Counselling for Older People
Many people over 70 still feel there is a stigma attached to depression and anxiety, viewing them as weaknesses or character flaws, rather than a genuine health condition.
This time of life can include feelings of loneliness, lack of a sense of purpose and frustration with becoming more dependent on others. These feelings are completely natural to have from time to time. It's important to get support when these feelings don't go away.
The Impact of Mental Illness on Older People
The rates of depression in older people is very high due to contributing factors such as physical illness or personal loss. It is thought that between 10-15% of older people experience depression and about 10% experience anxiety at any time. Rates of depression among older people living in residential aged-care are thought to be much higher, at around 35%.
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It is common for older people to feel there is stigma associated with experiencing depression and anxiety. Because of this, older people are much more hesitant to share their experiences of anxiety and depression with others, often ignoring symptoms over long periods of time and only seeking professional help when things reach a crisis point.
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Risk Factors for Older People
Mental illnesses, including depression and anxiety, can occur due to a variety of reasons in older people. Factors that can increase the chances of someone experiencing a mental health condition, or worsening of a pre-existing condition, can include:
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Experiencing worsening physical health - heart disease, stroke, Alzheimer's disease.
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Chronic pain - arthritis
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Physical limitations - pain - arthritis, degenerating joints, falls
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Side-effects of medications
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Admission to hospital
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Significant change in living arrangements - moving to aged-care facility
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Loss - loss of a spouse, siblings or an adult child, loss of friends
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Social Isolation
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Particular anniversaries and the memories associated
Signs and Symptoms That Someone You Know May be Becoming Unwell
An older person may be depressed if, for a period of 2 weeks or more, he or she has felt sad or down most of the time, or has lost interest or pleasure in most of his or her usual activities. A person may be experiencing depression if they experience several of the signs and symptoms across at least 3 of the categories listed below.
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Older people with depression tend to identify more physical symptoms, including difficulty sleeping or sleeping less, rather than complaining of feeling sad or having a low mood. Older people may also use different language including 'the blues', 'my nerves'.
Physical Symptoms:
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Sleeping more or less than usual;
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Feeling tired all the time;
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Difficulty getting out of bed;
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Slowed movement or 'slowing down';
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Memory issues;
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Digestive upsets, nausea, changes in bowel habits;
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Agitation, pacing;
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Loss or change of appetite;
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Significant weight loss (or gain).
Behavioural Symptoms:
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General slowing down or restlessness, difficulty being still;
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Neglecting responsibilities and self-care;
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Withdrawal from family and friends and social activities;
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Decline in day-to-day ability to function, being confused, worried and agitated;
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Inability to find pleasure in any activity, especially those which previously brought joy;
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Difficulty getting motivated in the morning;
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Behaving out of character;
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Denial of depressive feelings as a defence mechanism.
Thoughts:
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Indecisiveness
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Loss of self-esteem
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Persistent suicidal thoughts
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Negative comments like 'I'm a failure, 'It's my fault' or 'Life is not worth living'
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Excessive concerns about financial situation
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Perceived change of status within the family
Feelings:
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Moodiness or irritability, which may present as angry or aggressive
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Sadness, hopelessness or emptiness
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Overwhelmed
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Feeling worthless or guilty
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Loneliness
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No sense of purpose
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Feeling like a 'burden'
Dementia and Depression
Due to the similarity in symptoms between depression and dementia, it can be very difficult to differentiate the two illnesses. It is made even more challenging because approximately 20% of people with dementia also experience depression.
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Despite their similar symptoms, dementia and depression are very different conditions that require different responses and treatment. For this reason, it is important to visit the GP for an assessment. They will be able to provide an individual with a referral if a specialist is necessary.
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Regardless of the specific condition, whenever possible, having a partner, family member or friend involved is important to ensure the best treatment outcomes.
Elder Abuse
The World Health Organisation has defined Elder Abuse as:
'a single, or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust which causes harm or distress to an older person'.
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Put simply, elder abuse is anything that might be causing harm or distress to an older person.
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Elder abuse is most frequently financial, psychological and emotional, but can take various other forms, including: physical, social, sexual or neglect.
Elder abuse most often occurs at the hands of an elder son or daughter, however it also occurs within a wide range of other family and caring relationships.
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Elder abuse is often hidden and can be difficult for those experiencing it to talk about, especially when it is perpetrated by a person's adult son or daughter due to weight of responsibility a person feels towards their children. Emotional abuse is often used by perpetrators to create guilt and a feeling of helplessness and powerlessness of the older person, the victim.
