I am a Clinical Psychologist with a doctorate in geropsychology – which means that my area of expertise is working with older adults, helping them with the psychological changes and challenges associated with ageing.
As with younger adults, a variety of mental health disorders such as anxiety and depression, can – and do – affect older adults.
Growing older can involve new or different stressors as well, which can affect our health, independence and emotional wellbeing. Common life stressors in this age group include:
- adapting to and coping with late-life transitions;
- grief – for example, losing a partner;
- poverty and/or living on a fixed income;
- multiple medical conditions;
- functional limitations;
- cognitive changes;
- chronic pain;
- caring for an infirm family member.
I have a doctorate in clinical geropsychology, which is a fancy way of saying that my area of expertise is in working with older adults, to help them deal with mental health disorders and late-life stressors.
How Can a Psychologist Help?
When you come to see a psychologist about any of the issues you are struggling with – no matter what your age – they may draw on a range of therapies and techniques. Some of the more common ones include cognitive behavioural therapy (CBT), interpersonal therapy (IPT), and psychodynamic psychotherapy; behaviour modification and disease management strategies; cognitive training techniques; and environmental modification.
Alone or in combination with psychiatric medications, psychological interventions have been shown to be effective in the treatment of many mental health disorders.
The availability of non-pharmacological treatments for mental health problems is especially important for older adults. This is because they are often on multiple medications for physical health problems, are more prone to certain adverse side effects of medications than younger individuals, and, as noted, often prefer psychotherapy to psychiatric medications.
Common Challenges for Older Adults
It may be comforting to realise that not only are you not alone, but that help is available. Here are just some of the areas and situations where a psychologist specialising in the concerns of the ageing can help:
- Adjustment to the stressors of late life – dealing with the many life stressors that accompany ageing, such as decline in health, loss of loved ones, and relocation to a new living situation.
- Anxiety disorders – the frequency of anxiety in the older population is comparable to that of depression in younger people. Anxiety-related disorders include generalised anxiety disorder, panic disorder, post-traumatic stress disorder, and obsessive–compulsive disorder. A combination of psychotherapy and supportive counselling can be effective in the treatment of anxiety disorders in older adults.
- Caregiving – although the role of caregiving can be rewarding, it can also be quite stressful and taxing. Support can be vital in helping caregivers to better deal with the practical and emotional demands of caring for a physically or cognitively impaired older relative, as carers may develop problems with depression, anxiety, substance abuse, anger, and stress-related health problems, including cardiovascular disease.
- Dementia – a diagnosis of dementia can be devastating. A psychologist can help those in the early stages of dementia, to build coping strategies and reduce distress through psychotherapy and psycho-educational support groups. Memory training strategies can help you to optimise remaining cognitive abilities. It is common for individuals with dementia to also suffer from depression, paranoia, and anxiety, which benefit from psychological intervention. If you are caring for a person with dementia, there are behavioural and environmental strategies to help you deal with common behaviours such as aggression and wandering – and unlike sedating medications, do not lead to additional confusion or impairment of mental functioning in your loved one.
- Depression – depression in older adults is a very treatable disorder. However, symptoms of depression in older adults are often overlooked because they are assumed to be a normal part of ageing. Not so! Symptoms of depression can sometimes be triggered by medical illnesses or life events that commonly occur as people age; so it is important to seek professional help for correct diagnosis and treatment.
- Health promotion – as experts in human behaviour, psychologists have been at the forefront in developing effective health promotion programs and strategies to enhance healthy behaviours. Two examples of health promotion efforts that have proved successful for older adults include memory-training programs, and physical activity programs that elevate mood, relieve symptoms of depression, and contribute to the effective management of hypertension and diabetes.
- Insomnia – insomnia is prevalent among older adults, especially those with a medical illness. Older adults are especially vulnerable to the adverse effects of sleep medications, including memory impairment and impaired daytime performance. Psychologists have developed effective non-pharmacological treatments for insomnia, including cognitive behavioural techniques, sleep restriction and stimulus control, and sleep hygiene instruction.
- Management of chronic diseases – multiple chronic medical conditions often accompany ageing, such as heart disease, stroke, and arthritis. Psychological intervention can help to prevent excess disability and hospitalisation through treatment adherence and behavioural interventions, including physical activity, biofeedback, nutrition, and stress reduction techniques.
- Substance abuse – alcohol abuse is a significant problem for some older adults and is one of the eight leading causes of death among older Australians. Psychologists can help older adults boost their motivation to stop drinking, identify circumstances that trigger drinking, and learn new methods to cope with high-risk drinking situations. Some older adults have problems with addiction to prescription medication for anxiety and need help in reducing or stopping medication. In addition, as the baby boomer cohort enters old age, the prevalence of both alcohol and illicit drug use will likely increase.
- Suicide – sadly, older adults have the highest rates of suicide in Australia; depression is suicide’s foremost risk factor. Psychologists are skilled at identifying depression and assessing for suicide risk. Those at risk for suicide are often not identified by primary health care providers. In fact, it has been reported that two-fifths of older adults who commit suicide visited a physician within the past week; and three-quarters within the past month. Primary care providers often overlook the potential link between physical symptoms and mental health problems.
If you are finding yourself struggling with any of the changes associated with ageing, I urge you to seek help from a psychologist – preferrably, one specialising in these issues.
Author: Dr David Wells, B Psych (Hons), Dip Prof Couns, D Psych (Clin Geropsychology).
David is a Clinical Psychologist, with a doctorate in clinical geropsychology and a special interest in couples therapy, men’s health, and anxiety and depression. He is highly sought after as an expert in the psychological impacts of the ageing process.
To make an appointment with Dr David Wells Psychologist, try Online Booking – Mt Gravatt or Vision Psychology (Mt Gravatt) on (07) 3088 5422.