Dos and Don’ts of Caring for an Older Adult with Mental Illness

Mental health changes are not a “normal part of aging” so it’s important to recognize and address the symptoms.

Posted in , Jan 18, 2022

Father and son in their home; Getty Images

Kerstin Yoder, LISWS, is a Social Worker/Group Coordinator with Behavioral Health Services at Benjamin Rose Institute on Aging.

Understanding mental illness

Mental illness is characterized by a myriad of conditions that impact an individual’s thoughts, emotions or mood. Since mental illness can make it more difficult for a person to maintain rational thought and control, day-to-day self-care can be a challenge.

When it comes to older adults, stereotypes can add to the challenge. Common presumptions like, “The elderly are ornery,” or, “Getting older has made her impossible to deal with,” allow people to brush off symptoms that may point to mental health issues. Keep in mind that mental illness is not a “normal part of aging.” If you are a caregiver to an older loved one, it’s important to learn how to distinguish signs of mental illness.

Common symptoms of mental illness in older adults

Although they vary greatly, these are some of the more common symptoms of mental illness in older adults:

  • Changes in grooming or standards of living
  • Confusion, problems concentrating and making decisions
  • Increased or decreased appetite or weight
  • Feeling worthless, guilty or helpless
  • Short-term memory loss
  • Unexplained fatigue, getting too much sleep or not enough
  • Withdrawing from others
  • Lessened interest in activities

According to the National Alliance on Mental Illness (NAMI) Mental Health Facts in America report, about 1 in 5 adults experience mental illness in any given year. Two common forms of mental illness older adults face are generalized anxiety disorder and depression.

Generalized anxiety disorder is characterized by severe, persistent anxiety that interferes with day-to-day activities. For older adults, this can result in apprehension, restlessness, tension or dread, and bring on headaches, fatigue, insomnia, heart palpitations or stomach issues.

On the other hand, depression is characterized by on-going feelings of sadness and loss of interest that can interfere with day-to-day life. It can be brought on by stressful events or change. Depression can be exacerbated for those who experience social isolation, the passing of friends or loved ones, or chronic pain.

Make sure to see a doctor for a diagnosis since it can be tough to distinguish depression and generalized anxiety disorder from dementia, as the symptoms can be similar.

Dos and Don’ts of caring for an older loved one with mental illness

Mental illness is a touchy subject, and as a caregiver, you might be concerned that you’ll say or do the wrong thing when you’re only trying to help. Because you’re not sure how to broach the subject, you may avoid talking about it at all. But it’s important to get it out in the open since your loved one relies on you for support and validation.

These tips can help:

  • DO listen and adopt an attitude of respect
  • DO make it clear that you will be there to assist in whatever way is needed
  • DO accept that your loved one’s fears, anxieties, feelings of despair, and even hallucinations and/or delusions are real to him or her, even if you have a hard time understanding
  • DO build a trusting bond which allows your loved one to open up to you and know you are there
  • DO stay calm—if you appear agitated, it may heighten your loved one’s agitation
  • DO genuinely communicate your concerns
  • DO leave treatment decisions to psychological or medical professionals
  • DON’T communicate with aggressive body language
  • DON’T assume that your loved one has cognitive impairment
  • DON’T blame your loved one for his or her mental health issues or for not being able to control them. Saying something like, “just be positive” can make someone feel like they haven’t made enough of an effort.
  • DON’T assume your loved one is abusing alcohol or recreational drugs
  • DON’T drastically alter how you act around your loved one because of his or her mental health challenges

Helpful resources

In the event of a mental health emergency, make sure to get your loved one immediate help. If the situation is life-threatening, call 911, and if your loved one is suicidal, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for assistance from trained crisis workers.

In less severe situations, you can contact the SAMHSA Treatment Referral Helpline at 1-877-726-4727 to discuss available mental health services in your area. If your loved one needs ongoing support, consider looking into mental and behavioral health services that offer counseling and treatment, like Benjamin Rose Institute on Aging’s Behavioral Health Services.

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