Mental Health Concerns and The Older Adult
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bilities and time commitments acquired by the older adult. Housing The healthcare worker should assess the housing situation of the older adult. Housing is a basic need and typically must be met prior to the administration of in- terventions. It is estimated that about 5% of Americans live in nursing homes; how- ever, approximately 35% of older adults will reside in a long-term care facility at some point during their lifetime (Sadock et al., 2015). The living situation of an older adult can affect treatment options. For example, an older adult that lives near a bus stop has the necessary finan - cial resources, and is capable of navigat- ing will have greater options for meeting their needs like attending mental health treatment. Where an older adult resides must be assessed to understand available mental health intervention and treatment. Transportation—Driving safety One of the most difficult subjects for the healthcare worker to discuss with the older adult, yet an impactful topic for self and others is autonomous driving. Driv-
ing is the leading cause of injury-related deaths in the 65- to 74-year-old popula- tion and is the second leading cause (be- hind falls) in the 75- to 84-year-old pop- ulation (Promidor, 2019). The cessation of driving privileges is inevitable for ev- eryone. Each older adult interaction is an opportunity for the healthcare worker to assess for prevention. Knowing when and how to approach the older adult about driving safety is imperative. Preventing driving disability with properly timed in- terventions can impact lives. There are acute and chronic medical conditions that should be strong indica- tors of safety for the older adult client. Cessation of driving privileges should be reviewed when the conditions in Tables 2 and 3 manifest or the medications in Ta- ble 4 are prescribed in the older adult and until they are medically evaluated by their primary care provider. The health- care worker meeting mental health needs of the older adult will need to be in con- tact with the primary care provider about medical conditions and medications out- side of their scope of practice.
Table 2. Acute Medical Conditions That Require Immediate Driving Cessation ● Acute myocardial infarction.
● Acute stroke or other traumatic brain injury. ● Arrhythmia (e.g., atrial fibrillation, bradycardia). ● Lightheadedness, dizziness.
● Orthostatic hypotension. ● Syncope or presyncope.
● Vertigo. ● Seizure. ● Surgery. ● Delirium from any cause. ● Newly prescribed sedating medications or those that can cause confusion or dizziness. ● Acute psychiatric diseases impairing cognitive function or decision making.
Note . Reproduced with permission (Promidor, 2019).
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