Mental Illness in Elderly: Rising Mortality, Morbidity & Hospitalization - Essay Sample

Introduction

Mental illness among the elderly has gained prominence in the recent past, and the number of adults who are over the age of 65 is expected to rise exponentially (Segal, Qualls, & Smyer, 2018). Undeniably, the increase in the aging population often results in heavy financial and healthcare burden to most countries globally. It is instructive to note that there have been limited geriatric healthcare facilities, and this has led to the rise in mortality, morbidity, and hospitalization of the t elderly. Studies have demonstrated that the elderly are always socially alienated, and this often increases their chances of developing geriatric mental health disorders (Segal et al., 2018). Also, this social isolation has deprived the elderly the much-needed time to spend with other people in the society that can help in keeping them emotionally, physically, and most importantly, mentally stable. The paper will explore some of the common geriatric mental health disorders and the useful diagnostic screening tools that can be used in addressing them. Also, the paper will illuminate the underlying challenges with the diagnosis and treatment of the disorders and the role played by the Advanced Practice Nurse in caring for the patients with geriatric mental health disorders.

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Geriatric Mental Health Disorders and Diagnostic Screening Tools

There has been a major focus on the mental health affecting young people, but there has been a growing need to focus on the mental healthcare needs of elderly patients. Notably, depression is one of the most prevalent mental health issues in the elderly. Depression often results in severe physical and mental impairments. Moreover, anxiety disorders always affect the elderly, and in most cases, there has been a challenge in their diagnosis because the elderly often focus on their physical health and overlooking the psychiatric symptoms (Segal et al., 2018). Some of the common anxiety disorders are social anxiety disorders, obsessive-compulsive disorder, and post-traumatic stress disorder (PTSD) (Bartels et al., 2015). Social anxiety disorder often makes the elderly to avoid specific social settings for fear of being judged and rejected. PTSD often manifests among the elderly, particularly after they had experienced a traumatic event in the past. Additionally, bipolar disorder often manifests among older adults (Segal et al., 2018). This disorder always characterized by confusion, irritability, hyperactivity, and psychosis, among others. It should be noted that some of the geriatric mental health disorders are also depicted among other people in different age group and proper and professional diagnosis should always be conducted to establish their root causes.

It is instructive to note that many elderly patients often suffer because of the lack of proper screening tools that can be used to diagnose the disorders among older adults. Understandably, frequent screening can be instrumental in identifying mental health disorders before they cause adverse effects on the elderly (Bartels et al., 2015). Concerning depression, patient health questionnaire has been a useful screening tool to identify depression in the elderly. Additionally, the depression tool kit is often used widely by the clinicians to help them identify and most importantly manage depression (Segal et al., 2018). Moreover, for the anxiety disorders, the generalized anxiety disorder (GAD-7) which a seven-question screening tool used in identifying whether a thorough assessment for anxiety is depicted. Also, the PC-PTSD is a screening tool designed to be used in primary care to screen for PTSD. Furthermore, the most useful screening tool that is always used in screening for bipolar disorder is a STABLE resource toolkit (Bartels et al., 2015). This tool provides the necessary resources that can be helpful for the clinicians to identify and manage bipolar disorder. Also, the mood disorder questionnaire (MDQ) often encompasses thirteen questions that are related to bipolar disorder symptoms.

Challenges With Diagnosis and Treatment

The diagnosis and treatment of geriatric mental health disorders have been facing many barriers, and this has resulted in high morbidity and mortality rates among the elderly. Accessibility has been a major challenge in the diagnosis and treatment of the disorders. Most countries often lack adequate infrastructure, and this has created a barrier to the timely access of the mental health diagnosis and most importantly, diagnosis (Brenes et al., 2015). Moreover, the shortage of geriatric mental health professionals has impeded access to treatment of the geriatric mental health disorders, and the elderly often seek treatment from their primary care providers. Additionally, the information gap has been a major hindrance to the access of the geriatric mental health disorder diagnosis and treatment because the elderly always have inadequate information concerning their symptoms (Brenes et al., 2015). Also, there has been limited education concerning the mental illnesses among the elderly, which has contributed to the great unawareness of the mental disorders among the elderly. However, the advancement of technology has helped in improving awareness about the disorders, and proper diagnosis and treatment of the mental illness among the elderly have been significantly improved.

