All posts by Courtney Pulitzer

Caregiving Long-Distance Made Easier – One Aging Life Care Professionals® Account

In the pandemic world, we are currently living, long-distance caregiving is further complicated by the litigation set in place to protect our most vulnerable population, the elderly.  Families and friends cannot see their older adults to know they are well and cared for.

A Certified Care Manager and Aging Life Care Professional® such as those at Careplan Geriatric Care Managers in Cleveland, Ohio are the essential healthcare professional you need, where you need it, when you need it.

A care manager realizes how difficult it is for long-distance families to visit older adult parents during the pandemic.  Because it is difficult to travel right now, complicated by the fact that the best a facility may offer an adult child for visitation is a 15-minute window or patio visit behind a plastic shield, an Aging Life Care Manager® is there help.  Aging Life Professionals (aka Geriatric Care Managers) will assess, advocate, and provide the support needed to ensure the older adult is getting the care, socialization, and support they need through onsite 1:1 visits.

Essential for Sure!

Licensed social workers are deemed essential and are able to work with the care facilities to ensure they are providing the care that the older adult pays for, expects, and needs.

Local Examples

Home consultation for senior couple

Careplan has recently received authorization to see clients at a particular assisted living.  Careplan is able to visit older adults setting eyes on them.  Careplan will also meet with the care team to address any questions or concerns. Professionals at our company have worked for the last 20 years advocating for older adults assuring that facilities are following the Ohio Department of Health rules and regulations.  Careplan knows what is expected and what is far-reaching.  Careplan visits facilities ensuring resident’s rights are being honored.  Careplan can then report back to the family, lawyer, or other outside parties.  Careplan is passionate about advocating for clients that are declining due to social isolation brought on by this pandemic.  Careplan has written to Congressional Leaders including Congressmen, Senators, District Representatives, and the Ohio Governor.

The Services Provided by An Aging Life Care Manager Makes a Difference

The first visits with our clients were astonishing, the clients could not express themselves since being isolated for 3 months.  These clients could not make simple decisions and appeared bewildered.  They could not hold a conversation.  After seeing these clients now weekly for one month providing psycho-social visits and advocacy, they are now doing better cognitively as evidenced by being able to make decisions, eating better, and having social visits with me outside where we FaceTime with family around the world and locally.  Clients are using their brain-power again and they feel like someone cares.   We also advocated for physical therapy due to lack of exercise.  Advocacy is what Aging Life Care Professionals do best!

How Does an Aging Life Care Manager Care for Long-Distance Loved Ones?

An Aging Life Care Professional is an expert in assessing situations and developing a plan of care to promote wellness.  Care Managers such as those that are members of The Aging Life Care Association are dedicated to making certain that an older adult is living life as independently as possible in the least restrictive environment.

In today’s world, it is common for families and friends to be separated by great distances.  At some point in the older adult’s life, they will need an advocate to assist and help with navigating.  Aging Life Care Managers help make the right decisions at the right time while considering healthcare needs, finances, and lifestyle.

An Aging Life Care Professional Will Help Answer Questions Such As:

  • Does the older adult need an Institution versus their home?
  • How do I choose a Home Care Agency?
  • Who can provide transportation?
  • How can I make sure Medications are being taken?
  • Would it be beneficial to have the care manager attend Medical Appointments so that family knows what is going on and to ensure the doctor has all the necessary information?
  • How do we afford care? What if the older adult outlives their resources? Discuss difficult topics and complex issues
  • Make home visits and suggest needed services
  • Address emotional concerns
  • Make short- and long-term plans
  • Evaluate in-home care needs
  • Select care personnel
  • Coordinate medical services
  • Evaluate other living arrangements
  • Provide caregiver stress relief

Aging Life Care Professionals are specially trained professionals and can help find resources to make your daily life easier. They will work with you to form a long-term care plan and find the services you need.

Aging Life Care Managers Sort Out Options Helping Long-distance Families To Make The Best Decisions

When it comes to making senior care decisions for a parent or senior loved one, it can be incredibly intimidating.   With a range of senior living choices offering everything from apartments to full-time care, in-home caregivers, and rehabilitation, it can be overwhelming for families to research and understand which services their loved one needs – and when they need them.

