LEAVENWORTH, KANSAS (Leavenworth Times), June 10, 2005:
To many, the post-retirement years evoke images of travel, relaxation and leisure time. Unfortunately, the reality is that many older adults experience depression and anxiety disorders. Misguided by the popular notion that depression is a normal part of aging, many do not seek the help they need.
The generational bulge in the Baby Boom population will double the number of people more than 65 from 35 million today to 70 million people by 2030. Meanwhile, the prevalence of mental illness in older Americans is the same as that in the total population -- one in five -- so it, too, will double.
This year, 7.5 million adults 65 years and older will have some form of diagnosable mental illness. That figure will reach 14 million by 2030. The most common mental illnesses in older adults are anxiety disorders, particularly phobias. And as Vietnam veterans age, there will be an increase in the prevalence of post-traumatic stress disorder.
Older adults who have a mental illness usually know something is wrong, but can't identify it. In addition, primary care physicians, the medical professional most frequently seen by older people, fail to diagnose depression 50 percentof the time.
Besides the diminished quality of life issues associated with any untreated illness and the challenges created for caregivers, older adults commit suicide at a higher rate than any other age group, with white men being most at risk. Overwhelmingly, clinical depression is a leading factor in this tragic statistic. While grief and loss are normal parts of growing older, clinical depression is not.
Older people sometimes become vulnerable to depression and other mental health problems in connection with the onset of physical ailments. Stroke, Parkinson's, cancer, arthritis, diabetes and Alzheimer's disease can all cause or contribute to symptoms of clinical depression.
Conversely, older adults who live with mental illness are more likely to have physical problems and stay sick longer. They may be more likely to have heart problems and require early nursing care, as well.
The good news is that with treatment, older Americans recover from mental illness and can continue to grow and enjoy life into their later years. Research from the National Institute of Mental Health shows that 80 percent of older adults recover from depression after receiving appropriate treatment.
Successful outcomes depend on people accessing treatment. The vast majority of older adults with mental health problems do not receive treatment at all. The stigma attached to mental illness and treatment, in addition to the notion that such challenges are a normal part of aging, are significant barriers.
The best practices in successful treatment are community-based.
Unfortunately, Medicare and most health insurance plans provide fewer benefits for treatment of mental illnesses than for physical illnesses, which is worrisome for those with limited incomes. Inflexible Medicare requirements drive people into institutions, particularly nursing homes, in direct contradiction to what the research says.
The vast majority -- 94 percent -- of older Americans live in the community either on their own or with relatives or other caregivers.
Forty-four million people report that they currently provide caregiving of some type for an aging relative. Caregivers are most often women, have a job and may still have children at home.Thirty percent of today's work force has responsibility for an elderly relative. The national economic value of informal caregiving is estimated to be $197 billion.
The Guidance Center recognizes the importance of good mental health and the power of effective treatment. Providers, concerned families, consumers, primary healthcare professionals, and policy makers all have a role to play in assuring that the final chapter of life is full of dignity, good health and enjoyment of a life well lived.
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