of aging adults. Over 20% of people aged over 55 years or higher could be carrying some kind of mental health complication (Lima &Ivbijaro, 2013).
Biological shortcomings can interrupt the functioning of the brain. The feeling of worthlessness and isolation could lead to somatic diseases. Mental challenges could worsen the signs and functional disabilities that the elderly people exhibit. Therefore, inevitably, the use of healthcare resources will increase, including the length of hospitalization and associated costs. Mental health problems could lead to great negative effects on elderly persons experiencing disability.
They may not effectively be able to carry out their routine activities of life. Such effects lead to increased dependency, lack of autonomy, and depreciation of life quality. It is prudent to begin by going for a diagnosis if these problems are reduced and managed effectively. Unfortunately, mental health problems are commonly misdiagnosed thus remain untreated (Lima & Ivbijaro, 2013).
As people grow old, chronic illnesses increase. These simultaneous occurrences negatively affect the available resources such as the health systems. The healthcare systems cannot provide services ready to meet the increase in demand for the same. Well-being plays a protective role in the maintenance of health among the elderly. It has been pointed out that good nutrition prevents growing frail. Frailty refers to the continuous process of losing social resources, abilities, activities, and general resources for fulfilling one’s primary social needs throughout one’s lifespan.
Frailty has also been found to be an outcome of one or a combination of such factors as functional impairments, poor self-rating of health, depression, and lifestyle. Depression was strongly associated with frailty in older women in one of the studies accessed (Gronning et al., 2018).
Risk Factors among Older Adults for Mental Health Problems
Risk factors for mental health problems exist at all stages of life. The elderly may be subjected more to life stressors that other people experience. Some stressors affecting the elderly people are common only in later life. Some of the stressors that tend to affect elderly people include capacity loss and a functionality level decline. Older adults could show more frailty, chronic pain, among other concerns for which they need a kind of long-term care. Furthermore, the elderly have a greater chance to encounter such experiences as bereavement or socio-economic status decline following retirement. Such stressors can lead to isolation, psychological distress, and loneliness (WHO, 2017).
Mental health impacts physical health and vice versa. For instance, older adults with physical conditions that negatively affect health, such as heart complications, are more likely to experience depression than healthy ones. Furthermore, depression that remains untreated among the elderly suffering from depression can cause negative outcomes (WHO, 2017).
The elderly are also vulnerable to abuse by the elderly such as physical or psychological abuse, financial deprivation and sexual abuse, loss of dignity, and respect and abandonment. The elderly can lead to physical injury and long-lasting and serious psychological effects, including anxiety and depression (WHO, 2017).
It has been projected that 50 million people across the world are living with dementia. 60% of the number live in low or middle-income countries. The people projected to suffer from dementia by 2030 is 82 million. It is estimated that the number will increase to 152 million by 2050. There are notable social and economic concerns concerning direct medical care costs, social care, and informal care linked to dementia (WHO, 2017).
Furthermore, physical, economic, and emotional pressures can lead to great distress to families and those who care. There is a demand to help such people who have dementia and those who care for them, right from health, social, legal, financial, and social aspects. Depression leads to great suffering and triggers impaired functioning in life. 7% of the general older population suffers from unipolar depression and accounts for an estimated 5.7% of YLDs among 60-year-olds (WHO, 2017).
Depression is underdiagnosed and under-attended in primary care centers. Signs of depression are commonly overlooked and ignored because they occur alongside the symptoms of other maladies faced by elderly people. The elderly people suffering from depression manifest poorer functioning than people of the same age suffering from chronic health complications, including lung disease, diabetes, and hypertension. Depression also tends to exacerbate the perception of poor health, the use of healthcare services, and the costs (WHO, 2017).
Effect on Family and Social Networks
Family members are critical as the basic resource for caring for the sick and the support source in old age. Family caregivers are also blamed for ambivalence. Much literature demonstrates that relationships at the family level extended protected effects on individuals both directly and indirectly. They help ailing individuals deal with stress. Thus, they promote both physical and psychological health. Still, support from family, even though it intends well, family support does not necessarily encourage older adults’ well-being (Widmer, Girardin & Ludwig, 2017).