That’s where Aging Life Care Managers can help. They have extensive training on senior care options and can present a variety of options, helping families choose the living option that works best for their unique situation.

Aging Life Care Managers Are an Unbiased Often Welcomed Addition

ALCM’s are experts in their fields but have no emotional ties or family history to navigate. Their objectivity is valuable when it comes to navigating tough family conversations about the future of a senior loved one.

The older adult client usually appreciates this outsider who has no reason but to provide their professional honest, unbiased recommendations.

There When You Can’t Be

Acting as advocates and guides throughout the entire process Aging Life Care Managers can help families be present at medical appointments, coordinate complex care plans, facilitate hard conversations, and find residential care.  ALCMs can be a lifesaver for those challenging with living long distance.  To find an Aging Life Care Professional visit https://www.aginglifecare.org/

About the Author: 
Bridget Ritossa, LSW, CMC – Aging Life Care Manager and Founder of Careplan Geriatric Care Managers. Bridget developed a wealth of knowledge and resources in the areas of aging due to her 20 years of practice working at two major hospital systems in Cleveland and two of the largest nursing home chains in the country. Her grandmother lived with her while growing up. As a result, this helped develop a genuine love and appreciation for the elderly. Studies have shown that living at home is better for the mental health of seniors because they are happier in a familiar environment where they can live independently. When home is no longer the best option, Bridget will help families to find the most appropriate placement with her extensive experience in long-term care. Above all, Bridget’s goal was to create a company that would provide older adults with the resources and knowledge to successfully age at home. Therefore, creating an individualized care plan is at the very heart of Careplan Geriatric Care Managers.”

 

This Fall, Prevent Falls For Your Elder Loved One

Fall Prevention Week: September 21 – September 25, 2020

According to the National Council on Aging, one in four Americans aged 65+ fall every year. Having an Aging Life Care Manager as part of your health care plan for your older loved one can help avoid this common, but avoidable, part of aging.

As a supplement, here are some slides with further details and information for preventing a fall for your elder loved one.

About the Author:  Linda Fodrini-Johnson, MA, MFT, CMC. Head of Corporate Care Management for Home Care Assistance. Linda is a Licensed Family Therapist and a certified Professional Care Manager. She is also a past President of the Aging Life Care Association. In 1989, Linda founded Eldercare Services in the San Francisco Bay Area and became a pioneer in geriatric care management. Linda has always been a passionate educator to families and professionals in the “aging space”. Eldercare was sold to Home Care Assistance last year and Linda now serves as the Head of Corporate Care Management. She is also a consultant with Dr. Leslie Kernisan’s, Better Health While Aging/Helping Older Parents – an online coaching team.

 

How Social Isolation Stole My Mom

 On September 6, 2019, my mother turned 76. As was our birthday tradition, I invited her to lunch and suggested an outing to a local craft store she loved. For the first time ever, she refused to budge from her home. This was new behavior and it really worried me because her world was shrinking. She seemed to prefer solitary activities like beading, knitting, and weaving intricate pine needle baskets, only venturing out when she absolutely had to.

That summer, I informed her that I had been accepted into a Doctor of Social Work program at the University of Southern California and was on a quest to eradicate social isolation, a problem that has been gaining public attention because of its harmful effects on health and well-being. I asked for her assistance on my mission to find answers and spoke to her about how concerned I was about her own situation, which she acknowledged was becoming a problem. A tiny spark of hope suddenly ignited within her at the thought of helping me on my academic journey.

Ten weeks after her birthday she died suddenly and unexpectedly. Her death left me and my siblings shaken to the core. You see, Mom was relatively healthy when she died. The chronic health problems she had were stable. Her diabetes was controlled through exercise and diet. An episode that landed her in the ER in March had been nothing, she said. All diagnostic tests were negative – no stroke or heart attack, and her blood pressure was just fine. Her doctor chalked her dizziness and temporary confusion up to a panic attack and sent her on her way. I was skeptical about the diagnosis but shook off the doubt, preferring instead to embrace the idea that Mom was alright – it was just a false alarm – we had nothing to worry about.

