Dr. Val Farmer
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Rural Mental Health & Family Relationships

Avoiding Pitfalls Of Growing Old

November 22, 1999

Getting older? Having trouble finding the car keys? That may not be that big of a deal, but other problems are. My colleague, psychiatrist Robert Olson, at MeritCare Health System in Fargo shared with me some of the common problems he sees in his clinical practice with the elderly.

Olson believes that seeing a physician is half the battle. Older people usually have respect and appreciation for the medical profession and follow doctor’s orders after they have been seen. But there still may be problems.

Popping too many pills? It’s common for people to see different specialists about different health problems. Each physician prescribes a medication, unaware of the other medications the patient may be taking. Many times a patient may have upward of 6 to 8 or even 10 medications he or she takes on a daily basis. Each medicine has side effects. Look out when one medicine interactions with another medicines!

This situation often causes depression, confusion, unsteadiness, distressing physical problems and may interfere with the effectiveness of medicines on the remedy they are supposed to address. When going a see a physician, the patient or their family member should gather up all their medications and bring them to their appointment.

The prescribing physician can then see the total picture and look for problems. The solution for some perplexing health problems may consist of eliminating or changing medications that are causing difficulties.

Getting forgetful? There is normal forgetfulness in aging and then there is the forgetfulness connected with diseases like Alzheimer’s. It is important to know the difference. With Alzheimer’s disease, the process of losing one’s mental abilities and judgment takes place gradually. Consequently, the family may not comprehend or recognize what is happening.

These symptoms become apparent when the older person is away from their usual environment and becomes disoriented and confused, such as at a family reunion or being in a highly stimulating place like a mall. It is important for families to understand the disease and get an early start on knowing how to deal with it as effectively. Family members can play a key role in providing appropriate care. Most larger communities have support groups to assist family members.

Olson emphasizes that some memory problems are due to other causes such as Vitamin B-12 deficiency or thyroid problems. These problems are easily tested and treatments are available.

Get family members to go to the appointment with their parent or spouse. Getting an accurate history and full description of the difficulties is important. Olson finds that older people tend to minimize their troubles and leave out important information.

Too much booze? Excessive alcohol use confounds other health problems and depression. An older person’s ability to tolerate alcohol is much less than earlier years. Problem drinking among the elderly is a real and often hidden issue.

Driving a problem? Another health/safety concern is getting an older person to stop driving when they begin to lose their visual acuity. More importantly, however, is the loss of judgment and slowed reactions when they are exposed to driving situations with lots of stimulation and confusion. A physician can play a role in helping older patients and family members make decisions about driving.

How’s your spark? Depression in older people may not show up by sadness or feeling blue. It is diagnosed more often by sleep or appetite problems, excessive worry about health or financial problems, physical symptoms, weakness, fatigue and social withdrawal or isolation. The usual spark is missing. Olson emphasizes that depression is treatable. It is under-diagnosed in this age group.

Here’s how to counteract depression and loneliness:

  • Have some goals. Older people need to have meaningful purpose and goals in their lives. Goals energize and give focus. Older people need to be needed. They need to find a way to stay involved with life instead of passing time. Goals could be hobbies, pastimes, involvement with the grandchildren, passing on family history and stories, volunteering, church service, travel, managing their estate and investments, etc.
  • Keep on learning. Another way to stay young is be actively involved in learning new things. Older people need to stay current on what is happening in the world, continue to make sense of life and to distill and share their wisdom. Reading, conversation, being curious and inquisitive, exposing oneself to new ideas and rethinking old ones, going new places, doing new things - all this is important.
  • Keep social and emotional relationships alive. The older years are a time when family is extremely important. Family ties need to be cultivated and nurtured. Grandparenting can be a pleasure and a worthwhile contribution. Marriage in older years can mellow into a new closeness and deeper love. Older couples can sustain each other and meet each other’s needs.

Older people need to take responsibility and counteract loneliness and isolation through their own initiative. Being outgoing and involved with their peers and friends helps to balance life and to stay independent.

 

  • Be positive about life. Being old has its advantages. There is time to "smell the roses." The wisdom of age tempers problems and puts them in perspective. Older people enjoy peace of mind by having a vibrant religious faith, finding ways to compensate for limitations, and coming to terms with death. Older people often enjoy a sense of satisfaction and contentment about the lives they have led.

All that is well and good, but it doesn’t help find the car keys. Oh well.