Mental illness among retirees is a becoming an increasing industry focus. The number of people entering retirement in Australia is set to increase rapidly, and this raises a number of questions around the provision of elder mental care.
Latest figures show that globally, more than 20% of adults aged over 60 suffer from a mental or neurological disorder (excluding headache disorders), and 6.6% of all disability among over 60s is attributable to these conditions. The World Health Organisation states that,
“Depression is the single largest contributor to years lived with disability. So it’s the top cause of disability in the world today,” (Dr Dan Chisholm from WHO’s Department of Mental Health and Substance Abuse)
The most common neuropsychiatric disorders in this age group are dementia and depression. Depression is often not well recognised or detected in older people. Symptoms such as sadness, sleep and appetite problems or mood changes may be dismissed as a ‘normal’ part of getting older. Symptoms such as poor concentration and memory difficulties may also be confused with other conditions such as dementia.
Whilst handling the everyday stressors common to most of the population, this age group are particularly vulnerable as they face significant life changes. A drop in socio-economic status and income from retirement, the onset of frailty and chronic illnesses and a decreasing ability to maintain lifestyle choices, make the elderly particularly susceptible to mental illness. The loss of friends and significant others may lead them to ponder their ongoing role in the community.
In a number of non-western cultures, such as Korean, Mediterranean and Latino, the role of the elderly is clearly defined – they are leaders, care providers, revered for their experience and knowledge, an integral and valuable part of the family and society. As such, the elderly remain thoroughly integrated well into their last days.
Western cultures, in comparison, place greater value on youth-centric attributes such as independence and individualism. The concept of the “Protestant work ethic” traditionally ties an individual’s value to their ability to work, so as productivity decreases in old age, so does apparent value to society.
Anthropologist Jared Diamond has studied the treatment of the elderly across cultures and has stated that elderly societies in countries such as the UK and the US, traditionally live;
“Lonely lives separated from their children and lifelong friends.”
Today, people of retirement age are healthier, both mentally and physically, than ever before and are not content to slide into decline in their elder years. Increasingly there is evidence that good mental health is a key factor associated with healthy ageing (Kane 2005) and that mental health has an impact on physical health, and vice versa.
The growing interest in the importance of maintaining good mental health for healthy ageing, has resulted in an emphasis on positive ageing strategies and prompted a rethink about how to approach the mental health issues of older adults (Jeste & Palmer 2013)
Many retirees these days want to maintain or even expand their current lifestyles, remaining in their existing communities, homes and social groups for as long as they are able. Doing so has a number of apparent benefits:
Being an integral part of a community/family unit fosters a feeling of purpose after retirement from paid work.
Continual social and emotional support serves as a protective factor against depression.
Social isolation has been identified as a major risk factor in the rate of mental illness
Maintaining a sense of individualism and independence can maintain positivity and happiness.
Physical and mental exertion have been proven to have a positive impact on depression levels and maintenance of cognitive function.