Table 8. SAMHSA Recovery Principles and Definitions with Older Adult Applicability SAMSHA Recovery Principle Recover Principle Definition
Older Adult Applicability
Addresses Trauma
• Verbal, physical, emotional, domestic violence, sexual, war, natural disaster, financial, substance.
• Assess past and present. • Establish trust. • Promote safe space. • Ethical and legal implications.
Strengths/Responsibility
• Resource availability for self and community. • Empowerment.
• Personal responsibility in recovery and resources. • Find barriers and protective factors. • Eliminate discrimination and bias. • A sense of identity beyond the diagnosis. • Avoid labels.
Respect
• Acceptance. • Self-esteem.
Note : From SAMHSA (2012)
Hope, the first listed SAMSHA recovery principles in Table 8, has been studied in the older adult population. Verbalized hope in older adults has been proven to have a positive correlation with better overall physical and mental health, as evidenced by decreased mortality, fewer chronic conditions, lower cancer rates, fewer sleep disturbance problems, decreased stress, improved sense of purpose, and increased life satisfaction (Hernandez & Overholser, 2021). The healthcare provider can assess for social connections and support in the older adult. Family, friends, caregivers, community members, and healthcare workers are all capable of instilling hope in the older adult. Hopelessness can be experienced after loss (Kübler-Ross & Kessler, 2005). Hopelessness can be a target for intervention in the older adult. Individual, group, and community hope-based Conclusion Aging provides irrevocable changes and modifications to the human body, but it is not synonymous with mental health degradation. Theories of aging provide references for the healthcare provider who is assessing, intervening, and treating the older adult with mental health needs. Communication tailored to the older adult enhances the ability to build trust and rapport for the therapeutic relationship, the integral connection with the older adult. The healthcare worker might need to modify their communication with the older adult due to hearing, References • American Bar Association & American Psychological Association (2008). Assessment of older adults with diminished capacity. https://www.apa.org/pi/aging/programs/assessment/capacity- psychologist-handbook.pdf • American Geriatric Assocation. (2019). Tip sheet: Alternatives for medications listed in the AGS Beers citeria® for potentially inappropriate medication use in older adults . https://www. healthinaging.org/tools-and-tips/tip-sheet-alternatives-medications-listed-ags-beers-criteriar- potentially • American Geriatric Assocation. (2020). Tip sheet: The 5Ms of geriatric . https://www. healthinaging.org/tools-and-tips/tip-sheet-5ms-geriatrics • American Geriatric Assocation. (2022). Caregiver guide: Problems of daily living . https://www. healthinaging.org/tools-and-tips/caregiver- guide-problems-daily-living • American Psychiatric Association. (2010). Practice guideline for the assessment and treatment of patients with suicidal behaviors. https://psychiatryonline.org/pb/assets/raw/sitewide/ practice_guidelines/guidelines/suicide.pdf • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Association. • American Psychiatric Association. (2018). Best practices in videoconferencing-base telemental health. https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/Telepsychiatry/APA-ATA- Best-Practices-in-Videoconferencing-Based- Telemental-Health.pdf • American Psychiatric Association. (2019). Clinical practice guideline for the treatment of depression across three age cohorts . https://www.apa.org/depression-guideline • American Psychiatric Association. (2020). Stigma, prejudice and discrimination against people with mental illness . https://www.psychiatry.org/patients-families/stigma-and-discrimination • American Psychiatric Association. (2022). Culture. APA Dictionary of Psychology . https:// dictionary.apa.org/culture • American Psychiatric Association. (2022a). Anticholinergic effects. APA Dictionary of Psychology . https://dictionary.apa.org/anticholinergic- effects • American Psychiatric Association. (2022b). Capacity. APA Dictionary of Psychology . https:// dictionary.apa.org/capacity • American Psychiatric Association. (2022c). Culture. APA Dictionary of Psychology . https:// dictionary.apa.org/culture • American Psychiatric Association. (2022d). Extrapyramidal symptoms (EPS). APA Dictionary of Psychology . https://dictionary.apa.org/extrapyramidal-symptoms • American Psychiatric Association. (2022e). Grief. APA Dictionary of Psychology . https:// dictionary.apa.org/grief • American Psychiatric Association. (2022f). How to prevent depression as you age . https://www. apa.org/topics/aging-older- adults/depression • American Psychiatric Association. (2022g). Informed consent. APA Dictionary of Psychology . https://dictionary.apa.org/informed-consent • American Psychiatric Association. (2022h). Psychosis. APA Dictionary of Psychology . https:// dictionary.apa.org/psychosis • American Psychiatric Association. (2022i). Tardive dyskinesia. APA Dictionary of Psychology . https://dictionary.apa.org/tardive-dyskinesia • Ayalon, L., & Tesch-Romer, C. (2018). Contemporary perspectives on ageism . Springer. https://doi.org/10.1007/978-3-319-73820-8
