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It’s Leap Year! Take a Leap and Dare to Age Well.

The concept of aging well may seem puzzling – what exactly does it mean to age well? Is it about aging gracefully? It may appear unexciting, as striving to look younger or conforming to societal expectations based on age can be overvalued. Instead, perhaps we should focus on aging with purpose, finding happiness in the later years. Maybe grace, although it may sound pleasant, is not the solution. Heather Havrilesky once expressed in an article about aging well that she believes being powerful is more important than being graceful. She believes that aging gracefully requires constantly proving oneself against various challenges such as personal criticism, public humiliation, and a steady stream of negative comments. It also involves a slow deterioration of self-confidence and sudden shocks that can cause one’s illusions to crumble. However, she asserts that individuals should pursue their passions and be true to themselves, following their bold and unconventional impulses. Ultimately, the key to aging well is daring to live life on one’s own terms and by that token daring to age well.

Instead of persisting on the path of misogyny by trying to be a “nice lady” as we age, we can embrace and rejoice in the process of getting older by acknowledging the positive aspects of aging. While there may be difficulties to navigate with age such as physical weakness or fragility, it is important to face them with a positive attitude. This year let’s chart a path towards empowerment and redefine what it means to age well for ourselves as older women and defy societal expectations about aging. Let us also discover the resilience and confidence within us to age gracefully and optimistically. As we embrace the concept of leap year, let’s explore some tips for taking a leap towards aging well. Do at least one courageous thing this year to make you more interesting to yourself — and to others! Start with one of these suggestions:

Create a space for yourself (it could be just carving out some time for just YOU! Self-care, reading, taking a bubble bath, going to the hair salon. Step out of your comfort zone and try something you’ve always wanted to do but never had the chance. It could be learning a musical instrument, taking up painting, or even traveling to a new destination. Embracing new experiences can help maintain cognitive function and promote personal growth.
Nourish your mind and book a full hour with your counselor or psychotherapist to explore new ways to reinvent yourself. Allow space to dive deeper into your emotions and give yourself permission to feel. Leap year serves as a reminder that change is possible, at any age, and that personal growth should be an ongoing journey. Whether it’s overcoming fears, facing adversity, or pursuing lifelong dreams, leap year encourages us to take a leap of faith and believe in our ability to grow and evolve.
Go out with an old friend, with no-agenda. Just to share time, space, and being. Maintaining strong social connections is crucial for overall well-being. Try to nurture existing relationships and forge new connections. Spending time with other people can prevent you from feeling lonely or anxious and can provide a sense of belonging and contribute to a happier and more fulfilling life.
Join a dating online platform if looking for a companion or if you are single, divorced, or bereaved and would like to meet someone, (If not computer savvy, take a FREE course at your local library, no excuses! When finding your candidate, legend has it that Saint Patrick, the patron saint of Ireland, granted women the right to propose to men on leap day, leading to the tradition of women proposing on February 29^th, so go for it.
Engage as a volunteer at a preferred organization in your community. There are countless ways for older adults to get involved and make a positive impact through volunteering. Just few options are: mentoring and tutoring—using the tricks of the old dog, participating in local charity events, offering your skills and expertise to nonprofit organizations, engaging in community service projects like serving meals at a soup kitchen or organizing recreational activities for seniors.
Stay Active—and this does not mean joining, one more time, a gym, it means just to move, to engage in regular physical activity that suits your abilities and interests. This could be anything from walking, swimming, yoga, dancing, gardening, going up and down the stairs, walk to the store, do yard work, clean your house, or dancing, just keep on moving!
If you find that you are no longer able to do the things you used to do, try to develop new hobbies and interests (learn a language, take on playing an instrument, create new dishes in the kitchen. Whatever can rock your boat and gives you joy is IN! Pursue your passions.
Finally, do not procrastinate your health care and make this leap year, the one to repeat a full check-up. Make the most of your doctor. Everything taking care of yourself goes, after all why not devoting, simply, this year to love yourself more?

If in need of some inspiration, read what 100 centennials can say about living and aging well.

Among other things, they suggest you “… Keep your eyes open, never stay stuck in the past, , leap into the future, … and dance while you still can… ”

Resilience: The Client as an Active Agent of Change

Accepting we clinicians are not as mighty power as we , sometimes, want to believe, and as much of a blow to our egos, it can be, there is a fact we need to recognize as such: human resilience and people’s self-healing powers count for positive outcomes after traumas and strenuous circumstances, equally effectively or more than proven therapeutic approaches.

