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Dr Chido Rwafa Madzvamutse Mental Wellness

As discussed in previous articles, mental health is defined as a state of well-being in which an individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a meaningful contribution to their community.

As we get older, we can still continue to live fulfilling lives, enjoy life and thrive as well as carry on making a meaningful contribution to our families and our communities. The mental well-being of older people in our families and communities needs to be taken care of, so that our societies can benefit from what our elders still have to offer.

Factors that can affect the mental health of older people. Getting older in age is a normal transition of life. We all hope to live long and healthy lives, however, there are some challenges that we can face as we age that can affect our mental well-being. These include:

• Retirement and changes in work life: One of the major changes and major stressors as we get older is the change in our working life. For many people over 60 years, retirement is a stressful change that can come before we are prepared for it. This change comes with challenges of no longer having structure to our days, less financial security and sometimes a loss of purpose and meaning. This can take a toll on mental health and well-being and can put us at risk of developing mental health problems.
• Changes in physical health: Aging can come with challenges in physical well-being, increased risk of chronic health problems such as hypertension, diabetes and arthritis, decreased mobility, and physical disability. This can bring challenges of feeling unwell, the grief of losing our physical health and a sense of losing our independence as our bodies age and we need more assistance to continue to function. When we are physically unwell, we are at increased risk of mental health problems such as depression and anxiety.
• Bereavement and grief: One challenge of growing older is starting to lose family members and friends, initially those who are older than us then eventually, age mates and sadly, life-long spouses. Grief can become a frequent experience in older life and this can be overwhelming.
• Loneliness: As we get older, we may find our social circles may become smaller and even our children as they form their own families, may have less time to spend with us.

This sense of isolation could even be worse for those who have lost spouses and a feeling of loneliness can sadly affect our sense of mental well-being.

• Ageism and elder abuse: Unfortunately, older people often face discrimination because of age: being denied opportunities, or treated disrespectfully or in an undignified manner due to physical or cognitive challenges that come with age. Older people may be exposed to physical, verbal, emotional, and financial abuse and may even face neglect. This can all be stressful and compromise our mental health as we grow older.

Common mental health problems in older age. It is estimated that 15 percent of people 60 years and older experience some form of mental health disorder worldwide. These conditions can include:

• Depression: Older people can experience depression with symptoms of sadness or despair, fatigue, loss of motivation and drive for life, poor sleep, poor appetite, poor ability to concentrate, feelings of lack of self- worth, helplessness and hopelessness and even thoughts of death and suicide.

Symptoms of depression can often be misunderstood and missed in older people and this may result in poor access to appropriate care.

• Anxiety: Feelings of worry and dread, symptoms of panic, fear of being left alone, feeling of being increasingly vulnerable, can occur as we grow older. Anxiety can affect concentration and memory as well. This can result in misdiagnosis and delayed treatment.
• Insomnia: Poor sleep is a common challenge that older people face. This can be difficulty falling asleep, interrupted sleep and not feeling rested even after sleeping for adequate hours. Physical and psychological health problems faced in older age can contribute to the problem of insomnia.
• Dementia: memory problems are common as people grow older. However, for some older people, the forgetfulness is severe and may be linked with difficulty recognising familiar people and places, getting lost, difficulty communicating, changes in personality and difficulty caring for oneself. These are common symptoms of a brain disorder called dementia. For some older people unusual experiences such as hallucinations (seeing or hearing things others cannot) and delusions (believing unusual things or being excessively suspicious) can also occur as part of dementia.

How can I care for my mental health as I get older? Maintaining our mental well-being involves us being intentional about how we live. Aging is a normal part of life but there are many things we can do to remain mentally healthy as we get older. These include:

• Remaining physically active: As we grow older, it is important that we try to remain physically active to remain fit and as mobile as we can for as long as we can. Exercise helps release endorphins which are the body’s natural feel good hormones.
• Remaining mentally active: It is important that we also remain mentally active as we grow older and keep the mind active through reading and learning new skills even playing mind stimulating games. Continuing to work in some way for as long as possible can also help keep the mind active.
• Maintaining a sense of purpose: Having a sense of meaning and purpose in life is good for our mental health. It is important to continue to have a vision for our life and carry on setting goals for ourselves to help us to continue to have a sense of purpose for our lives.
• Maintaining strong relationships: A strong social support system is critical for good mental health. We should strive to maintain relationships with family and friends to help keep ourselves connected socially as we grow older.
• Learning to recognise the signs and symptoms of common mental health problems like depression, anxiety, dementia and seeking help early.
• Maintaining a positive perspective and hope: Hope is mentally protective and can help us weather the many storms of life. As we grow older it is important to continue to have hope and to build and rebuild a positive perspective of our lives to remain mentally well. As we strive to be more aware of our mental health and well-being, it is important to care for our mental well-being as we age and to care for those who are older in our families and communities with dignity; helping them to thrive even as they grow older. If you think that you or someone you know may be struggling with a mental health problem linked to older age, please contact your nearest health care provider and get help.

Association of Healthcare Funders of Zimbabwe (AHFoZ) article written by Dr Chido Rwafa Madzvamutse, consultant psychiatrist. Feedback:263714987729)(www.ahfoz.org ; [email protected])