As discussed in earlier posts, the aging population faces an
array of barriers when needing mental health services. For instance, Bartels (2003)
discovered that although an overwhelming majority of older adults prefer to
receive services either at home or in their local community, the current
healthcare system is geared more towards providing services for this population
in a hospital-type setting. Moreover, the majority of Medicare funds are meant
for long-term stays in institutional care, such as nursing homes, but it is important to note that there is only a small percentage of older adults living in nursing homes (Bartels,
2003; R. Smith, personal communication, June 16, 2014). Furthermore, Bartels (2003)
uncovered another major barrier facing the aging population: fragmented care.
Older adults are receiving care from multiple institutions, which is not time
or cost-efficient for any of the parties involved. In addition, this fragmentation of care may
result in client falling through the cracks of care.
With these issues hindering this population
from receiving the adequate care they need, I still consider the lack of
cultural sensitivity and stigma surrounding mental illness to be among the biggest
failings of the systems of care for older adults. Many in the aging population will not seek
services because American society views those with mental illness as being “weak”
or “defective”. This cultural oppression means that shame often stops older
adults from getting the mental health services needed to improve their quality
of life. Further, when these individuals
do receive services, it raises another question of whether or not helping
professionals have a high enough standard for cultural competence. The Baby Boomers are a diverse population,
thus the needs of older generations will continue to become more and more varied
(R. Smith, personal communication, June 16, 2014). So, you might ask: how do we go about eliminating the stigma surrounding
mental illness while also increasing the cultural competence in helping professionals? The first step is education!
Most helping professionals are
required to take continuing education classes in order to stay current on social issues and increase their awareness of the role of helping professionals in the world. Thus, I suggest, on a policy level, that it be a
requirement that at least one of those courses be focused on serving older
adults. Moreover, relevant Public Service Announcements (PSA)
that educate the general population about mental illnesses in the aging
population could had a wide-reaching impact through means of commercials and
billboards. In addition, fostering relationships between healthcare and social
agencies allows a more integrative approach for reducing stigma and increasing
awareness of unique barriers facing older adults from differing cultural
backgrounds.
Also, please remember: EVERYONE has a part to play in improving the aging population's quality of life. Educate your friends, family, and colleagues about the powerful influence of words so that the language we use can be used to encourage rather than perpetuate stigmas that bring about shame!
image retrieved from
http://www.co.shasta.ca.us/index/hhsa_index/mental_wellness/Communityeducationcommittee.aspx
Interested in taking some low-cost, easy access online classes to increase your skills when working with the aging population? Check out this website, which offers CEUs focused on issues in aging: http://www.freestatesocialwork.com/?cat=5
References
Bartels,
S. J. (2003). Improving the United States' system of care for older adults with
mental illness: Findings and recommendations for the president's new freedom
commission on mental health. American Journal of Geriatric Psychiatry, 11(5),
486-497.
Education is key! Everyone has the potential to age, and everyone has the potential to experience these barriers. If we work together, we can eliminate or reduce the stigma for the current generation and generations to come!
ReplyDeleteYou're right, Dana, we do need to work together! If you've noticed, I am attempting to mobilize all helping professionals, not just social workers, because it is not the duty of just one profession to take on this issue; all of us in direct care must get involved to make any sort of change possible. Thanks for your comment!
ReplyDeleteIt is hard enough to have a mental illness, however when you couple it with age then it get's even tougher for individuals to seek treatment or understand the need for services. It's not ok to be depressed or have anxiety because you are elderly. These are real symptoms of mental health services that the elderly face. I think this is a very important advocacy project and I thank you for your commitment to this cause.
ReplyDeleteSarah- thank you for your support! Developing this blog has opened my eyes to how the extent of oppression that older adults face. You're correct in saying that it is NOT okay to allow the aging population to suffer in silence when experiencing treatable symptoms such as depression and/or anxiety.
DeleteWhen I worked in hospice care, I saw issues like these all the time. I had several patients with Alzheimer's, and just when they would get comfortable and familiar with one face, someone new from a different organization would come in, and they would have to get readjusted. I found it to be much easier on the patient when the least amount of people could be involved in their care as possible, while at the same time providing them with their needs. I surely would not want a slew of people in and out of my home, so I am certain these elderly individuals don't either.