A very respected and renowned colleague of mine, Dr. Arthur Bohart always reminded me and anybody who wanted to listen to his revolutionary opinions in regards to the effectiveness of some therapeutic approaches or the best personality traits for a successful clinician, that human beings are more resilient that what we want to account for and that the theory of some approaches being more effective than others are more of a myth than a fact since for Dr. Bohart” the “client acts as a self-healer” and human resilience counts for more of the positive outcomes in therapy. So, what is the clinician’s role? In a way, we therapists are a catalyst or better said a witness to the self-healing process. A guide to educate and share the process with the client. In an article published in the Journal of Psychotherapy Integration, Vol. 10, No. 2, 2000, he describes the dominant “medical” or “treatment” model of psychotherapy and how it puts the client in the position of a “dependent variable” who is operated on by supposedly potent therapeutic techniques. Next I argue that the data do not fit with this model. An alternative model is that the client is the most important common factor and that it is clients’ self-healing capacities which make therapy work…” Read his article

The same concept works with the forgotten population, the older adults and elders. Resilience and aging: it’s a favorite theme of gero-psychiatrist Helen Lavretsy, MD, MS. It’s the subject of her new book, Resilience and Aging: Research and Practice and the theme of a symposium at the APA Annual Meeting in New York City. In a recent podcast, she talks briefly about interventions that can help bolster resilience and help older people recover quickly from adversity. Listen to her podcast

Resilience and aging: it’s a favorite theme of geropsychiatrist Helen Lavretsy, MD, MS. It’s the subject of her new book, Resilience and Aging: Research and Practice and the theme of a symposium at the APA Annual Meeting in New York City.Here, she talks briefly about interventions that can help bolster resilience and help older people recover quickly from adversity. – See more at: http://www.psychiatrictimes.com/apa2014/strategies-bolstering-resilience-older-adults#sthash.LuOVSHfT.dpuf

This entry was posted in Elders mental Health and Wellness, General, Mental Illness, Psicoterapia, Psychotherapy, Senior Wellness, Terapia en Español on August 5th, 2022.
Tags: Elder therapy, Healing the soul, Humanistic Psychotherapy, Hummanistic Psychology, LGBT Psychotherapy, senior and mental illness, therapy with seniors.

Elders, Mental Illness, and the Expertise Gap

The US population is aging rapidly. Advances in medicine have led to the expectation that the US population of seniors will grow from12.4 Million in 2000 to 19.7 million in 2030 (US Census data). As the oldest baby boomers become senior citizens in 2011, the population 65 and older is projected to grow faster than the total population in every state. Twenty-six states are projected to double their 65-and-older population between 2000 and 2030. The impact of this anticipated population increase, which has been described by some as an “age wave” and by others as an “aging tsunami,” would be felt in every aspect of society. This “tsunami” predicts that humane healthcare will soon be financially out of reach or simply unavailable for tens of thousands of elderly Americans. There is an urgent need to expand training opportunities for geriatric care providers to meet the growing demand for psychological, medical, and social services. Older adults are commonly represented in the current literature as presenting co-morbidity of many conditions and illnesses about what we will talk a little more further along but we need to say that meaningful and engaging aging happens as well but it is often underscored. A great number of older adults lead a meaningful life, a healthy one where they take advantage of exercising, changing dietary patterns, seeking information, relying on spirituality and/or religion, and engaging in life, I would also like to stress the positive coping skills of many other older adults.

However, mental health issues among the elderly have reached epidemic proportions and are expected to worsen in the next few decades. Elders with mental illness find more difficult dealing with adjustment in lifestyle, such as isolation or loss of independence, and this is complicated by medical conditions or physical diseases. The most common diagnoses in gero-psychiatric patients include depression, dementia, psychosis and anxiety.

Elderly suicide currently accounts for 20% of suicides in the U.S. – the highest suicide rate in the country compared to other age categories.[1] One in four elderly over 85 years old is diagnosed with dementia and one in two with Alzheimer’s Disease.[2] A landmark report estimated that by 2030 the number of elderly who suffer from a mental illness will grow to approximately 15 million;[3] and in California alone the projected number of elderly persons diagnosed with depression will reach 1.2 million by 2025.[4] A lack of access, education, and awareness lead many older individuals and their doctors to accept depression and mental illness as a normal part of aging when it is not. Among the elderly, mental health conditions are frequently untreated or inappropriately treated; more than one in five older persons with mental disorders are given an inappropriate prescription and are at increased risk for inappropriate medication treatment.[5] As a result, many older persons with mental disorders have a lower quality of general health care and associated increased mortality.[6]

However, researchers expect there will not be enough gero-psychologists trained to handle the increasing demand for psychological services from this age group. The National Institute on Aging estimates that 5,000 full-time, doctoral-level gero-psychologists will be needed by 2020 to accommodate the increasing demands of aging baby boomers. In 1991, slightly more than 700 psychologists who spent at least half of their time working with older adults were listed in the National Register of Health Service Providers. Along with the need for more gero-psychologists, the number of adults with mental disorders and behavioral health problems in 2030 is expected to reach 15 million–four times the prior census. In addition, older adults have the highest rates of suicide of any age group.

