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IN THE RING OF LIFE: AGED CARE & MENTAL ILLNESS.

Aging is the process of growing older, a process that includes physical changes and, sometimes, mental changes. “The aged” refers to elderly people, those who have reached an advanced age (Encyclodpedia.com, 2024). The term has different conceptions in different contexts; while in Africa and China it refers generally to people aged 50 and above, it begins from 65 and 70 years in Europe and America respectively (Aged Care Guide, 2024). In most cases, old age is tied to retirement age in each country (Aged Care Guide, 2024).

According to the United Nations (2009), the world population over the age of 60 is expected to reach two billion by 2050. Aging in the African context particularly in Ghana is often considered as a remarkable achievement. It connotes goodwill and prosperity for the family and an evidence of a life worthy of emulation by the community at large. However, research indicates that “one of the possible negative consequences of the rapid ageing of the global population is the increase in the number of people with mental disorders, which will soon overwhelm the mental health systems in all countries” (World Health Organization, 2015). The rising life expectancy of older people in resource poor settings often goes along with many socioeconomic and health-related challenges, including increases in old-age poverty (partly due to retirement and irregular income sources), declines in physical functioning, increased psychological distress and general later-life poor health outcomes (Gyasi & Phillips, & Amoah, 2020; WHO, 2015).

Despite the concern that research into mental health conditions related to the aged in Ghana are quite scanty, there is some evidence pointing to the fact that the aged in Ghana are predisposed to mental health conditions such as depression, dementia, parkinson’s disease, schizophrenia, substance abuse, anxiety, frequent mental distress and substance related disorders. Unfortunately, many people consider some of these mental health conditions as normal conditions in aging. Also, fear of stigma makes it difficult for aged persons living with a mental health disorder or their families to seek appropriate psychotherapy or psychiatric intervention to improve their lives. They are therefore left at the mercy of the condition causing significantly reduced quality of life.

Agreeably, it is difficult to identify some mental health conditions early enough. However, it is important that in situations where aged persons exhibit some symptoms in their behaviour not typical of common conditions related to aging such as diabetes, cardiovascular disease and cancer, there should be a conscious effort to seek support from a professional counsellor, psychologist or psychiatrist. In cases where aged persons are left to face mental health conditions without right treatment, their long life which hitherto should have been marked with blessings and peace translates into a burden, abandonment or the hope that they should pass on quickly to give their caregivers rest. This should not be so!

Symptoms like tremors, forgetfulness, distorted speech and thoughts, prolonged sadness and feeling of worthlessness, talks about death, hallucinations (hearing, seeing, feeling, touching and smelling) things that do not exist and delusions (having strong beliefs or convictions about things that are not true or factual) may denote an onset of psychotic conditions or abnormalities that need urgent psychotherapy or psychotropic medications. Below are some practical tips to support caregivers of aged persons who may be showing signs of an onset of a mental health condition or diagnosed with same.

1. Encourage them to seek early therapy and/or psychiatric intervention. The most essential help is to urge such aged persons to seek the right clinical support. The cultural belief in existential forces, cost of mental health care, poor understanding of psychotherapy and social stigma may cause denials or delay in seeking the right care. Such persons must therefore be encouraged and possibly accompanied to psychotherapy or psychiatric consultations.

2. Show support. Financial, emotional, physical and psychological assistance is key in uplifting the spirit of such aged persons. When they know that they are not alone, it gives them hope and reassurance that all is not lost. This can facilitate the will to press on and fight against the condition to get treated.

3. Be present. This requires that attention is paid to the needs and wants of such aged persons. It involves appreciating and engaging them here and now without wishing you were doing something else in another place. Avoid showing disdain in their presence as much as possible.

4. Indulge them. It may seem stressful and even boring to keep such aged persons company. However, indulging them means taking delight in engaging them without reacting badly should their behaviour result in any anguish or discomfort for you. They may no longer be the same person you knew but your ability to take delight in their life will give them joy.

5. Seek support or help. Combining work or a career and caring for such aged persons can be strenuous and draining emotionally, physically and psychologically for the caregiver. It is important to solicit support of trusted persons who can complement the care provision to offer you relief. Alternatively, one can engage the services of professional caregivers to prevent burnout or breakdowns.

6. Support them to take their medications. Support with taking medications requires effort and intention to ensure that medications are taken regularly in the right dose at the appropriate time. This should be supported with well-balanced and nutritional meals.

7. Accompany them for check-up. Prioritise their medical visits to ensure that they receive the best care and their medications are up-to-date. Excuses should not be given when it is time for their medical check-ups and they should not be left to patronise health facilities by themselves.

8. Express love to them in diverse ways. Hold their hands, give them hugs and gentle body rubs, express care, show warmth and tenderness and do not leave them alone. Continuously remind them about how much you love and appreciate them.

9. Accommodate their views on issues. Decisions should not be made on their behalf as they directly suffer consequences of such actions. Ignoring their opinions may also imply disrespect and an offense to their person. Their views should always be sought on issues that affect them; this will serve as a significant reminder that they are important and their choices count.

10. Be mindful of triggers. Certain factors being environmental, biological, social, or psychological may spark negative reactions or cause crises with respect to the aged with mental health conditions. The individual should be under constant observation to avoid situations like agitation, getting lost outside the home or causing harm to themselves and others.

Some warning signs to look out for in the aged include change in sleeping patterns (not enough sleep or oversleeping), high stress levels or constant worrying, suicidal thoughts, trouble feeling positive emotions, unusual ideas or high-risk activities/ behaviours, a need or dependence on drugs and alcohol, feeling hopeless or giving up, constant fatigue, headaches and pain, anger, extreme sadness or crying and irritability.

Mental health conditions imply change in the mood, thinking, and behaviour patterns of the individual and should attract a sense of urgency especially among caregivers of aged persons who are not physically fit to care for themselves properly.



Bibliography

Aged Care Guide (2024). What is considered “Old”? Talking Aged Care. Retrieved on 4th June, 2024 from https://www.agedcareguide.com.au/talking-aged-care/what-age-is-considered-old

De Mendonça Lima, C. A. & Ivbijaro, G. (2013). Mental health and wellbeing of older people: opportunities and challenges. Mental Health Fam Med. 10(3):125-7.

Encyclopedia.com (2024). Aging and the Aged. Medicine. Retrieved on 4th June, 2024 from


Gyasi, R. M. Phillips, D. R. & Amoah, P. A. (2020). Multidimensional Social Support and

Health Services Utilization Among Noninstitutionalized Older Persons in Ghana. Journal of Aging and Health. 32(3-4):227-239. doi: 10.1177/0898264318816217.

United Nations (2009). United Nations World Population Ageing 2009. UN: New York.

World Health Organization (2015). World Health Organization and Alzheimer's Disease

International Dementia: a health public priority. WHO: Geneva.

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