Mental Health Concerns and The Older Adult
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● Be aware that crying is also a sign of intense emotion and warrants further investigation; assess for safety. The healthcare worker should view each older adult client as an individual- ized opportunity. Being able to effectively communicate is crucial for the healthcare worker to assess and build trust with the older adult. Understanding the problems and difficulties the client is facing will not be possible if a mutual understanding is not present. There are a multitude of variations in communication styles and techniques the healthcare worker can uti- lize to nurture rapport, build trust, and foster a therapeutic alliance with the old- er adult. If more assistance is needed to connect and communicate with the old- er adult client, ask for help from family, caregivers, and/or your employer. An in- ability to communicate is determinantal to successfully meeting the mental health needs of the older adult. SOCIAL DETERMINANTS OF HEALTH AND BARRIERS TO ACCESSING CARE FOR OLDER ADULTS Older adults seek mental healthcare 40% less than younger populations (Sub- stance Abuse and Mental Health Services Administration [SAMHSA], 2019). Men - tal health treatment for instability or ill- ness for the older adult is multifaceted. How the older adult views their collective health can determine the level at which they will seek care to maintain or restore their mental imbalance or illness. The U.S. Department of Health and Human Ser- vices, Office of Disease Prevention and Health Promotion (ODPHP) in Healthy People 2030 names five areas related to social determinants of health: education access and quality, healthcare access and quality, neighborhood and built environ- ment, social and community context, and
neutral ground can provide an easier and subtle way into difficult thoughts, feelings, or emotions. ● Remember that rapport and trust take time. ● Triage the information you need at each visit, and prioritize safety. Recommendations for the overly talk- ative patient include the following (Car- lat, 2017): ● Use close-ended questions and multiple-choice questions to keep the patient’s answers brief (an interview needs open-ended questions as well, but closed questions and multiple choice can speed the interview along to maximize the information shared). ● Learn to politely interrupt. This requires empathy. If it was not covered prior to starting the assessment, a reminder of the allotted time of the interview helps reign in an overly talkative client. The older adult who is unable to com- municate may experience high rates of loneliness and depression (Palmer et al., 2016). Depression in older adulthood is often accompanied by tears. This can make interviewing difficult for the health - care worker. Traversing tears and sad emotions can be heavy and uncomfort- able for the healthcare worker. Recommendations for the tearful patient include the following (Carlat, 2017): ● Refrain from self-disclosure. ● Provide tissues. ● Embrace any lengthy silences and lean into empathy. ● Try to understand the meaning behind the tears. ● Assess the frequency of tearful episodes. ● Validate that crying is acceptable if needed.
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