By Cleo E. Brown

On Friday, May 15th, 2009 I attended a Geriatrics Mental Health Conference in Brooklyn, New York at The Marriott Hotel. Amazingly, I found out that for the next twenty-five years, as the baby boom generation matures joining the ranks of our Nation’s Senior Citizens, the numbers of elderly people in The United States who are mentally-ill will also increase dramatically. According to Michael B. Friedman, who is the Chairperson for The Geriatric Mental Health Alliance of New York, in any given year twenty percent of all older adults have a diagnosable mental illness. During the next twenty-five years, all people sixty-five years of age and older increase from 35 million to 70 million people. The number of older adults with mental disorders will grow from 7 million to 14 million people. The types of disorders they will be afflicted with are dementia, anxiety and/or depressive mood disorders, schizophrenia, paranoia, and substance and alcohol abuse.

The older adults deteriorating mental health combined with developmental changes: i.e. loss of work and retirement; being relieved of care-giving responsibilities; loss of family, friends, and other loved-ones; and advancing physical conditions (diabetes, hypertension, heart-disease, and arthritis) adds to the senior citizen’s emotional distress and need to be cared for by health-care professionals. Unfortunately, however, although the numbers of Senior Citizens will double up to the year 2035, the numbers of health-care professionals will decrease. According to Friedman, a possible solution to this dilemma is to train elderly people who remain healthy to meet the health care demands of the elderly baby boom generation.

Although Friedman’s analysis and conclusion are optimistic, the realities of old age amongst those who are both elderly and mentally ill remain. Many of these people will die ten years sooner than their mentally ill counterparts. Those who survive may loose their independence as they are “shifted” to adult homes and to nursing homes. Those with Alzheimer’s Disease run the risk of being cared for by people who, although humane, fail to grasp the dynamics of the disease and who, consequently, fail to ask the appropriate questions which would aid them in understanding better and caring for their patient.

According to Cameron J. Camp Ph.D., it is important to constantly ask of The Alzheimer patient’s bizarre behavior, “Why?” Dr. Camp gives the examples of a man who fights with himself when he gazes at his reflection in the mirror, and a woman who throws her tray of food when it is taken from her. Without the answer to the question “why” in both cases, the victims and their behavior remain enigmatic Dr. Camp also recommends using Maria Montessori as a model with which to treat Alzheimer’s patients. Maria Montessori was a childcare activist who believed that children should engage in activities only when they were developmentally able to. Consequently, in treating an Alzheimer’s patient, it is important to be aware of activities which were familiar to the patient before the onset of the disease.

The rate at which elderly people commit suicide is also significantly higher than suicide in the younger segments of the population. There is, currently, in The United States one suicide every sixteen minutes and 89 suicides per day. And, although more men commit suicide than do women at a rate of from 4-1, women who are approaching their senior years experience the highest rates of suicide. Amongst African-American people only 9.8 percent commit suicide while Caucasians commit suicide at a rate of 19.1 percent. Among people sixty-five years old, however, 14.7 percent commit suicide while those seventy-five years old and older commit suicide at a rate of 37.97 percent. Men prefer to use hand-guns while women use poison more often.

According to Ennio Ammendola, who is a Behavioral Specialist from The National Institute for People with Disabilities, suicide cannot be predicted although research suggests that there is some genetic predisposition towards committing suicide among people of the same family. If you suspect that a person may want to commit suicide be very clear and direct with the person about the value and the sanctity of human life. Ask the person directly, “Do you want to commit suicide?” And, use intervention techniques which include removing the means for committing suicide from the elderly person’s environment.

Couple’s Therapy, which was presented by Maryann Kenney, Carole Chase, and Louise Marcigliano from The Service Program for Older People (S.P.O.P.) is also a useful tool by which the Geriatric Mentally Ill can strive to both repair and protect their mental health while bonding as a couple with their loved one. In Geriatric Couple’s Therapy, as the couple ages, often problems become magnified. There are four types of couples: Traditional, Non-Traditional (Gay), Formal, and Informal (Without the benefit of marriage). These four types of couples have access to the following various treatments: conjointly, individual, and collateral in which there is participation by the partner although he/she is not present in the therapy session.

The Couple then evolves through the following stages of development:

The Dating Couple
The Married Couple
The Birth of Children
The Family with School-Aged Children
The Teen-Age – College Family
Retirement
Old-Age
Death and Separation, or the loss of one-half of the couple.

Finally, heartbreaking is the fact that the developmentally disabled and the mentally retarded, who are also mentally ill, have an even shorter life-span than the rest of the elderly and the mentally ill population. According to Phil Levine MD, who is the Chief of Psychiatry with Premiere Health Care, Fifty-five years old is the new 65 years old among this segment of the population .The life expectancy for this group of people is sixty-five years old. For people with Down Syndrome their life expectancy is even younger being from twenty-five to forty-nine years old. And, in all people with Down Syndrome who died in their fortieth year or older, there is some evidence of Alzheimer’s Disease. Compounding this phenomena of diminished life expectancy for this group are other risk factors such as arthritis, sensory losses, visual deficits, hearing deficits, heart disease, obesity, and seizure disorders. Dr. Levine’s solution for treating this extremely at-risk group of senior citizens is to assess the entire individual and to treat him/her holistically.

Inspite of these factors, however, it is not impossible to maintain one’s mental health through the aging process. And, whether or not you have a mental health diagnosis, it is imperative to maintain mental health to not only age gracefully but to age at all. Perhaps those people fortunate enough to remain healthy will be able to care for their less fortunate contemporaries as we all age in the coming years.

Cleo Brown is an editor and writer at Hip-Hop Republican.com she is a moderate Republican who works as an Instructor and as The Dean of Student Affairs in a GED Preparation Program in New York City. Cleo holds a Master’s Degree in Contemporary African-American History from The University of California at Davis