Psychotherapy can aid the elderly in many more ways than generally accepted. It can treat problems directly associated with older people like loneliness and isolation, insomnia, and the side effects of multiple pharmacological drugs, while at the same time providing major health benefits. Older people need to regenerate their minds as much as younger folk to stay energised and connected. The applicability of psychotherapy for the elderly as an approach to care as well as a treatment is broad and useful. A wealth of opportunity exists for psychological approaches to deal with the transitions and changing roles of old age in addition to specific mental health problems. In sharp contrast to this are inadequate training and services and a dismal lack of understanding of the psychological challenges that aging people face. What is abundantly clear is that the elderly have unique anxieties related to age, not least of all the anxiety of their approaching death.
Why is Psychotherapy is Particularly Needed in the Elderly?
There are many reasons why the elderly can benefit hugely from psychotherapeutic approaches. Older people find it difficult to come to terms with transitions such as retirement, increased vulnerability, poor health and potential institutionalisation, failing bodily functions, and the prospect of death. At this stage of life, their memories may become tinged with nostalgia as they think of happier times in the past when they felt cared for. It is not uncommon to see older people develop psychological problems as they struggle to come to terms with the loss of a loved one or the end of a lifelong career. Personal transformation through psychotherapy can help them enjoy fruitful and meaningful relationships again whether at home, in a care facility, or in the community.
Challenges of Aging
Falls can have a devastating effect on the aged. The experience can cause a loss of confidence and can sometimes lead to hospitalisation. Falls are often a reflection of a significant change or shift in everyday life for the elderly. Our bodies form a boundary between external reality and the self and falls can reveal the physical fragility of the aging body. Care often focuses on the outward physical harm while the emotional needs stemming from falls are neglected. After a fall the idea of emotional containment should be considered to assist in the rehabilitation of an aging individual. Shifts in equilibrium caused by the perception of a failing body can cause emotional pain in the form of guilt, disgust, shame, and injury to the psyche that stems from the loss of pride and independence. There is a need to recognise the vulnerability of an elderly person who has suffered a boundary insult such as a fall before they become lost in the emotional pain.
Fear of dependence and loss can haunt anyone, but it certainly has more significance for the elderly. Loss of physical ability or mental function as well as fear of ending life with regrets or without resolution of important goals are all factors for improvement that can be addressed by psychological intervention. Psychotherapy can help the elderly to accept past failures and allow good experiences that are significant for that person to shine through to the present.
Dementia can cause behavioural problems in the aged that severely impacts the function of the interaction between a patient and caregivers. Both behavioural and psychodynamic approaches can help caregivers and family members to provide care that is more effective and certainly less stressful for the patient as well. In caring for patients with dementia the care should centre around the value of more meaningful relationships, supervision by skilled staff, and a therapeutic environment that explores the reactions of patients to caregivers in day-to-day situations.
Personality disorders in the elderly are increasingly becoming apparent in the elderly, particularly late-onset personality disorders and the relationship to depression and treatment-resistant anxiety. Careful exploration of the personal history of such individuals is valuable in uncovering hidden stories of untold childhood trauma, often including physical and sexual abuse. Needing to be cared for in old age can re-ignite old attachment issues from childhood and disturbing interpersonal relationships from the past. Older people have learned to be stoical in adversity. Consequently very few have had the opportunity to work through difficult issues from the past. They need the best efforts of professionals to make access to psychotherapy treatment a reality for older people.
Drugs are another reason why psychotherapy can be a powerful treatment for the elderly. Older people take a lot of prescribed drugs and the effects are multiplied by age. Many physicians routinely prescribe drugs like antidepressants, anti-anxiety medication, and potent anti-psychotic drugs as a treatment for undiagnosed mental problems and even for common symptoms like insomnia in older people. With the short consultation times in the doctor’s room, it is understandable that it is faster to prescribe pills than taking the time to find out the underlying causes such as family issues and finding behavioural means to help people get better.
Meanwhile hospital admissions from drug side effects and death from overdosing keeps on rising. Psychotherapy is the answer as it has no side effects and, in fact, can be used to great effect to get people off addictive drugs and sedative-hypnotics. It has been proven over and over again that just talking to someone with a sympathetic understanding of problems associated with age, intelligent advice, and social support can help heal emotional problems and provide major physical health benefits. And psychotherapy for the elderly can also save the medical profession a lot of time and money which seems like a good deal that shouldn’t be passed up.