Given the size of the Baby Boomer population, older adults are a growing proportion of our nation. People live longer, healthier, and more productively than previous generations. Today most people can expect to live into their 60s and beyond. Every country in the world is experiencing growth in both the size and the proportion of older people in the population. (Aging and Health, 2022). Older adults in this country are living longer. According to demographers at the U.S. Census Bureau, the number of centenarians in the U.S. grew from over 53,000 in 2010 to over 90,000 in 2020. By 2030, there will most likely be over 130,000 centenarians in the U.S. (Poston, 2020). The average life expectancy of Americans has been increasing dramatically over the past century. A male child born in 1900 could expect to live only 46 years, and a female child, 48 years. In 2019, the average life expectancy in the U.S. for the total population was 79 years. Although much of this gain can be attributed to the significant decrease in childhood mortality, life expectancy at every age beyond 40 has also increased dramatically. For example, a 65-year-old man can now expect to live to about age 83, and a 65-year-old woman to about age 86 (Stefanacci, 2022). Overall, women live about 5 years longer than men (Stefanacci, 2022). Exactly what constitutes normal aging is not always clear. Nevertheless, aging leads to a gradual decrease in physical and mental capacity, a growing risk of disease, and death. Common conditions in older age include hearing loss, cataracts, refractive errors, back and neck pain and osteoarthritis, chronic obstructive pulmonary disease, diabetes, depression, and dementia. As people age, they are more likely to experience several conditions simultaneously. While these circumstances can occur at any time during a person's life, they are more likely both to occur and to be a consistent presence in the life of an older adult. If the older adult is not able to cope effectively with the cumulative effects of these stressors, mental health concerns may be triggered or perpetuated. Mental health issues impact older adults. Mental health is a key element of overall health and well-being in older adulthood. Individuals with mental health needs face significant impacts on daily functioning, socialization, meaningful relationships, and health and safety. While not a normal part of aging, in 2017 roughly 20% of adults over 60 suffered from a mental health or neurological disorder. In fact, this estimate may be low, as research consistently documents the challenges of obtaining accurate measures of mental health in older adults due to underdiagnosis, varied definitions of the terms “mental health” and “older adult,” and different sampling methods for individuals living in the community compared to those who are homeless or living in nursing home settings (Krajci & Golden, 2019). According to the National Institute of Mental Health (NIMH), major depression is one of the most common mental disorders in the U.S., and it carries the heaviest burden of disability among mental and behavioral disorders (Depression, 2022). Along with cognitive symptoms, experiencing a depressed mood, loss of pleasure in activities, significant weight loss or gain, decrease or increase in appetite, sleeping too much or too little, fatigue, feelings of worthlessness, or excessive or inappropriate guilt, is a serious situation and requires intervention by a professional. But depression, like many other ailments, often manifests differently in the elderly compared with younger people. For example, an older person who is depressed doesn’t necessarily feel sad but may complain of lack of energy and attribute symptoms to age. That can make it trickier for doctors, loved ones, and older people themselves to spot depression. The fact that certain
medications and medical illnesses can bring on depression or mimic it also complicates matters, making it tough to know when to get crucial help. The complex interaction between age-related conditions and mental health symptoms frequently complicates accurate identification, diagnosis, and treatment in older adulthood (Krajci & Golden, 2019). The impacts of these circumstances often mimic formal mental health diagnoses that need treatment and vice versa. For example, in an older adult with multiple losses, it may be difficult to determine if his or her reactions are normative grief or depression. Memory problems may be depression, early signs of dementia, or complications from medical conditions or medication side effects. Isolation and withdrawal from usual activities may be due to depression, dementia, physical impairments, or hearing loss (Krajci & Golden, 2019). These confusing overlays, especially when coupled with ageist stereotypes, complicate assessment and care planning. In fact, studies show that 40–90% of older adult mental health concerns are not detected in primary care, the setting where the majority of individuals, regardless of age, obtain mental health treatment (Krajci & Golden, 2019). Suffering from a mental illness as an older adult is associated with a great deal of stigma. One issue that can make older people reluctant to get treatment for depression or make it tough for those who love them to coax them to go to a doctor is the belief that getting treatment for depression is a sign of weakness or lack of moral fiber. Due to stigma, misinformation, and false beliefs about aging, they frequently go without adequate care for depression and other psychiatric illnesses and psychological problems. Stigma has the power to influence the behavior of individuals. In addition to these direct negative consequences for the older adult, mental health and aging also have implications for the healthcare system. For example, compared to older adults without depression, those with depression had nearly twice the number of outpatient visits and, when hospitalized, had twice the number of inpatient days over the anticipated discharge date (Krajci & Golden, 2019). Individuals with symptoms of depression also represented 75% of patients who overutilize primary care services. Older adults with mental health disorders account for over 25% of mental health–related emergency department visits. These numbers will continue to increase as the “boomer” population ages (Krajci & Golden, 2019). One form of discrimination that is pervasive in the U.S. is ageism. Ageism involves stereotyping or discriminating against people based on their age and can occur in various aspects of society. Ageism can be directed at older adults and young people alike. However, our culture glorifies youth, so older adults are often the victims of age-based discrimination and negativity. According to recent research, 9 out of 10 Americans between ages 50 and 80 report suffering from ageism to the point that it damages their mental and physical health due to age-based discrimination, prejudice, and stereotyping in day-to-day living (Opinion: Americans May Value Diversity and Inclusion, but Ageism Still Thrives, 2022). Here is how ageism manifests itself, according to the adults surveyed: ● Nearly four of five people say they hear this statement: “having health problems is part of getting older” - even though the overwhelming majority surveyed described their health as good or very good. ● Those surveyed say they are exposed to “internalized” ageism and that feeling lonely, depressed, sad, or worried is part of getting older.
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Book Code: PCTX1325
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