Forms of Elder Abuse:
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Financial Abuse:
The theft or improper use, restriction and/or mismanagement of a person’s money, property or resources.
Examples can include: - Misusing an older person’s bank cards. - Using coercion or threats to obtain money (or financial gain) from an older person. - Misusing a legal document, such as an Enduring Power of Attorney. - Coercing someone to alter their Will. - Selling or transferring property against an older person’s wishes, or failure to respect agreements made in regard to property and living arrangements. - Not repaying loans or contributing to household expenses. - Withholding appropriate care for financial gain.
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Emotional and Psychological Abuse:
Emotional and psychological abuse is behaviour that causes mental distress and/or emotional harm. It is behaviour that might cause an older person to feel humiliated, isolated or fearful. Psychological and emotional abuse can deeply affect an older person’s sense of self-esteem, confidence and self-worth.
Examples can include: - Shouting or making degrading comments. - Making verbal threats – these might be directed towards the older person, someone else or even a pet. - Coercing/pressuring a person into decisions they don’t agree with. - Not seeking out the wishes of an older person when acting as their attorney. - Blaming a person for things out of their control. - Attempts to cause disharmony among an older person’s relationships with other friends or family . - Gaslighting - a form of psychological manipulation in which the abuser attempts to sow self-doubt and confusion in the other person's mind. - Typically, gaslighters are seeking to gain power and control over the other person, by distorting reality and forcing them to question their own judgment and intuition.
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Neglect:
Neglect is the refusal or persistent failure of a carer (or responsible person) to meet the basic needs of an older person. Neglect can be intentional or unintentional. It may be a deliberate action or the result of carer stress/burnout, apathy or a lack of skills and awareness.
Examples can include: - Refusing access to, or failing to engage, appropriate healthcare or aged care services. - Failing to provide basic clothing, hygiene and/or nutritional needs. - Allowing an older person’s household to deteriorate into squalid conditions. - Withholding access to appropriate medication(s). - Withholding aids that support an older person’s safety such as an aid for walking, showering or other daily activity.
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Physical Abuse:
Physical abuse is an action that may result in physical pain or injury. It can also include the use of restraints, such as locks on doors or medication/chemical restraints. Physical abuse can pose a greater risk to older people, as some can become more susceptible to injury over time and experience longer recovery times.
Examples can include: - Slapping or pushing an older person. - Medication misuse or chemical restraint: use of medication or other drugs for the main purpose of controlling an older person’s behaviour. - Locking an older person in a room, or in a position (e.g. lounge chair) they can’t get out from. - Rough and aggressive handling of an older person when assisting with care. - Throwing items at someone.
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Social Abuse:
Social abuse is when someone exercises control over an older person’s social connections and support networks. This might be attempts to limit when, how or with whom, the older person may have social contact. It can drastically increase an older person’s sense of isolation, as well as limit their ability to seek help.
Examples can include: - Monitoring phone calls, text messages or phone records. Listening into calls. Limiting access to a phone or other modes of communication. - Not allowing family, friends and support networks to visit where an older person lives. - An attorney using their powers to instruct hospital or aged care staff to limit visitors or phone calls to an older person. - Not allowing an older person to speak with others alone. - Withholding mail. - Moving an older person (particularly someone with impaired capacity) so that family, friends and networks are unable to maintain a connection. - Attempts to cause disharmony among an older person’s relationships with other friends or family e.g. telling lies or mistruths about a sibling.
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Sexual Abuse:
Sexual abuse can be a broad range of unwanted sexual behaviour, language or activity. Sexual abuse can also be perpetrated using technology, such as mobile phones or online activity. It can include sexual assault, harassment or any other activity of a sexual nature to which consent has not been given. An older people with a capacity impairment may not be able to provide sexual consent e.g. a person with advanced dementia.
Examples can include: - Unwanted touching. - Leaving a person undressed or nude. - Sending unwanted explicit material to an older person. - Making sexually suggestive comments. - Posting images online of an older person in a compromised state. - Posting comments online about an older person’s sexuality. - Engaging in sexual activity with someone who cannot consent. - Sexual assault and rape.
How Can I Book a Counselling Session and Get Some Help?
For more information, or to book an appointment:
Contact Jess on 0493 613 883 or empoweredmindbody@gmail.com
Or
Make a Booking Online