Even though she never finished high school, she owed her own business, and through grit and determination, she raised us six kids, mostly on her own. In her youth, she was vivacious, hard-working, and made friends easily. But as she grew older, her ability to connect with others gradually vanished. At family gatherings, she was grumpy and wanted to return home as soon as her obligations were satisfied.

Mom called me a few times before her death wisely explaining why isolation happens as people age and gave me suggestions about what to do for those caught in the spiral of darkness, she knew all too well. Her observations about her own slide into loneliness dovetailed with all the research findings. Retirement as a hairstylist and closing her salon was a turning point for her, that’s when her all her social connections suddenly evaporated. Vision changes and anxiety caused her to stop driving, limiting where she could go without help. She confided in me about the embarrassment she experienced wearing dentures. Eating with others filled her with so much shame that she purposely avoided social gatherings involving food.

Like many retirees, she said she couldn’t relate to the “old people” who frequented a nearby senior center. When I suggested teaching a class on beading or basket making there, she refused to consider it. Mom had also dealt with panic attacks her entire life and they seemed to worsen as she grew older. The cycle of isolation was self-perpetuating, and she couldn’t seem to find any way out.

Unfortunately, medical providers rarely ask their patients about isolation and loneliness despite the overwhelming evidence linking seclusion to worsening health and early death. In fact, the harmful effects of isolation are so strong that social support is considered a “social determinant of health” – meaning those who are connected live longer and healthier lives than those who aren’t. Researcher Dr. John Cacioppo discovered that loneliness actually changes our brains. That’s why people who are lonely misperceive social cues and have a hard time building relationships. It’s hard to break the cycle once you’re in it.

But if the cycle is interrupted, the benefits of connection are enormous. Older people who regularly interact with others and participate in social activities report better emotional and physical health and have improved cognition. Studies show that those with strong social connections actually require less pain medication after surgery and even recover more quickly. Older people also fall less often, are better nourished and have a lower risk of depression.

It turns out that we don’t need a lot of connections to soften the edges of loneliness. Having a few quality connections that are meaningful and sustained are actually more important than the number of connections someone has.

Answers to the problem of isolation and loneliness will likely be different for each person – there doesn’t seem to be any cookie-cutter approaches that work. Take Mom for example: she had no desire to connect with the older people at the neighborhood senior center, no matter how many nice people she met there. So, we can’t expect that just referring people to places like senior centers or volunteer programs will magically solve the problem. It really comes down to discovering what provides meaning to each individual and then helping make those connections stick. Aging Life Care™ Professionals are particularly well-versed at helping clients enhance wellbeing, rediscover purpose and joy, and make those meaningful, lasting connections.

During this COVID-19 pandemic, we’ve all come to truly appreciate how important our relationships with one another are. While distancing from others protects against the virus, doing so can also make overall health and wellbeing worse. My hope today is that readers take this story about my mother to heart and make time to regularly reach out to people who are isolated. Their lives may depend on you more than you even know. If you feel you or a loved one could benefit from the guidance of an Aging Life Care Expert, visit the Aging Life Care Association website to explore what aging well looks like and to find a professional to help you navigate the journey.

Jullie Gray, DSW(c), MSW, LICSW, CMC, is a trained and licensed as a clinical social worker, she combines over 35 years of experience working in diverse healthcare settings with her passion for working with older adults and their families. Jullie is a principal at Aging Wisdom, an Aging Life Care management and consulting practice serving the Seattle Metro area. She is an award-winning care manager, is the immediate past president of the National Academy of Certified Care Managers and the past president of the Aging Life Care Association. Jullie holds the distinction of Fellow Certified Care Manager. She is currently pursuing her doctorate in social work – focused on eradicating social isolation among older adults.

 

Cataracts in Seniors | Senior Care Options

“My mother has been complaining about blurry vision, and I am concerned she might be developing cataracts. I don’t know how she is going to adjust if she loses her sight! Is there anything that we can do, or is it too late to save her vision?” – Silvia from Woodstock

 

If your loved one has cataracts, she is in good company, but it doesn’t mean her sight is gone forever. By the time people reach 80, at least half of the elderly population will either have cataracts or have had surgery to remove them. Usually, you can tell if your loved one has a cataract, thanks to the distinctive cloudy appearance which results from a clumping of protein inside the lens. Let’s talk more about what causes cataracts in seniors as well as how to prevent and treat them.