ReplyDeleteKelsey- I had not considered that aspect of older adults with Alzheimer's needing consistency with staff - thank you for that insight! As mentioned in an earlier post, consolidation of services is such an important piece of this puzzle so that clinicians can actually learn their clients' needs and streamline the process of providing treatment. I appreciate you sharing your personal experience!
DeleteMy grandfather had Alzheimer's and would often would have spells where he treated me and his wife of 50+ years as if he didn't recognize us. When he snapped out of his spell he would talk to us like nothing ever happened. So, I can see the importance of having as few faces necessary involved with caring for Alzheimer's patients as too many faces just may make matters worse and hinder their quality of life. How can they live in peace if they're constantly trying to figure out who is around them? Excellent point Kelsey.
DeleteI think that it shows a tremendous amount how much society invests in aging adult mental health care by the turnover or staff, and the amount of resources (and money) are put into paying staff. For example, I used to work in residential facility for adolescents with behavioral issues that had been abused; I am a firm believer that individuals that are working for betterment of others should be paid a good livable wage. Being paid well is a part of an agency not having a high turnover rate. Thus, this makes me feel that the lack of support for staff that work one-on-one with aging individuals is both a statement about aging individuals, and also the lack of value placed on those that work with aging individuals.
DeleteBruce- I’m sorry to hear about your grandfather. It can be a painful experience for everyone involved when a loved one has Alzheimer’s disease. Thank you for sharing your personal story and providing additional insight to Kelsey’s suggestion of not having a constant influx of new workers when working with this population.
DeleteCat- excellent point about providing support to staff working in long-term care facilities! Having experience with my practicum placement being in a residential setting with children and adolescents, I can relate to the high levels of stress that go along with the job. The turnover rate was sky-high and the most common complaint I heard from staff were that they had too little pay and too little support. These issues are not just in youth residential facilities, but also long-term care placements for older adults. If we think about caregivers who are taking on caring for older adult family members and/or friends, they, too, are often lacking in financial and social/emotional support. There is obviously a gap in care for caregivers and staff workers, which needs to be filled so that they can provide the best treatment for those whom they serve!
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ReplyDeleteAs I was reading this blog I was reminded of a conversation I had with a friend of mines who sits with an elderly lady. My friend says that her clients doctor still makes house calls. I found that to be very odd in this day and time. If we were to go back to that model of doctors making house calls, this would eliminate some of the barriers that the elderly face.
ReplyDelete~ YoLanda Scott
YoLanda- Having a doctor who goes to the client's home rather than requiring that they make a trip to the office seems out of the ordinary to me, too! In my research, I found that the majority of older adults strongly prefer receiving community-based services, so I agree that more helping professionals being willing to make house calls could improve our ability to reach this population.
DeleteI thought I posted but do not see it, so forgive me if I am commenting twice. I definitely think education is key and recently experienced this personally. I have little experience working with the elderly population and recently attended a training hosted by the Alzheimer's Foundation talking about working with patients that have memory loss. A common theme was the idea that many long-term care facilities are giving their patients antidepressants and antipsychotics such as Haldol because they present as a difficult patient to manage or have anger outbursts. The lecturer talked about the increased chance of death that is associated with many of these drugs and the fact that it is not the most appropriate fix for the behavior. I was very intrigued about their recommendation of monitoring the patient's behavior and environment throughout the day to identify triggers (time of day, staff member, etc.) and to change their routine if for example they are moody in the afternoon so that is not their busiest time of day. They also talked about having a positive and reassuring attitude which is so important because with patients that have memory loss, they may not understand what is going on from one minute to the next, and it can be very upsetting if a person is suddenly confused about why someone else is bathing them or touching them.
ReplyDeleteMeghan- it sounds like you capitalized on a great opportunity by going to that training! I discovered that helping professionals not looking closely enough at the interactions between different drugs, in addition to the overmedication of older adults are major concerns for the aging population today. Moreover, society often views changes in behaviors for older adults as a "normal" part of the aging process, but this can be a sign that there is a mental health issue needing to be addressed. I'm so glad that the training discussed focusing on identifying triggers since this can be a beneficial approach when trying to figure out what is going on with the client. Thanks for all this great information!
DeleteAlso, you can follow this link (http://abcnews.go.com/Health/study-highlights-dangers-medicated-seniors/story?id=17060793) to gain some additional information about the dangers related to medication and the aging population!
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