169 Mental Health Concerns and The Older Adult
● Healthy coping skills. ● Marriage or committed relationships. ● Social and family support. ● Autonomy and independent living. ● Accountable basic needs covered (food, shelter, safety). ● Positive self-esteem and self-image. ● Access to medical care and medications. ● Sense of purpose and belonging. Person-centered care accounts for old- er age and lifestyle modifications, access to care, and quality of life considerations (SAMHSA, 2022d). The healthcare pro - vider needs to consider the following for the older adult seeking treatment: physi- cal disabilities to accommodate (mobility, hearing, vision), cognitive deficits that in - terfere (memory and attention), learning needs and preferences (slower pace and repeated information if needed), and re- spect for age and gender preferences for provider and group therapies. Spirituality The spiritual assessment of the older adult is documented in the social histo- ry section of the psychiatric evaluation. The healthcare worker is reminded that it is critical to maintain neutrality of stance while assessing the older adult’s spiritual beliefs. Spirituality is a broader topic than religion. It is estimated that 80% of Amer- icans practice some type of religion (APA, 2013). All healthcare workers will inter- act with the spiritual aspects of an older adult’s beliefs, religion, or purpose of life while meeting their mental health needs. The inability to address spiritual involve- ment in an older adult’s life can limit a client’s recovery (Neathery et al., 2020). If the healthcare worker is reluctant or uncomfortable assessing an older adult’s spirituality, a self-assessment to identi- fy the barriers can be beneficial. Cultur -
brief structured treatment; patient education; relapse prevention techniques; formal SUD treatment programs; and pharmacotherapy).
With alcohol being the most common- ly misused substance by older adults, the healthcare worker must understand the risk factors contributing to increased alco- hol consumption by the older adult. Old- er adults will experience numerous life stressors such as financial hardship, re - tirement or involuntary loss of job, living rearrangement, loss/grief/bereavement, trauma, or social isolation (SAMHSA, 2022d). Increased alcohol use and mis- use can be detrimental to the older adult. Due to aging factors such as decreased metabolism and body fat storage, the older adult is more at risk for confusion, falls, injury, and exacerbated chronic con- ditions (SAMHSA, 2022d). The healthcare provider should assess tobacco product use presently or historically. Older adults who are lonely are at greater risk for smok- ing (Czaja et al., 2021). Smoking, vaping, or oral tobacco habits can be noted and assessed for intervention. Assessment of substance (legal or illegal), quantity, and frequency of use is critical for accurate as- sessment. Barriers to older adults seeking treat- ment for substance misuse include the following (SAMHSA, 2022d): ● Negative beliefs and attitudes. ● Denial. ● Justification (caregivers accepting misuse due to the end of life). ● Decreased information on dangerous effects of substances and older age. ● False information about older adult treatment. Protective factors for the older adult against substance misuse include the following (SAMHSA, 2022d):
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