There are times when they cause stress more than provide comfort. Thus, if family support is considered intrusive, controlling, and dominating, it can promote resentment and resistance behavior from the patients being cared for, hence increasing stress levels (Widmer, Girardin & Ludwig, 2017).
It has also been observed that unsolicited, too obvious, inappropriate, or excessive help could deprive individuals of their self-esteem, self-confidence, competence, and the zeal to be independent. The invasive efforts to help elderly people make them feel as if they are a burden to their families. Such a feeling opens doors to other feelings of vulnerability and stress. These developments lead to a greater danger of health impairments. The feeling of dependence and reversed roles, especially when one’s power to reciprocate, has diminished affects health negatively (Gouveia, Matos & Schouten, 2016).
In families closely knit, control and interference from family members are common and have consequences. Generally, available reports from empirical studies show that relationships breed negative content. Therefore, it is evident in this case that family relations cause ambivalence. When autonomy is threatened, conflicts arise in families. Usually, such conflicts are left to the members of the family to deal with. These challenges face the elder receiving care and those who are providing care and accused of causing ambivalence (Gouveia, Matos & Schouten, 2016).
They both undergo stressful times and tension that resonates through the whole family. Generally, therefore, individuals in their sunset years experience ambivalence relating to other family members as an outcome of the loss of independence. Concerning the social network size, it is established that the networks of the elderly, at the social level, shrink. The reason for such a development can be linked to the demise of those who were close to the subject, children leaving and pursuing their dreams independently, poor health, and the fact that people at such an age are retired; therefore, their social networks at the place of work is constricted (Gouveia, Matos & Schouten, 2016).
The selective emotional theory also comes into focus. The theory explains that when people hit 6o and above, they become more and more aware of the future limitations of time that is available. They are inspired to be highly selective in the choice of their social habits. They tend to prefer more emotionally sensitive relationships (Gouveia, Matos & Schouten, 2016).
If one is involved in a network of friends, they are more likely to be guarded against the effects of aging. Traditionally, the fact that one is married has been used as a benchmark to determine well-being. Thus, relating marital status, associations, and friendship is a way to understand friends’ place in guarding against the negative events of life. Studies focused on this area, which contrasts the impact of friends among married but elderly and those informal marriages, even if traditionally (Blieszner, Ogletree & Adams, 2019).
The studies also cast light on how friendship structures vary and what goes on across various subgroups of elderly people. Another view on the link between well-being and friends is in later years is associated with the idea that partners in a relationship depend on each other across the plain of social, cognitive, and emotional interaction. Consequently, life events can affect not just the principal subject but also the people surrounding such a person. Thus, a research question arises on whether one’s problems draw friends closer or repel them (Blieszner, Ogletree & Adams, 2019).
Some elderly people build relationships with voluntary kin or even brothers and sisters. They may also build relationships with healthcare personnel or those they have come to regard as members of the family. In such scenarios, the elderly keep supportive and satisfying ties while releasing the ones that are not comfortable. Such decisions could be an outcome of strategies that target the selection, replacement for, and using one’s resources at a relational level to its optimum, to age with fulfillment and success (Widmer et al., 2017).
Owing to the overarching negative effects, some elderly people may avoid making changes that they view as significant family members. The caution commonly informs such a decision that they seek to prevent confrontation or differ with such significant family members. Finding a new definition for one’s family structure to limit interacting regularly could be one-way social selectivity occurs in later life (Widmer et al., 2017).
Therefore, social staff and other professionals could view the redefinition of the family members they consider important as a valid and working technique by older adults to avert stress and conflict. The stakeholders could promote such strategies to enhance the efforts of the elderly to maintain and sustain good health and well-being as they grow older (Widmer et al., 2017).
Interventions and Prevention Programs to Promote Older Adults’ Mental Health and Well-being
Being happy, being content, and providing satisfaction in relationships at the social level and autonomy are prime traits of well-being that help one age well in the later years (Halaweh et al., 2018). In traditional society, efforts to prevent stress and other issues related to aging are directed at children to enhance a positive health continuum from childhood to when one grows old. Nevertheless, mental health complications are more prevalent among elderly people. They are linked to risks and protective activities that are different from those that occur when they are still young. Some of the factors, such as education, cannot be changed in late life. Others such as level of activity and social support can be readjusted when one is old. It is projected that the number of elderly people will increase exponentially in the near future. The demand for healthcare for the group will also increase. Unfortunately, though, the current intervention methods to solve the health and psychosocial concerns of the elderly are not fully successful (Leggett & Zarit, 2014).
