It’s often said that aging isn’t for the faint of heart, and that can be especially true for older adults facing mental health challenges. The American Psychological Association reports that up to 25% of adults ages 65 and older experience a mental health condition, with depression being the most common.
While there are many reasons mental health concerns arise later in life, treatment can help your loved one maintain the best quality of life possible.
Still, as the adult child of an aging parent, what can you do if your parent is resistant to the idea of seeking help for a mental health issue?
Read on for what to know about this common problem and how best to navigate this challenging aspect of aging and caregiving for an older loved one.
[Read: What to Do When You Become the Family Caregiver]
Why Older Adults Are Vulnerable to Mental Health Issues
Older adults are at particular risk for mental health concerns because of their experience of loss and decline later in life, explains Jennifer Szakaly, founder and CEO of Caregiving Corner, a care management and counseling firm in Charlotte, North Carolina.
Big changes, such as retirement or the loss of a spouse can trigger grief and other mental health issues.
“Once their career is gone, or their role as a spouse for decades is gone following the loss of a partner, they can easily begin to struggle with finding meaning and purpose in everyday life,” Szakaly says.
Giving up a driver’s license can also make an older adult more vulnerable to mental health issues, explains Shauna Buchmoyer, a licensed occupational therapist with United Disabilities Services Foundation, a Lancaster, Pennsylvania-based human services organization offering care solutions for people with physical and age-related disabilities.
“This can feel as if they are giving up their freedom which can significantly impact their mental health, as they feel like they must rely on others and often fear becoming a burden.”
Older adults also tend to experience more frequent losses as friends and contemporaries get sick and die. It’s enough to make anyone contemplate their own mortality, which can lead to anxiety and depression.
But subtler shifts associated with aging and changes in health status can also trigger a decline in mood. This can lead to changes in an older adult’s ability to socialize with others, and mobility changes can rob them of hobbies they once enjoyed. For example, worsening arthritis in the lower body can make golfing challenging, while arthritis in the hands and fingers can make knitting painful and less enjoyable.
[READ: 9 Signs of Depression: Symptoms to Watch for]
Mental Health Warning Signs to Watch Out For in Your Aging Parent
Tessa Lundquist, a board-certified geropsychologist with the Wolk Center for Memory Health at Hebrew SeniorLife in Boston, says that mental health can look different in aging parents versus younger populations. “Older adults may not have the vocabulary or knowledge to clearly state or identify that they are struggling with mental health.”
But if your parent starts to deviate from their normal self, it might be time to check in with them.
“Mental health struggle can look like them not taking care of themselves or the things around them — like their home, yard, etc. — the way they used to,” Lundquist says.
Other common signals can include:
— Loss of interest in activities that used to bring happiness
— Loss of motivation or purpose
— Refusal to try or learn anything new
— Distancing themselves from friends and family
— Increased negativity, irritability, restlessness or moodiness
— Changes in sleep patterns and appetite
— Increased memory problems
— Neglecting personal hygiene
— Lack of energy or feeling tired all the time
— Trouble concentrating, making decisions or remembering things
Older adults also sometimes express mental health struggles in physical terms, Lundquist explains. “They may describe feeling ‘slowed down’ or fatigued when feeling depressed. Or they may describe having body aches and pains when they are stressed or emotionally struggling.”
Jhanell Biggs, a certified professional retirement coach and founder and CEO of Moro, a retirement planning consultancy based in New York City, has seen many of these symptoms in her professional work, but also as the daughter and caregiver for aging parents.
“As someone who has cared for an aging parent, I know these changes happen gradually,” Biggs notes. “We may even discount them as just a phase because it’s hard to pinpoint, or we simply normalize the shift.”
But experiencing depression, anxiety or other mental health issues is not a natural ‘part of aging,’ Biggs notes. “We should always take note of changes in mood and behavior.”
You can look for context clues as well. For example, if you know that your aging parent has recently experienced something traumatic, such as losing a spouse, be on the lookout for isolation behaviors, withdrawal from normal activities and sudden weight loss. These are all signs that the older adult either doesn’t have, or isn’t using, appropriate coping skills to get through the trauma and they need support immediately, Szakaly says.
Approaching the Mental Health Conversation
As the saying goes, if you see something say something. But letting an older loved one know you think they need help from a professional for mental health concerns can be a fraught experience.
Here are some tips and strategies for keeping the conversation on track to help your loved one.
1. Do some research.
Before you even open this conversation, Buchmoyer recommends doing some research so you have some resources ready to suggest. That way, if they surprise you by being open to the suggestion, you’ll have a plan ready to go.
But be forewarned they might not be happy about the conversation, Szakaly says. “Be prepared for them to be in denial or experience shame when you are trying to discuss this with them.”
Some will balk at the idea that they need help, and that can make for a delicate conversation.
[READ: Mental Health Resources for Seniors]
2. Be open, honest and compassionate.
To get around this tendency, let compassion and honesty be your guides. Good conversations involve open dialogue and active listening, rather than pushing or convincing, says Lina Supnet-Zapata, an aging life care manager and CEO of Mir Care Consultants Inc., in Austin. “When a parent resists help, pushing harder usually backfires.”