Nature and Nurture

Cataracts can be hereditary, but they can also come from other health conditions or lifestyle choices. For example, diabetes can cause cataracts, as can prolonged steroid use which may be for other health problems. A history of smoking and alcohol use can also lead to cataract formation as well as prolonged sun exposure. Even an eye injury in the past may result in cataracts as a senior. Now a bit of disturbing news: cataracts can occur in children and people in their 40s. They can be mild to severe, and they do get progressively worse over time.

Signs and Symptoms

Blurry vision is perhaps the most obvious symptom of cataracts in seniors, but it is hardly the only one. Be on the lookout for some of these other signs:

  • A halo-like glare surrounding light
  • Cloudy images
  • A brownish tint or dulled, faded colors
  • Poor vision at night
  • Double vision
  • Frequent prescription changes

Any time your loved one notices vision problems, he or she should visit the eye doctor for a thorough exam. The ophthalmologist may dilate your senior’s eyes to check for cataracts and other conditions, and based on the exam, make recommendations for treatment.

Options and Treatments

Unfortunately, there is no cure for cataracts, and treatment depends on the severity of the vision loss. If your loved one in the early stages, no treatment may be needed. Instead, lifestyle changes can improve sight, at least in the short-term. Simple adjustments such as reading large-print books or listening to audio books, using a magnifying glass, or relying on brighter light bulbs may make daily activities and hobbies easier. Check the home environment for any tripping hazards, as falls can occur in seniors with vision problems. When outside, your loved one should wear a hat and anti-glare sunglasses to prevent harmful UV ray exposure. Of course, it goes without saying that alcohol consumption should be limited (and smoking stopped altogether), and your senior should also eat a healthy diet rich in fruits and vegetables to improve eye health. A new glasses prescription may also correct some of the symptoms.

More severe cataracts may not respond to these home remedies, and in those cases, surgery may be the only option. Luckily, surgical treatment is common, safe, and effective. Only one eye is treated at a time, and the recovery time is roughly four to eight weeks. Because the patient does not need general anesthesia, healing may not take as long as other types of surgery. You can reassure your loved one that cataract surgery has a high rate of success and zero fatalities.

Fortunately, cataracts cannot come back after surgery, and if your senior has a cataract in one eye, it does not mean the other eye will get one. Schedule regular vision checks for your loved one to keep on top of any problems, and while you’re at it, schedule one for yourself too.

Best of luck!

About the Author: Lisa Kaufman, MS, CMC, CTRS, C-EOLD is a certified Aging Life Care Manager™, and most recently, a certified End of Life Doula. She has owned and operated SeniorCare Options since 2001, and she is an active member of the Aging Life Care Association™, and is one of only a handful of certified care managers in Georgia. She is a Past-President of the ALCA™ South Eastern Chapter and is the only Fellow / Certified member of ALCA™ in Georgia.

My History with ALCA: Phyllis Mensh Brostoff

Listen to 2009 ALCA Board of Directors President Phyllis Mensh Brostoff talk about her experience and thoughts on the association over the course of its history. She talks about how early members found commonality and strength by sharing their backgrounds, experience, and the challenges. Looking at the business side, in addition to their practices, these members developed all elements essential to an aging life care business.

“Dad resists every suggestion I make! Help!”

Susan is getting burnt out trying to care for her 91 year old father.  She has a part-time job teaching and takes care of her two school-age grandchildren in the afternoons.  Her mother has been gone for three years and Dad is truly struggling to stay independent, and failing at that.  His neighbors and church friends are calling Susan almost daily with stories of his poor judgment or his obvious weight loss.  Susan lives 2 hours from her dad and has tried unsuccessfully to get him to move to a retirement complex near her and her only sibling, a brother who has his own set of health problems but would visit if Dad were closer.

She has tried home-delivered meals, daily visitor programs, emergency response systems, and also purchased him a simple cell phone–all received with a smile and then canceled or not used.  Dad has some memory issues not yet diagnosed; his diet is poor, mostly fast food and salty snacks.  He is still driving to the chagrin of the neighbors; actually, he goes so slow they can’t really go anywhere.