treatments have been found to be effective for increasing hope, which in turn optimizes physical and mental health for the older adult (Hernandez & Overholser, 2021). Hope holds positivity for the older adult, yet is only one of 10 principles where the healthcare worker can assess and intervene. Focusing on the recovery and healthy aging of the older adult, beginning with the initial interview, promotes a journey toward recovery as a fluid process with dimensions and principles to guide the healthcare worker. Healthy aging and recovery strategies can be preventive for mental health or goals set during any stage of mental health illness. Together, the healthcare worker and patient can maximize quality of life for the visual, or cognitive impairments. The healthcare worker is charged with considering the unique presentation of the older adult when assessing social determinants (protective factors or barriers) and biopsychosocial factors. Knowing risk factors, symptoms, and treatment options for older adults with mental health needs enables the healthcare worker to provide treatment options that maximize safety, recovery, and quality of life for the older adult • Bartels, S. J., DiMilia, P. R., Fortuna, K. L., & Naslund, J. A. (2020). Integrated care for older adults with serious mental illness and medical comorbidity: Evidence-based models and future research directions. Clinical Geriatric Medicine , 36 (2), 341-352. https://doi.org/10.1016/j. cger.2019.11.012 • Boyd, M. (2017). Essentials of psychiatric nursing . Wolters Kluwer. • Carlat, D. J. (2017). The psychiatric interview (4th ed.). Wolters Kluwer. https://www.loc.gov/ catdir/enhancements/fy1702/2016008384-d.html • Centers for Disease Control and Prevention [CDC]. (2021a). Challenges affecting health literacy of older adults . https://www.cdc.gov/healthliteracy/developmaterials/audiences/ olderadults/understanding-challenges.html • Centers for Disease Control and Prevention [CDC]. (2021b). Depression is not a normal part of aging . https://www.cdc.gov/aging/depression/index.html • Centers for Disease Control and Prevention[CDC]. (2021c). Loneliness and social isolation linked to serious health conditions . https://www.cdc.gov/aging/publications/features/lonely- older-adults.html • Centers for Disease Control and Prevention[CDC]. (2022a). Older adult drivers . https://www. cdc.gov/injury/features/older-driver- safety/index.html • Centers for Disease Control and Prevention[CDC]. (2022b). What is health equity? https://www.cdc.gov/healthequity/whatis/? CDC_AA_refVal=https%3A%2F%2Fwww.cdc. gov%2Fcoronavirus%2F2019-ncov%2Fcommunity%2Fhealth-equity%2Frace-ethnicity.html Cepla, E. (2014). Schizophrenia and getting older. https://www.nami.org/About-NAMI/NAMI- News/2014/Schizophrenia-and-Getting-Older • Chu, J. N., Kaplan, C., Lee, J. S., Livaudais-Toman, J., & Karliner, L. (2022). Increasing telehealth access to care for older adults during the COVID-19 pandemic at an academic medical center: Video visits for elders project (VVEP). Jt Comm J Qual Patient Saf , 48 (3), 173- 179. https://doi.org/10.1016/j.jcjq.2021.11.006 • Conner, K. O., Copeland, V. C., Grote, N. K., Koeske, G., Rosen, D., Reynolds, C. F., 3rd, & Brown, C. (2010). Mental health treatment seeking among older adults with depression: The impact of stigma and race. Am J Geriatr Psychiatry , 18 (6), 531-543. https://doi.org/10.1097/ JGP.0b013e3181cc0366 • Corey, G., & California State University. (2013). Theory and practice of counseling and psychotherapy (9th ed.). Brooks/Cole/Cengage Learning. • Czaja, S. J., Moxley, J. H., & Rogers, W. A. (2021). Social support, isolation, loneliness, and health among older adults in the PRISM randomized controlled trial. Front Psychol , 12 , 728658. https://doi.org/10.3389/fpsyg.2021.728658 • Edemekong, P. F. Bomgaars., D. L.; Sukumaran, S. & Schoo, C. (2022). Activities of daily living. StatPearls . https://www.ncbi.nlm.nih.gov/books/NBK470404/ • Gaddey, H. L., & Holder, K. K. (2021). Unintentional weight loss in older adults. Am Fam Physician , 104 (1), 34-40. https://www.ncbi.nlm.nih.gov/pubmed/34264616 • Harandi, T. F., Taghinasab, M. M., & Nayeri, T. D. (2017). The correlation of social support with mental health: A meta-analysis. Electron Physician , 9 (9), 5212-5222. https://doi. org/10.19082/5212 • Hernandez, S. C., & Overholser, J. C. (2021). A systematic review of interventions for hope/ hopelessness in older adults. Clin Gerontol , 44 (2), 97-111. https://doi.org/10.1080/07317115 .2019.1711281
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