Mental Illness: Elders

by

Carole B. Cox

• LAST REVIEWED: 28 February 2017
• LAST MODIFIED: 28 February 2017
• DOI: 10.1093/obo/9780195389678-0246

Introduction

Mental illness is not in itself a normal part of aging but the transitions and changes that accompany the aging process place many older adults at risk. Depression and dementia are two of the most common mental illnesses impacting older people and may easily be confused. Diogenes syndrome (hoarding) was identified by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in 2013 as a psychiatric diagnosis mainly affecting older adults and requiring specific interventions. Each of these mental health problems requires proper assessments in order to diagnose and treat effectively. However, assessments are frequently compromised as many view their problems as a normal part of aging and thus do not seek treatment. In addition, people may somatize symptoms so that they are perceived and treated as more acceptable physical problems. Consequently, there is an increased risk that mental illnesses are not detected and appropriate interventions not offered. The appropriate treatment must begin with a thorough biopsychosocial assessment and history of the individual with particular attention given to the impact of diversity on his or life.

Textbooks on Mental Health and Aging

These textbooks focus on mental health and aging and contain information that can be used by social workers as they develop assessments and interventions. Models of mental health and mental illness as well as implications for treatment are offered in Segal, et al. 2010. Two books, Zarit and Zarit 2007 and Lichtenberg 2010, provide guidelines for assessments as well as suggestions for interventions focusing on functioning and common cognitive changes in older adults. Birren, et al. 2013 provides a valuable multidisciplinary perspective on mental health and older adults.

• Birren, James, Gene Cohen, R. Sloane, et al. 2013. Handbook of mental health and aging. 2d ed. Saint Louis, MO: Elsevier.

  This multidisciplinary book includes chapters on research, psychiatry, social work, psychology, pharmacology, and nursing. It discusses both clinical and practical issues with each chapter having a comprehensive bibliography.

• Lichtenberg, Peter, ed. 2010. Handbook of assessment in clinical gerontology. 2d ed. Boston: Elsevier.

  The book offers guidelines and tools for assessing general mental health, cognitive functioning, functional age, psychosocial health, comorbidity, and behavior deficits. It offers in-depth discussion of psychopathology, behavioral disorders, common cognitive changes that are common in older adults. It also reviews how assessment instruments can be adapted for different cultural groups.

• Segal, Daniel, Sara Qualls, and Michael Smyer. 2010. Aging and mental health. 2d ed. New York: Somerset, NJ: John Wiley.

  The book offers a very comprehensive review of models of mental health and mental illness along with implications for treatment of older adults. Case studies are given that help to link theory with practice and the implementation of evidence-based treatments.

• Zarit, Steven, and Judy Zarit. 2007. Mental disorders in older adults: Fundamentals of assessment and treatment. 2d ed. New York: Guilford.

  This book focuses on function rather than disease and thus is very compatible with social work interventions reflecting the strengths perspective. It provides valuable material to be used in assessing and treating the most common mental disorders of older adults.