Biggs agrees that trying to convince your parent they need therapy can make the problem worse. “Adult children should realize that they can’t force their parents to accept help. The parent must want to do this for themselves, not to appease anyone else.”
3. Bring in an unbiased supporter.
Helping your parent understand your point of view can sometimes be helped by recruiting others into the conversation, such as your loved one’s primary care doctor, says Supnet-Zapata, who is also president-elect of the Aging Life Care Association.
“Sometimes it can be easier to accept help when it is recommended by a neutral third party rather than adult children who have so much emotion and history with their parent.”
[READ: How to Talk to Your Parents’ Doctors: Tips for Successful Communication]
4. Reframe the issue.
Lundquist says it can be helpful to reframe the issue: Think about how it may not be that your parent doesn’t want to seek care or get support, but that they are scared and unsure what that would look like.
She notes that older adults were raised in a time when mental health was not openly discussed and it was typically not OK or safe to express emotional struggles. That stigma lingers for many.
“Approaching the conversation with understanding that they are resistant due to possible fear and discomfort can be helpful. Helping them understand what the process would be to getting mental health support can take away some of the unknowns they may be worried about,” Lundquist explains.
For Biggs, when her mother’s mood changed, she shared that she’d noticed a change. Her mom acknowledged it, but struggled to articulate why or what she was feeling.
The conversation moved on to discussing her mom’s fears and uncertainties about her impending retirement and what to do with her life after work. That gave them a starting point to work from in finding the right path forward.
5. Recast mental health care as health care.
Unfortunately, many people still have outdated ideas about what it means to get mental health care, but likening this action to getting treatment for a physical issue could help them understand that times have changed.
For example, if their knee was bothering them, they wouldn’t hesitate to talk to their doctor or a specialist to get that pain addressed.
“With mental health struggles, you are getting your emotional health checked and accessing treatment to help that pain and regain functioning and a happier state of being,” Lundquist explains.
It’s also important to “assure your parent that identifying their mental health struggle and seeking treatment does not mean they are ‘crazy,'” she says.
6. Emphasize that you support them.
Emphasizing that your parent is not alone in their struggles can also be a helpful way to support someone, Lundquist says.
“I have encountered many older adults who do not realize that others experience depression or anxiety, and they just think that they are ‘crazy’ for struggling emotionally. Letting your parent know that others struggle too, and that they deserve a little extra support right now, can be effective.”
7. Ask for their advice.
Another strategy that can be effective is asking your parent to think about what advice they would offer a friend or loved one if they were experiencing mental health struggles, Lundquist says.
“Often times they will identify how they would want that person to get treatment, which can help them realize that they themselves could benefit from treatment too.”
8. Keep trying.
Convincing someone to get help can be a process.
“You may need to raise the issue, and then give your parent time to wrap their heads around it. Provide them the education to take away some of the unknowns, and then check in again about if they would be willing to try mental health treatment out,” Lundquist says.
When Biggs was helping her mom seek mental health support, they didn’t come to a resolution during a single discussion. But they kept talking.
“This conversation happened over a series of weeks. She needed time to get comfortable with the idea of speaking to a therapist about something she was experiencing but could not pinpoint the cause or source of.”
Who Can Help Me With My Aging Parent’s Mental Health Concerns?
An older adult’s primary care provider is a good first stop, Lundquist says. This is not only because they can connect you with local resources or in some cases manage the issue themselves; but it’s also important to rule out any possible underlying medical problems that could be triggering the mental health issue.
For example, urinary tract infections can cause psychiatric symptoms in older adults. Treating the infection can resolve those symptoms.
But if there is no underlying medical issue, you can also seek help from a counselor or aging life care manager who can walk you through locally available mental health resources.
Options may include:
— In-home counseling or therapy
— Telehealth-based psychological or psychiatric care
— Office-based psychological or psychiatric care
— Inpatient psychiatric care facilities
Some practices and facilities are specifically geared toward treating and supporting older adults, and providers affiliated with such organizations often have specialized training in working with the aging population.
In addition, Lundquist recommends looking for community-based support groups or contacting a geropsychologist who’s specifically trained to provide therapy to older adults.
She also recommends checking out the E4 Center website, a publication of the E4 Center of Excellence for Behavioral Health Disparities in Aging affiliated with Rush University. “They have a plethora of community resources available, which provide education and tangible guides for navigating mental health support with older adults.”
Paying for Mental Health Care for Older Adults
The good news is, Medicare covers mental health care for beneficiaries. And in many cases, this care can be managed by your loved one’s primary care provider or geriatrician in an office or telehealth setting.
Medicare also covers medically necessary inpatient mental health care under Part A, the hospital insurance part of Medicare. In these instances, meals, nursing care, therapy and medications are covered, but there are limits to coverage depending on the type of facility and the length of your stay. Plus, you’ll be responsible for copayments and deductibles, so it’s important to ask what’s covered and what’s not to avoid expensive surprises.
In addition, some mental health providers and psychiatric care centers do not accept Medicare as payment. In such cases, you’ll have to pay out of pocket for any services rendered, so be sure to check with the provider before booking an appointment to understand your financial responsibilities.
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How to Get Your Aging Parent Mental Health Help Even When They Refuse It originally appeared on usnews.com