Experts agree that adequate staff is the most important factor in good patient care. However in spite of the growing demand for elder care, the education system and the pool of medical and mental health care providers with appropriate geriatric training are extremely inadequate.[7] A lack of training and institutional support has resulted in the 27% decline in certified geriatricians since 1998.[8] In 2005, there was one geriatrician for every 5,000 Americans 65 and older.[9] Nationally, geriatric mental health specialists comprise one of the smallest groups of health care professionals. By 2010, an estimated 5,000 psychiatrists, 19,000 gerontological nursing specialists, and over 50,000 social workers will be needed to provide mental health care for elderly patients.[10]

The “expertise gap” is among the greatest challenges to mental healthcare for the elderly,[11] and the effects are already apparent in many regions of the country where two out of three skilled nursing facilities failed to meet the state’s minimum nursing staff requirements[12] and a majority of surveyed primary care physicians considered themselves only “somewhat” (66%) or “not very” (20%) knowledgeable about geriatric mental health issues.[13] Even many specialists, internists and emergency room doctors said they felt “unprepared” to deal with depression and other mental health and end-of-life issues of elderly patients.[14] Of the 145 medical schools in the United States, only 9 have departments of geriatrics; most teaching hospitals graduate internists with as little as six hours of geriatric training. Only about 10% of U.S. medical schools require course work or rotations in geriatric medicine. While many more offer geriatric courses as electives, fewer than 3% of medical school graduates choose to take those courses. In nursing there is no gero-psychiatric certification and only one-third of masters level programs offered a course in aging.[15]

The integration of mental health services in the system of care for the elderly has proven to raise the quality of care to patients and support the larger network of care facilities to increase access to, and build capacity in mental health services. Research demonstrates that the integrated mental and medical health service arrangement achieve a higher level of access to mental health care[16] and is associated with better health and treatment outcomes at a lower cost.[17] Traditional models of service and professional training programs are frequently costly, disjointed and ineffective due to their inability to incorporate contemporary research findings and evidence-based practices into usual care.[18]

There is an undeniable need for professionals who would develop a humanistic and comprehensive approach to care for elders and to see the aging process as a fulfilling part of life as well as to offer a different, humanistic approach to approach aging and to treat those older people afflicted with Alzheimer’s and other dementias, and mental challenges, while implementing the best practices with seniors diagnosed with these phenomena. These professionals will challenge their attitudes towards aging and their attitudes for working with older adults. They will attempt to develop a humanistic-existential perspective to the creative and meaningful phases of aging and the possibilities of growth and development in later life. In particular, they will be able to articulate the relationship of the humanistic tradition to this specific subject and the importance for a new paradigm that encourages unfolding wellness versus the Cartesian dichotomy of mind-body separation.

Wellness is an alternative to the split between health and illness because people move along the continuum toward optimal wellness at each stage of life by way of their own efforts. As Dr. Judah Ronch says in his book Mental Wellness in Aging: “… People have more options than to be sick or healthy; they do not have to be sick in order to take advantage of the means to improve wellness. …this is an especially important outlook for aging as a process — people can have an array of illnesses as they age and yet enjoy wellness and a good quality of life.”

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References

[1] Mentally Healthy Aging: A Report on Overcoming Stigma for Older Americans. US Department of Health and Human Services & SAMHSA, 2005

[2] The Mental Health Workforce: Who’s Meeting California’s Needs? California Workforce Initiative, February 2003

[3]Consensus Statement on the Upcoming Crisis in Geriatric Mental Health: Research Agenda for the Next 2 Decades, Archives of General Psychiatry, 1999

[4] The Mental Health Workforce: Who’s Meeting California’s Needs? California Workforce Initiative, February 2003

[5] Mentally Healthy Aging: A Report on Overcoming Stigma for Older Americans. US Department of Health and Human Services & SAMHSA, 2005

[6] Ibid.

[7] Consensus Statement on the Upcoming Crisis in Geriatric Mental Health: Research Agenda for the Next 2 Decades, Archives of General Psychiatry, 1999

[8] Wanted: Geriatricians. Dani Dodge. Ventura County Star, September 5, 2004

[9] Geriatrics Lags in an Age of High-Tech Medicine. Jane Gross. The New York Times, October 18, 2006

[10] The Mental Health Workforce: Who’s Meeting California’s Needs? California Workforce Initiative, February 2003

[11] Bartels, Stephen, et al. Evidence-Based Practices in Geriatric Mental Health Care. Psychiatric Services, Vol. 53, No. 11, November 2002

[12] Nursing homes: Stronger Complaint and Enforcement Practices Needed to Better Ensure Adequate Care. U.S. General Accounting Office (Testimony before Senate Special Committee on Aging), 1999

[13] Halpain, Maureen, et al. Training in Geriatric Mental Health: Needs and Strategies. Psychiatric Services, Vol. 50, No. 9, September 1999

[14] Decision Making at a Time of Crisis Near the End of Life. David E. Weissman. The Journal of the American Medical Association, October 13, 2004; 292: 1738 – 1743.

