Mental Health Concerns and The Older Adult
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fits that include preventative screenings and services; check what services are cov- ered; submit claims; compare providers; find physicians, group practices, hospi - tals, home health agencies, and facilities based on star ratings, services offered, and quality of care; and get a replace- ment card if needed ( United States De- partment of Health and Human Services [HHS], 2022). Another website to search is Medicaid. The older adult client can access information about state programs (HHS, 2022). The website Eldercare can connect the older adult to local and com- munity-based care. The older adult, fam- ily, or caregiver can use their ZIP code or city and state to find resources in the local community that provide information and assistance for older adults and caregivers (HHS, 2022). Sometimes access to care is hindered by awareness, and the health- care worker can increase awareness by providing federal and local sources for care. Transportation A crucial component of face-to-face ac- cess and quality of healthcare is transpor- tation. The older adult may access public, community-based transportation options or a privately owned vehicle. If options are lacking, the deficit can be noted and further assistance sought. The need to as- sess an older adult’s ability to safely oper- ate a vehicle will be addressed in depth in the psychosocial assessment section. Technology The use of technology for healthcare dramatically increased with the COVID-19 pandemic. Telemedicine decreases direct contact and limits disease transmission while providing access to care. The WHO (2021) classifies its use as advantageous for vulnerable populations such as older adults. Telemental health has been found
to reduce the number of emergency de- partment visits for older adults with co- morbid depression and chronic obstruc- tive pulmonary disease or congestive heart failure (Tusaie & Fitzpatrick, 2017). It has also been effective for psychotherapy interventions. One study found that older adults who suffer from depression and in- somnia had positive outcomes from cog- nitive-behavioral therapy administered via telemental health (Tusaie & Fitzpat - rick, 2017). Telemental health can benefit the older adult in many ways. The American Psychiatric Association (APA) collaborated with the American Telehealth Association (ATA) to address telepsychiatry. The healthcare worker is encouraged to reference the APA and ATA for clinical tips, tools, guidelines, and more, while continuing to follow all policies at their place of employment. The APA (2018) has specific recommen - dations for the healthcare worker caring for the older adult population: include family members on video calls when clinically necessary (with patient permis- sion); adapt technology and assessment for cognitively, visually, or audio impaired patients; modify cognitive testing carried out via videoconferencing. Although telemedicine ensures access to care, it is not always available for the older adult client. It is estimated that 40% of older adults on Medicare are unable to receive video care and 20% are unable to receive phone care (Chu et al., 2022). This can place an older adult needing virtual mental healthcare in a difficult position. The healthcare worker must perform a baseline assessment of the infrastructure required for and attainability of this op- tion for the older adult. Deficits in cognition, hearing, or vision may present greater challenges for the
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