1. Pharmacological Prevention
The positive outcomes of the use of antidepressants for depression treatment are documented. Nevertheless, although most elderly people recover safely from depression after being treated with antidepressants, many of them relapse. Issues to do with either previous or current use of AD also come to the fore. Prophylactic use of antidepressants has been tested as a treatment to prevent relapsing in older populations who have recovered recently from a major depressive disorder. The results of Ads, even for the latter purpose, are still mixed, in any case. Ethical limitations also arise concerning prescribing Ads to persons with no diagnosis for the disorder. Ads and benzodiazepines are linked to ineffectiveness for mild disorders. They are also linked to a myriad of side complications. Therefore, pharmacotherapy should be avoided as much as possible for primary efforts of prevention. It should only be used with some cases at high risk and cases where one has had depressive episodes before (Leggett &Zarit, 2014).
2. Psychological Prevention
The demand to prevent psychological side effects with non-pharmacological options will grow with the rise of baby boomers. Some researchers regard psychotherapy to be an effective option for preventing psychological effects relative to traditional treatment. Nevertheless, several results have given promising indications. Some recent findings aimed at CBT and problem-solving therapies have been examined.
a. Cognitive Behavioral Therapy (CBT)
Many psychotherapy studies apply a cognitive behavioral approach aimed at dealing with dysfunctional thoughts and the extent of activity. They are meant to restore ones thinking patterns and alter their behavior. Coping With Depression course by Lewinsohn is the most common type of CBT form used. A therapist operates as a trainer for a set of participants. They teach helpful skills to deal effectively with feelings of depression, including completing pleasant engagements, building social skills, relaxing, and approaches for restructuring the maladaptive processing of thoughts (Leggett &Zarit, 2014).
b. Problem Solving Therapy (PST)
PST aims to mitigate depression by focusing on erroneous appraisals of challenges. It seeks to impart skills to resolve the challenges in an adaptive way. One research used a PST selective intervention targeting people with macular decline. Since muscular decline would change potential individual character, PST offers a behavioral alternative to dealing with such visual shortcomings and forestalling depression in the end. After 2 months, the live experimental group showed half the incidence of depression visa avis the experimental group – 1.6% vs. 23.2%. There were no differences noted by the researchers in the incidence rate at the six-month point. The intervention may help adults with accompanying chronic ailments. When PST is administered over a short period, it could prevent depression effectively, more so in people with comorbidity (Leggett &Zarit, 2014)
Stepped Care Program
Stepped care gives intervention as required. It aims at making the best use of available resources. The program by Van’t Veer –Tazelar and others incorporates four periods that last three months. It starts with waiting watchfully. If notable symptoms lasted beyond the first three months, participants’ randomization was to assume either the usual care group or the biotherapy intervention by CBT (Leggett &Zarit, 2014).
Prevention of Sleep Problems
Disturbance of sleep and one’s mood have a strong relationship. As patterns of sleep change and circadian beats are also altered as one grows old, they become a core component in older adults’ life and health. Research targeted insomnia used Brief Behavioral Treatment and included a 45-minute sleep session and another brief booster after a fortnight. The treatment encompasses educating one on regulating sleep and factors that influence sleep. Participants were only asked to retreat to bed when they felt sleepy and wake up when the sleep had gone. It was noted that the mean Hamilton Rating for Depression and Anxiety reading was below what is acceptable for the study subjects at baseline. Those receiving treatment improved their sleep patterns such as waking up, the latency of sleep, quality, the symptoms they exhibited, and depression compared to a control group (Leggett & Zarit, 2014).
Reminiscence Therapy
Reminiscence therapy is commonly preferred for treating dementia and care for older adults because of its non-pharmacological design. I am a therapy in which behavior is internalized. There is a dialectic or interplay between an individual’s internal mental processes and the external display of thoughts. The therapy has been found to improve older adults’ well-being, irrespective of whether they have health complications or not (Hsin-Yen & Li-Jung, 2018).
