163 Mental Health Concerns and The Older Adult
Psychosocial considerations There are psychosocial considerations related to an older adult’s mental health- care. Some overlap with biological con- siderations and can be assessed and tar- geted for treatment. For example, driving is a psychosocial aspect that can be af- fected by biology. Activities of daily living (ADLS) The healthcare worker needs to assess the older adult’s ability to be autono- mous. The inability to perform ADLs may indicate an unsafe or poor quality of life (Edemekong et al., 2022). The healthcare worker can utilize standardized measure- ment tools for assessing ADLs (basic and instrumental) of the older adult and inter- vene with other services when safety or quality of life is at stake. The AGS defines ● Ambulating (ability to move and transfer independently, walking). ● Feeding (ability to feed self independently). ● Dressing (ability to cover self with clothing). ● Grooming (ability to care for personal basic and instrumental ADLs. Basic ADL are (AGS, 2022): hygiene, bathing, hair and nail care). ● Continence (ability to maintain bowel and bladder function). ● Toileting (ability to make it to the toilet and clean self). Instrumental ADL are (AGS, 2022): ● Transportation and shopping (ability to buy groceries and necessities). ● Financial management (ability to pay bills and manage finances). ● Cooking (ability to prepare meals and serve them). ● Household maintenance (ability to clean and live in a home).
● Communicate (ability to get in touch with others via phone or electronic means). ● Medicate (ability to manage medications as prescribed). Increasing age and health problems can cause increased difficulty with ADLs. Decreased physical functioning can be caused by biological deficiencies in the musculoskeletal, neurological, circulato- ry, or sensory systems. Cognitive, audi- tory, or visual impairments can increase difficulty with ADLs (Edemekong, 2022). Dementia can limit the older adult’s ca- pable and safe performance of ADLs like cooking and self-medicating. The health- care provider can assess the strengths and weaknesses verbalized by the older adult as well as gather information from collateral sources. Interventions might in- clude caregivers, family, other healthcare providers, or case management. Employment status The healthcare worker needs to as- sess the employment status and working habits of the older adult. Retirement is common in the older adult and can be a turbulent period of transition. The health- care worker should attempt to assess whether retirement was voluntary or in- voluntary. Involuntary retirement is asso- ciated with negative mental health effects and decreased self-image (Rhee et al., 2016). However, the Age Discrimination Employment Act (ADEA) of 1967 protects older adults in the workforce from forced retirement by making it unlawful (Sadock et al., 2015). If the older adult is retired, follow-up questioning about how the old- er adult feels about the loss of occupation can open an opportunity for exploration of other topics like finance and relation - ships. The healthcare provider can assess beyond formal employment for responsi-
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