Susan has tried local senior clubs and has even hired a caregiver for cooking and light housework, but Dad fired her too.  He says that he can do everything by himself; however, the house is looking more unkempt and clutter is covering every space.  Susan is amazed that he can find his checkbook to pay his few bills; she did successfully get most bills paid automatically.

Susan just heard a lecture from an Aging Life Care Manager about the importance of planning ahead with aging family members and wonders what will happen when Dad has a major fall or illness.  The Aging Life Care Manager (also called a Geriatric Care Manager), convinced her to have a “strategy meeting” for some “Win-Win” ideas.

She was happy to hear during her time with the Care Manager that her dad might be more likely to accept suggestions from a non-family member than from his “overly worried” daughter, which is what he calls her.

These are some of the suggestions that are working for her father now (all introduced by the Aging Life Care Manager and not Susan):

  • Instead of being called the “caregiver”, they came up with the idea of a “personal trainer.” Dad did like to work out when younger but his eyesight has diminished, making a trainer a welcome change in addition to having another male to talk with twice a week. The trainer now brings healthy meals and has extended his time to 4 hours a day, five days a week over a few months.  The trainer is actually a “home care worker” who loves to exercise – but the daughter learned not to tell Dad all the details or how much it costs.  The daughter has access to the family trust and is keeping a good record of all expenses.

 

  • The dad’s doctor finally agreed to have him tested for dementia and he does have early-stage Alzheimer’s disease. Dad understands it as an illness that impairs memory, but he still can live at home because he has “Jim” the trainer. Jim is willing to extend his hours as time goes on.

 

  • Susan was also encouraged to join a support group lead by the Aging Life Care Manager and has learned so many tricks for managing Dad’s needs without a lot of discussions with Dad. That has led to a much better relationship between the two.  She has also found a retirement complex near her and “Jim” the trainer is going to drive up to see it for the future (or so that is the story).

 

With the assistance of the Aging Life Care Manager, Susan has moved from “worried” to “grateful” that Dad can still have some quality time in his own home that is safe, well-monitored, and in line with Dad’s values for now.  She also has a plan and an ally with her Aging Life Care Manager for the strategy when it is time to move Dad.

About the Author: Linda Fodrini-Johnson, MA, MFT, CMC. Head of Corporate Care Management for Home Care Assistance. Linda is a Licensed Family Therapist and a certified Professional Care Manager. She is also a past President of the Aging Life Care Association. In 1989, Linda founded Eldercare Services in the San Francisco Bay Area and became a pioneer in geriatric care management. Linda has always been a passionate educator to families and professionals in the “aging space”. Eldercare was sold to Home Care Assistance last year and Linda now serves as the Head of Corporate Care Management. She is also a consultant with Dr. Leslie Kernisan’s, Better Health While Aging/Helping Older Parents – an online coaching team.

My History with ALCA: Vicki Doueck

Member since 1989, Vicki Doueck talks about her practice then, and now. Her words of encouragement to members to get active and join the Board is part of her experience, as well as her yearly conference attendance. Listen to the “tech” (i.e. telephone cards) early members had to use to manage their businesses, and how expanding the professions adds dimensions to the aging life care profession.

Caring for our Elders and Raising Abuse Awareness

Nearly 1 in 10 American senior citizens are abused or neglected each year, yet only 1 in 14 cases of elder abuse is brought to the attention of authorities, according to the U.S. Department of Health & Human Services. Elder abuse can mean physical and psychological harm, but it also may manifest through financial exploitation and theft. The United Nations has designated June as World Elder Abuse Awareness Month.

To take action and be part of the solution, the Aging Life Care Association sent an InstaPOLL to members to see how prevalent elder abuse may be with their clients. Of the 171 members who responded to the poll, a whopping 151 or 87% indicated they had had a client who was a victim of elder abuse!  The top three areas Aging Life Care managers saw abuse were:

  1. Financial exploitation– The unauthorized use of an elderly person’s funds or property, either by a caregiver or an outside scam artist. An unscrupulous caregiver might:
    • Misuse an elder’s personal checks, credit cards, or accounts
    • Steal cash, income checks, or household goods
    • Forge the elder’s signature
    • Engage in identity theft

Financial Abuse topped the chart with 128 responders or 86% of members indicating they had experienced this with their clients.

