Ageism, Older Adults, Mental Illness

What is your opinion on ageism?

Ageism is an insidious practice characterized by an ingrained negative perception of older people. It is shaped by explicit and implicit assumptions about the ageing process. Archaic stereotype characterize older adults as; senile, unproductive, old fashioned, sick, disabled, isolated, depressed, dependent, frail, lonely and rigid.  Contrary to these popular misconceptions, chronological age provides little information regarding individual circumstances and needs. The older generation is a vibrant and diverse group consisting of individuals with unique characteristics and predispositions. Disease, disability and mental deterioration are not an inevitable accompaniment of the ageing process.

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What is the greatest challenge for the ageing population?

While the aging population faces significant challenges such as poor mental health and physical disability, I believe the greatest challenge facing the ageing population is ageism. Outdated social norms have denied elderly people individuality and diversity. As ageism is so deeply embedded in social contexts, it impedes the formulation and enforcement of policies that promote healthy ageing, thereby effectively denying older adults access to support, health and social services.

What are personal and professional issues in working with older adults?

Working with older adults requires a high degree of self-awareness on the part of the social worker. Experiences with older adults can influence personal attitudes towards aging and death. Unlike other fields in social work, aging is an inevitable developmental stage. The universality of the aging process and death itself can trigger fears about aging and death, anxiety, avoidant attitudes towards death and discomfort around the elderly patient. Professional issues arise when ageist attitudes are internalized by the social worker and prompt the development of inappropriate feelings towards the patient, which could be detrimental to the professional relationship between the patient and the social worker. Countertransference of negative/positive feelings may trigger impatience and intolerance/ inappropriate displays of benevolence towards the client.

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Name the two (2) most common forms of mental illness in the aging community and explain the symptoms. 

Mental health disorders are fairly common in old age. They may induce functional disability, necessitate hospitalization and impair the perceived quality of life by older adults. Depressive symptoms such as such as fatigue, insomnia, confusion, irritability, uneasiness, stress and sadness are frequent in the elderly population, and may be confused as a normal occurrence in ageing. The presence of multiple co-morbidities, a history of depression or anxiety and death of a spouse or close relation are important predictors of depression in the elderly. Depression in old age typically coincides with the progression of chronic illness. Patients with chronic illnesses such as diabetes, coronary heart disease, dementia, cancer, stroke, Parkinson’s disease and Alzheimer’s disease are especially prone to experiencing depressive symptoms. 

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Anxiety disorders occur more frequently in older adults compared to middle aged and young adults. Anxiety disorders in the elderly typically manifest as generalized anxiety disorders, which are most likely to develop following a stressful event, panic disorder with frequent remissions and recurrences of panic attacks, specific phobia (lightening, flying and heights) and post-traumatic stress disorder.

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Why do you think many older adults are reluctant to seek psychiatric treatment that could alleviate or cure their symptoms and return them to their previous lifestyle?

Older adults do not recognize the need for psychiatric care as depressive symptoms have been normalized as a normal part of ageing. Negative attitudes towards mental health have created stigma around the subject of mental illness which continues to impede help seeking in elderly populations. According to study by Diala et al. (2000), individuals who endorse negative attitudes are five times less likely to utilize available mental health services than those who do not.

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Mental health stigma also accounts in part for the existing disparities between African American older adults and their white counterparts. Individuals who accept and internalize negative social attitudes towards mental health acquire distorted perceptions about help-seeking that impede decision to seek help for mental illness in old age (Link & Phelan, 2001)

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