Furthermore, there was a concern for the affordability of healthcare for the elderly. The high cost of healthcare often prevents the elderly to seek proper diagnosis and treatment for the mental illness in aging adults (Brenes et al., 2015). It is worth noting that there have always limited treatment services that are embedded in the most medical covers and more often not they always exclude mental and behavioral health. Understandably, stigma usually affects the diagnosis of the mental illness and more particularly among the elderly. Older adults with mental illness often shy away from seeking treatment because of stigma (Brenes et al., 2015). Studies have indicated that mental health stigma is a major impediment to proper access to necessary mental health services as the elderly often feel embarrassed to admit that they have a mental illness. Notably, there has been a shortage of workforce particularly those who specialize in the provision of geriatric psychiatric services and this adversely affected effective diagnosis and treatment of the mental disorders among the older adults (Brenes et al., 2015). Additionally, there have been difficulties in training and hiring experienced psychiatrists who can take an active role in providing the much-needed diagnosis of the mental illness and hence, proper treatment.

Role of Advanced Practice Nurse

Psychiatric mental health services are often provided by adequately trained nurses who can identify the most appropriate screening tools that can be used in the diagnosis of the mental illness particularly for the elderly population (Bartels et al., 2015). The Advanced Practice Nurse (APN) often have the highest educational level, particularly in the psychiatric-mental health nursing field (Dowling et al., 2013). The APN often play an integral role in the assessment, diagnosis, and most importantly, the treatment of elderly patients with geriatric mental health disorders. Also, the APN is always tasked with the responsibility of identifying the potential risk factors for the mental disorders among older adults. Moreover, they often play an instrumental role in formulating policies, conducting quality improvement, nursing practice evaluation, and most critically enhancing healthcare reforms that can help provide adequate mental healthcare services to the elderly (Dowling et al., 2013). More importantly, the APNs often have acquired additional advanced degrees in nursing that enable them to work as researchers and professors, and this has been instrumental in identifying contemporary screening tools for the geriatric mental health disorders in the elderly.

Recent legislations have allowed the APNs to treat patients with severe mental illness. Also, there have been expanded structural changes that have allowed the APNs to treat even the vulnerable members of the population and more particularly the elderly. Additionally, the APNs have received advanced education, and they have been duly accredited by the National Council of State Boards of Nursing (Dowling et al., 2013). APNs often have an advanced set of skills that have been instrumental in conducting advanced diagnosis and consultation that has helped provide mental healthcare services to the mentally ill elderly patients. Notably, the APNs have been cooperating with healthcare policymakers and experienced physicians to formulate more efficient methods that have helped in improving the mental health among older patients (Dowling et al., 2013). Also, APNs have been incorporated in the medical leadership roles that have enhanced their ability to offer the necessary help to the ever-increasing numbers of elderly patients with mental illness.

Conclusion

Mental illness among the elderly has always been under-emphasized and challenges that often characterize the diagnosis and treatment of the geriatric mental health disorders have contributed significantly to the deteriorated health and well-being of the elderly in most countries. There is always a need to ensure that the mental disorders among older adults are appropriately identified and diagnosed using the most appropriate diagnostic screening tools. Some of the common disorders are depression, anxiety disorders, and bipolar disorders which often cause adverse effects to older adults, particularly if they go untreated. Notably, there have been different challenges with the diagnosis and treatment of the elderly with mental illness and key amongst them has been concerns with the proper access to the mental healthcare facilities. Additionally, the high cost of Medicare and stigma have been a stumbling block in undertaking the most appropriate diagnosis and treatment of the mental illness among the elderly. It is worth noting that, there should be wide adoption of modern healthcare equipment that can help address the high cases of geriatric mental health disorders that continue to cause adverse effects to older adults.

References

Bartels, S. J., Gill, L., & Naslund, J. A. (2015). The Affordable Care Act, accountable care organizations, and mental health care for older adults: Implications and opportunities. https://psycnet.apa.org/record/2015-40852-002

Brenes, G. A., Danhauer, S. C., Lyles, M. F., Hogan, P. E., & Miller, M. E. (2015). Barriers to mental health treatment in rural older adults. The American Journal of Geriatric Psychiatry, 23(11), 1172-1178. https://www.sciencedirect.com/science/article/abs/pii/S1064748115001876

Dowling, M., Beauchesne, M., Farrelly, F., & Murphy, K. (2013). Advanced practice nursing: a concept analysis. International Journal of Nursing Practice, 19(2), 131-140. https://onlinelibrary.wiley.com/doi/abs/10.1111/ijn.12050

Segal, D. L., Qualls, S. H., & Smyer, M. A. (2018). Aging and mental health. John Wiley & Sons. https://books.google.co.ke/books?hl=en&lr=&id=1xg-DwAAQBAJ&oi=fnd&pg=PP11&dq