  1. Emotional elder abuse– The treatment of an older adult in ways that cause emotional or psychological pain or distress.

Emotional Abuse came in second with 96 responders or 64% indicating their clients had experienced this type of abuse

 Elder neglect– Failure to fulfill a caretaking obligation. It can be intentional or unintentional, based on factors such as ignorance or denial that an elderly charge needs as much care as they do.

Self Neglect and Neglect in general, were statistically close with 53% of responders indicating this type of experience with a client.

 

Elder abuse is a serious crime against some of our nation’s most vulnerable citizens. Aging Life Care Managers have focused on caring for these defenselessness, older adult members of society since its founding in 1985. The seasoned professional members of the Aging Life Care Association can identify what type of person is susceptible to abuse and the elusive signs a family may miss. They are also aware of the resources to refer to when abuse of any nature is suspected.

In interpreting the comments of those taking the survey, the Aging Life Care Managers felt that cognitive impairment due to Alzheimer’s disease and related dementia placed their elders at a high risk for abuse and neglect.

Members also indicated that the person most likely to be the abuser were often adult children, other family members such as grandchildren, or a spouse or partner. Perpetrators also frequently mentioned were those in a caregiving capacity.

An Aging Life Care Professional can help families prevent abuse by being their eyes and ears on the scene, monitoring and overseeing all interactions with the older adult. According to the poll, their primary source of referrals when abuse was identified were the Department of Aging,  Attorneys and the police. Polled members indicated they were unfortunately frequently called in to assist families after the abuse occurred.

Elder abuse is a serious crime against some of our nation’s most vulnerable citizens,

And a matter of worldwide concern that demands a global multifaceted response.

For more information on World Elder Abuse Awareness Day, visit the National Center for Elder Abuse (https://ncea.acl.gov/) website. Additionally, the Department of Justice offers an abundance of information and resources online through its Elder Justice Initiative. (https://www.justice.gov/elderjustice)

If you suspect elder abuse, call 911 for an emergency. In a non-emergency situation, use the online Elder Care Locator, (https://eldercare.acl.gov/Public/Index.aspx)

or you may call 1-800-677-1116 to find your local elder care agency.

About the Author: Barbara (Bobbi) Kolonay RN MS CCM. Owner of Holistic Aging (www.holisticaging.com) An Aging Life Care Management practice in Pittsburgh PA. Fellow of the Leadership Academy of ALCA

Suicide Among Older Adults – And Help For Them

//// By Susan Birenbaum LCSW, MBA, C-ASWCM ////

People do not realize that suicide is a major problem in the elderly. Since Older Adults have so many medical issues, it is assumed that death is a result of co-morbidity rather than suicide. Albeit, our society does not value older adults as other cultures do. In fact, if you read statistics and concerns about suicide in this country, the media reports about a rise in suicide in the youth and college-age population. The mental health community is much more active in trying to stem the suicide rate among this population. According to the World Health Organization (2012), suicide among older adults is a far more common occurrence in the United States than youth and are the highest rate of completed suicides. In 2013, more than 7,000 people age 65> died by suicide. (CDC, 2013) and14% of all suicides in the United States are among older people. In addition, thousands of older adults who die by suicide, many more have made suicide attempts and suffer from the emotional pain of suicidal thoughts.

The issue of suicide in the United States is a rapidly growing problem. The increase of the population living longer and the large cohort of “Boomers” who are transitioning into this demographic, means that we are facing a major mental health crisis that needs to be addressed now. In a review of the literature, there does not appear to be any actions by the Federal  Government or individual States that our healthcare system has any initiatives to help older people prevent suicide. Despite the fact, that suicide prevention continues to be a priority in healthcare, suicide in the elderly remains a neglected subset with little interest and few studies.

Suicide rates are particularly high among white males 65>, higher than any other group in our population. (SAMSHA, 2013b). Although suicide attempts are more common among older women, attempts are more fatal among men because 35% of men use alcohol and firearms.

