Blog: How to protect older people's mental health in challenging times

Elaine McLernon is Age Scotland’s dementia training officer and a former mental health nurse. For Mental Health Awareness Week she shares her thoughts on how older people can protect their mental health, how being kind can help and looks at the negative impact of lockdown on the over 70s.

Growing older does bring with it changes both in physical health and how we feel about things. Most of us will experience times in our life when we feel down and research suggests that people in later life can be at greater risk of experiencing the effects of mental ill health.

Changes we may experience as we transition into later life can effect our mental health, but it is very important to remember that poor mental health is not a normal part of ageing.

During Mental Health Awareness Week we need to address the stigma which still exists around older people talking about how they feel about poor mental health in later life. Older people don’t want to feel like a burden and that in itself sometimes stops people from getting the help that they need. It can be difficult to express how we feel about growing older.

There are lots of positive things about later life. In retirement we have lots of opportunities to pursue new learning, contribute to services by volunteering as skills and knowledge are valued by organisations along with the life experience that we can take into that role.

We make plans for later life and maybe saved for retirement. But big changes, such as losing a loved one or a partner, can have an impact on an older person’s mental health. We find that the plans we have made will no longer play out. Finding other routes to fulfil our sense of purpose benefits our self esteem and sense of self worth.

Older people might also experience a change in their relationships. If they are living with a partner who is diagnosed with dementia or another illness, their role changes and feels less like a spouse and more like a carer. That can have a direct impact on mental health and can lead to feelings of isolation. Caring for a person with dementia can be rewarding however it can also be stressful and also has an impact on the carer’s mental health.

There are lots of support and resources that older people and their families can access to look after their mental health and there is support anyone who needs it.

How to protect older people's mental health

The theme of this year’s Mental Health Awareness Week is kindness. Kindness towards a person makes them feel valued and this may motivate the person to act kindly to others. There is evidence that kindness can help us reduce the stress on our health. Kindness is thought to be a way that people create and strengthen their social connections. 

Older people should be supported and encouraged to look after their physical health. I understand that an annual review with general practitioners are available for those people 75 and over. This is an ideal opportunity to discuss any worries or anxieties.

Exercise releases endorphins the release of brain chemicals that have a positive impact on our mental health, and overall health so keep active. It’s never too late to get active.
Eating well and drinking sensibly. Try not to fill up on the wrong things but also be mindful and do not ignore sign that you may not be eating enough.

Doing activities, including online activities, give a sense of connection with other people.
Structure in daily life is important as is setting achievable and realistic goals that gives meaning and purpose. It doesn’t have to be anything difficult – just getting through a wee chore a day is good. Again, it is about being kind to yourself.

Getting enough sleep, as we grow older sleep patterns change and the lack of sleep can directly affect the way we feel.

Allow yourself a small treat, meet up with friends for lunch, something that you find enjoyable, or simply take some time to yourself.

What are the signs that someone's mental health is deteriorating?

Families can be the first to notice changes in someone’s behaviour. Maybe an older relative is more irritable or restless than usual. They are not paying attention to their personal care, not changing their clothes or brushing their hair.

You might notice they are making excuses to avoid social contact. There might be changes to sleeping patterns – either they are sleeping more or less.

There could be changes to appetite. They might be comfort eating or experiencing weight loss. Other people can be the first to notice that an older person’s clothes are becoming loose.

Are there missed appointments?

Sometimes if someone is feeling low, they find it difficult to make eye contact. They don’t want to engage.

Where can an older person turn for help?

Older people can find it difficult to talk to someone close about changes to their mental health. They might also think the changes are just part of getting older and think it’s not worth bothering family about.
If that is the case, they can call our Age Scotland helpline and have a chat to someone about how they are feeling. We can listen and give out information about other organisations if it is needed.

For anyone who have been feeling low for a while, it is important to see a GP. Doctors can prescribe medication, which can be helpful but is not always the answer.

GPs can refer patients for ‘talking therapies’ which support a lot of people.

Anyone experiencing very negative thoughts can contact the Samaritans.

It is important for older people to have someone to listen to their concerns. Sometimes realising that a lot of people are feeling like they do, and they are not alone, can help them move on.

What impact is lockdown having on older people's mental health?

Older people are feeling increasingly isolated during this time.
Many will be asking: ‘Why am I not being allowed out? I am physically able.’ They do not see themselves as old.

Older people who are being asked to socially isolate could find their mood is lower and they become more depressed. They could feel like they don’t have much to offer and they have less value and worth.

Most older people, including those living alone, normally have contact with other people. Even exchanging a smile with someone the street or having a chat with someone at the shops can make older people feel connected. And smiling is contagious – it makes people feel better.

Now older people are starting to ask themselves, is this what life is going to be like? The truth is that nobody knows and that uncertainty is one of the hardest things to manage.

We know that Covid-19 is not an age specific virus however we do know that older adults are more likely to have underlying conditions and comorbidities that raise the risk of severe illness from the virus, especially those older adults that are increasingly frail. The loss and breakdown in social networks impacted by Covid-19 may impact greatly on mental health and the psychosocial support needs of many older adults. The restricting of visiting in care homes will have an impact on both the person being cared for and the families who may play a pivotal part of the ongoing care of that person within the care environment.

We must remember though that there will be a number of older adults who are responders too. Health workers, carers and essential providers.