Involvement in Physical Exercise
There is evidence that improved physical functioning is a product of physical activity. Indeed, when physical functioning is good, the number of falls reduces, and even the effects of falls become less injurious, socially, and healthwise (Halaweh et al., 2018). Subjecting older adults to PA regularly can reduce morbidity, defer disability, and extend one’s life. It can even fight some of the disabling effects of growing old. It has been suggested that PA can help increase muscle mass, prevent sarcopenia, and reduce metabolic rate among the elderly. There is also evidence that activity enhances cardiovascular performance, decreases chances of diabetes and some cancer strains (Lautenschlager, Almeida, Flicker & Janca, 2004).
Improving Social Support
Friendship is just as important as a family in the prediction of psychological health among the elderly. Research has established that support and close attachments by relations and friends are central to maintaining cognitive functions. Furthermore, aging presents special challenges, including those that call for caregiving (Blieszner et al., 2019).
Conclusion
Healthy aging is an aspect of life that all societies must promote. It is also important to diagnose health issues early enough and treat the ailments, including mental disorders common among the elderly. Care for elderly people calls for tact, sensitivity, and observational acumen. It is also important to protect and support the caregivers attending to the elderly. Such interventions can be provided in primary care settings.
Suggestion for Future Research
It has also been established that family caregivers cause ambivalence and disagreements among the elderly. Such conflicts negatively affect the elderly being cared for. Generally, the composition of family structures influences the likelihood of the occurrence of conflict. Thus, it is important to examine the negative relations that exist to include alters that will promote peaceful coexistence and promote a positive self-appraisal of the older adults, including understanding their health concerns (Widmer et al., 2017).
It is also critical to consider mobility aspects, independence, cognitive functioning, and how resilient the elderly are in the design of preventive measures. New research efforts focusing on the preferences of the elderly concerning their mental and psychological well-being could be of much help. To promote participation, it will help to include physicians working in primary care settings, including social service workers who interact with older adults experiencing depression or anxiety. Consideration should be made on how services could reach older adults in rural settings and those who cannot afford them. Individualization of prevention measures could be made possible by biomarkers, making the programs save on cost and work more efficiently. There is a world of possibilities in the latter proposal (Leggett & Zarit, 2014).
References
Blieszner, R., Ogletree, A., & Adams, R. (2019). Friendship in later life: A research agenda. Innov Aging, 3(1). DOI: 10.1093/geroni/igz005
Gouveia, O., Matos, A., & Schouten, M. (2016). Social networks and quality of life of elderly persons: a review and critical analysis of literature. Rev Bras GeriatrGerontol, 19(6). https://doi.org/10.1590/1981-22562016019.160017
Gronning, K., Espnes, G., Nguyen, C., Rodrigues, A., Gregorio, M., Sousa, R. . ., & Andre, B. (2018). Psychological distress in elderly people is associated with diet, well-being, health status, social support, and physical functioning- a HUNT3 study. BMC Geriatr, 18(205). DOI: 10.1186/s12877-018-0891-3
Halaweh, H., Dahlin-Ivanoff, S., Svantesson, U., &Willen, C. (2018). Perspectives of older adults on aging well: A focus group study. Journal of Aging Research, 4.doi: 10.1155/2018/9858252
Hsin-Yen, Y., & Li-Jung, L. (2018). A systematic review of reminiscence therapy for older adults in Taiwan. Journal of Nursing Research, 26(2), 138-150. DOI: 10.1097/jnr.0000000000000233
Lautenschlager, N., Almeida, O., Flicker, L., &Janca, A. (2004). Can physical activity improve the mental health of older adults? Ann Gen Hosp Psychiatry, 3(12). DOI: 10.1186/1475-2832-3-12.
Leggett, A., & Zarit, S. (2014). Prevention of mental disorder in older adults: Recent innovations and future directions. Generations, 8(3), 45-52.
Lima, C., & Ivbijaro, G. (2013). Mental health and well-being of older people: opportunities and challenges. Mental Health in Family Medicine, 10(3), 125-127.
WHO. (2017). Mental health of older adults. Retrieved from https://www.who.int/news-room/fact-sheets/detail/mental-health-of-older-adults
Widmer, E., Girardin, M., & Ludwig, C. (2017). Conflict structures in family networks of older adults and their relationship with health-related quality of life. Journal of Family Issues, 39(6). https://doi.org/10.1177/0192513X17714507
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