[15] The Mental Health Workforce: Who’s Meeting California’s Needs? California Workforce Initiative, February 2003

[16] Bartels, Stephen, et al. Improving Access to Geriatric Mental Health Services: A randomized trial comparing treatment engagement with integrated verses enhanced referral care for depression, anxiety, and at risk alcohol use. American Journal of Psychiatry, Vol. 161, No. 8, August 2004

[17] Bartels, Stephen, et al. Evidence-Based Practices in Geriatric Mental Health Care. Psychiatric Services, Vol. 53, No. 11, November 2002

[18] Ibid.

[19] Ronch, Judah L. &Goldfield, Joseph A. (2003). Mental Wellness in Aging: Strengths-Based Approaches. Baltimore, MD. Health Professions Press, 2003

This entry was posted in Elders mental Health and Wellness, Mental Illness, Senior Wellness on July 24th, 2014.
Tags: Depression in Seniors, Elder therapy, senior and mental illness, senior wellness, Spanish speaking psychotherapist, Terapia en Español, therapy with seniors.

Therapy for the Elderly

Many of us have the impression that old people are sad, depressed, and/or grumpy but it turns out not to be particularly accurate. Many older adults and seniors can lead a very happy life. However, what about those who had experienced multiple losses, heartaches, and little access to therapy?

Moreover, for many of the elders with whom I work, emotional distress is their own business, sometimes a source of shame, and for sure something not to share with “strangers” like the therapist. Others think therapy is for young or younger people to what even Sigmund Freud noted that around age 50, “the elasticity of the mental process on which treatment depends is, as a rule, lacking,” adding, “Old people are no longer educable.” (Never mind that he continued working until he died at 83.) and as an article in The New York Times by ABBY ELLIN states: “…In years past, too, there was a sense among medical professionals that a patient often could not be helped after a certain age unless he had received treatment earlier in life… ‘that’s been totally turned around by what we’ve learned about cognitive psychology and cognitive approach — changing the way you think about things, redirecting your emotions in more positive ways,” said Karl Pillemer, a gerontologist and professor of human development at Cornell, and author of “30 Lessons for Living.”

Treatment regimens can be difficult in this population. Antidepressants, for instance, can have unpleasant side effects and only add to the pile of pills many elderly patients take daily. Older patients may feel that they don’t have the time necessary to explore psychotherapy, or that it’s too late to change.

But many eagerly embrace talk therapy, particularly cognitive behavioral techniques that focus on altering thought patterns and behaviors affecting their quality of life now. Experts say that seniors generally have a higher satisfaction rate in therapy than younger people because they are usually more serious about it. Time is critical, and their goals usually are well defined. Read Ellin’s article

This entry was posted in Elders mental Health and Wellness, General, Mental Illness, Psychotherapy on July 17th, 2014.
Tags: Depression in Seniors, senior and mental illness, senior wellness, therapy with seniors.

The Forgotten Elders: They Also Benefit From Psychotherapy.

George Kraus, a geriatric clinical psychologist debunks the stereotypes about working with elderly populations, and shares his discovery of the joy and gratitude that come from intimate contact with wise elders. He, wisely, address three important myths regarding psychotherapy and/or counseling with seniors:

Myth #1: Psychotherapy with the elderly is time wasted, because the elderly client has so little time to enjoy any gains that might be made.
Myth #2: The grief, loss, and somatic and socioeconomic burdens of the elderly are too excessive to warrant believing they could get better.
Myth #3: Old people are staid in their ways; they are too stubborn to change. Dr. Kraus emphasizes the fact that In America, “…we honor the young for their beauty, strength, and vitality. However, in other places on the globe, old men and women are objects of veneration. This leads to a curious consequence: the less we acknowledge what can be respected, admired, or even venerated in the parents and grandparents of the world, the more we make ourselves orphans who lose a piece of our faith, security, and connection to a past that we risk repeating. This has been part of my joy in working with older adults: I am able to honor them, to sit at their feet, marvel, and learn. As their therapist, I have become their faithful student, their privileged witness, and my life is ever richer because of it…” Read his article

This entry was posted in Elders mental Health and Wellness on June 28th, 2014.
Tags: Elder therapy, therapy with seniors.

Doris Bersing, PhD
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Tag: therapy with seniors