 

I recommend that you watch the YouTube video by Dr. Yeates Conwell, “Suicidal Behavior in Older Adults” (2013). [1]

Dr. Conwell has identified what he considers as the 4 D Risks of Suicide:

  • Depression
  • Disability
  • Disconnectedness
  • Deadly Means

Depression:

The population attributable to suicide risk has a high association with depression. However, depression as a predictor of suicide is low. Hopelessness and suicidal ideation are neither necessary nor sufficient to predict suicide.  Depression is a treatable illness. Reduction in depression can lead to a reduction in suicide.

Signs of depression are: lack of interest, sleep issues, problems concentrating, changes in activities.

Disability:

Depression frequently occurs with impaired vision, hearing loss, heart attacks, strokes, and dementia and amplifies disability associated with them.

Disconnectedness:

Disconnectedness results in loneliness and isolation for both older men and women due to major changes and losses in their lives. Often times, their spouses die, their friends die and/or move away, they are forced to change their lifestyles and move out of the house that they have lived in for many years and move away from their community. This means going to another place, often an assisted living facility, a nursing home, or a place near their children. They also experience a loss of independence. Due to physical disabilities, dementia, they are forced to stop driving and rely on other people. They feel that they are no longer part of a community.

Women suffer these losses, but overall they are generally able to form new friendships and activities, where men are not accustomed to friendships and activities.

The loss of identity is felt most in men beginning at age 65 and becoming more extreme by the time that they reach age 85. They are usually very isolated and did not build friendships the way women do. They often resort to alcohol abuse and loneliness. They do not have family or peers to leverage interventions for their benefit.

Deadly means:

In general, it is more common for older men to end their lives by using firearms.

Dr. Conwell has reported that studies of older adults are generally composed of the female population, not including men.

Promoting Emotional Health and Preventing Suicide

It is known that older adults do not believe in Mental Health Professionals, but they do rely on their Primary Care Physicians. In fact, it has been reported that many people who have died from suicide had seen their PCP in the month prior to their death. Most PCPs are not trained in Geriatric Mental Health.

  • It is important that PCPs as part of their practice have the tools to evaluate their patients for Depression and Suicidal Risk. Ideally, it would be best if they had a trained Mental Health Professional in their office who could screen patients. There are many measurement tools available to identify risks. If there appears to be a risk, then patients should be referred to Mental Health Professionals.
  • Family members, peers, friends, and others should monitor the older person’s mood and if there is a change in regular activity or mood, they should reach out to professionals. When speaking with older adults, do not ask if they are depressed, but rather are they sad.

Tool Kit for Senior Centers/Assisted Living Facilities

(http://store.samshsa.gov/product/SMA10-4515)

An individual should be designated and trained to use the screening tool which could identify signs of depression and suicidality in residents. Although suicide is rare in congregate living facilities, when it occurs it has a devastating effect on all the residents.

Profile of characteristics associated with depression among residents in facilities:

  • Greater Disability
  • Negative attitude toward aging
  • Poorer self- rated health
  • Lose of sense of mastery
  • Less religiosity

Many of the reasons that older adults have moved to facilities are very stressful and complicate adjustment to new surroundings, new neighbors, and new norms. The events include: loss of spouse or caregiver, increased physical vulnerability, illness, cognitive impairment.  The majority of residents are women.

Resources:

American Foundation for Suicide Prevention (afsp.org)

  • The foremost organization for research, education, advocacy for prevention of suicide in the United States.

National Suicide Prevention Help Line

  • 1-800-273- talk (8255)
  • Text 741741 to speak with a trained counselor 

Federal Communications Commission

  • Is implementing a number to call if someone is in crisis of suicide. The number will be 988. It is not operational yet, but will be soon. Check their website for updates.

[1] Dr Conwell is Professional & Vice Chair, Co-Director of the Center for Study and Prevention of Suicide Prevention and Director of the Geriatric Psychiatry Program in the Department of Psychiatry at the University of Rochester.

About the Author: Susan Birenbaum is the founder of Susan Birenbaum Associates LLC. She is a certified Aging Life Care™ Manager for over 12 years; a New York State Licensed Clinical Social Worker (LCSW); and has Guardianship Certification by the State of New York. Follow Susan on Twitter @SBLCSW, Susan Birenbaum on Linkedin and Susan Birenbaum on Facebook or email her: susanbirenbaumllc @ Gmail .com