People don’t often warn us about the challenges of growing older, or talk about how we can prepare for “the twilight years” of life.
Being over 60 is not like the first six decades of life; there are unique challenges associated with being old.
The Twilight Years: What to Expect
Health: Firstly, our health may not be so good.
Many older adults have multiple chronic conditions – conditions that don’t resolve. Having one is manageable, but several things going wrong with our bodies at any given time can be depressing. The incidence of chronic conditions increases with age, so that by the time a person gets to 65, 49.6% of the population have two or more chronic conditions. These may be accompanied by fatigue, pain, feelings of unwellness, and a limitation on activities or work. There is a real burden in carrying the weight of multiple illnesses.
Restricted Lifestyle: There may be restrictions on our activities.
With less energy, and limitations from chronic conditions or pain, we may have to downsize! This may involve not doing the work we once enjoyed, or not being able to work at all. With this we can lose our place in society, and feel that we are of less value. We can also lose needed income, friends and connections.
Losing Loved Ones: We can lose people that are important to us.
As time goes on, we may find that important friends or family have moved to another city or country. Some people may have passed away. We can lose our support network or connections, and become isolated.
Losing our Independence: We might lose our ability to live in our homes or drive a car.
There may come a time when it is no longer safe for us to drive, or we need better care than living alone at home or with our spouse can provide, necessitating a move into a rest home. For the first time in maybe decades, we no longer have the control and privacy we used to have over our lives. And we are living close to people we have not chosen. This is a huge adjustment, and depression and anxiety can result.
We may find ourselves depressed: Which is not surprising given the above challenges!
Generally older adults don’t have higher rates of depression than any other group over the lifespan, but there are exceptions. Older adults who are also care givers, those with multiple chronic conditions, those with dementia, older adults over the age of 85, or in residential care, are more vulnerable to depression. Medication is the usual treatment, but many adults are already on a large numbers of pills for chronic conditions, and some medications for psychological conditions increase the risk of falls, as well as adding to unpleasant side effects.
Enjoying Life No Matter What Your Age!
What can we do to make sure we still have a good quality of life, and enjoy our twilight years?
Psychological interventions are very effective in helping us cope better with chronic conditions and pain. There really is a lot that can be done to make us feel we can enjoy our lives again, despite the high level of physical challenges.
Psychological interventions are also very good at helping us find value and meaning in our lives, when the phase of being a parent (of grown adults!) and work has passed, or when we have had to downsize our involvement in them. Instead of shrinking in self-esteem (and then feeling low), we really do need a guide/coach to find a better way to live in later life.
As a “more mature” psychologist, I can help with strategies to make life work again. I can also be a great help in overcoming barriers to isolation and loneliness, so you can reconnect, and adjust to new living situations. Finally, psychological interventions are an effective treatment for depression, therapy being more effective in the long-term than medication.
If you are struggling with the challenges of growing older, I welcome you to make an appointment with me.
Author: Paul Carver.
An important message for Rest Home or Residential Care Providers
The incidence of anxiety and depression rises in older adults in residential care, compared to those living at home. The highest rate of suicide in the population is in the 85+ bracket. There may also be behavioural problems associated with older adults who have cognitive decline or dementia. Intervention by a psychologist is very effective, with studies showing a reduction in all-cause hospital visits by 10 fold (a really astonishing improvement) as well as 50% less GP visits, and 33% less gerontologist visits. Therapies such as Problem Solving Therapy, Interpersonal therapy and CBT for mild dementia are all effective.
An important message for families of older adults about dementia
Families are reluctant to face the spectre of dementia, envisaging symptoms of dementia will be the beginning of the end. However what is not known about dementia is that early detection is extremely helpful. This is because modern medicine is very effective at slowing the rate of decline of dementia right down. It doesn’t stop it, it just postpones the worst symptoms until the very end, retaining the present quality of life of the older adult so that neither they or the family have to go through years of unnecessary suffering. So if you suspect symptoms, and aren’t sure whether they are cognitive decline or dementia, don’t delay in getting an assessment. Your early intervention could mean everybody will be much better off.
What I can do for you
In the clinic I am experienced in working with older adults across the range of difficulties I have mentioned. If a family member does not want to, or is not able to, come into the office, I can arrange a home or residential visit. If it is relevant, an assessment will include psychological testing that can pick up dementia symptoms and differentiate them from cognitive decline. It also includes an assessment of the burden of chronic illness, and an assessment of depression, anxiety, alcohol use and activities of daily living (including social contacts and ability to do ordinary tasks, such as get groceries, clean the house, use stairs etc). A note of when the last medication review was done will be made. Guided by the assessment, appropriate therapies can be used.
When I was the Manager of Primary Care Mental Health for a good part of a major city, I introduced new initiatives for better care for older adults. I organised and worked with a team including a head of a hospital department, a Psychogeriatrician, Psychologist, a Nurse Specialist in gerontology and Manager of Nursing for older adults. I also trained in Clinical Health Psychology, which focuses on physical health conditions, dementia and old age.
To arrange an appointment with Brisbane Psychologist Paul Carver, freecall 1800 877 924 or you can book online.