Medicare Mental Health Week

This week the NBCC and organizations nationwide are recognizing Medicare Mental Health Week. Dr. Kerri Schroder shares some insight on this topic.

“Loneliness and the feeling of being unwanted is the most terrible poverty.” ~ Mother Teresa

These words describe the feeling of many of the elderly in our country. Despite longer life expectancy, increased facilities and technology that medical and social systems provide to elderly, loneliness and depression are all too common.

Loneliness is not a new concept only beginning during senior years.  Loneliness is not synonymous with being alone, nor does being with others guarantee protection from feelings of loneliness. Loneliness has been described as a complex set of feelings that occurs when intimate and social needs are not adequately met and that drives individuals to seek the fulfillment of these needs. It is a universal phenomenon found in the humans and is closely associated with changing life circumstances.

We can also distinguish emotional and social loneliness. Emotional loneliness is missing an intimate partner, such as a spouse or sibling and is accompanied by feelings of isolation and insecurity, and of not having someone close.  Social loneliness is lacking a circle of friends and acquaintances that can provide a sense of belonging, of companionship and of being a member of a community.

Studies have found that increased age, absence of partner, dependency; institutionalization and health impairment were associated with increased risk of loneliness.  And loneliness is linked to depression, lower quality of life and increased vulnerability to both physical and mental health problems of the elderly. Factors like cognitive function and limitations in activities of daily living were not related to loneliness. Other factors: education, income, marital status, and perceived stress are not predictive of loneliness.

Coping mechanisms are cognitive and behavior efforts to manage perceived overwhelming demands, whether external or internal. The way these difficulties are faced directly influences levels of health and psychological well-being They can be divided into two categories.  Adaptive coping mechanisms are fairly active, and include instrumental and emotional support, planning, acceptance, humor, positive re-framing and religion.  Mal-adaptive coping mechanisms are more passive and include behavioral disengagement, denial, self-distraction, self-blame, substance abuse and venting.  Often time seniors react to feelings of loneliness with sad passivity, distancing, and denial as a way to cope due to a sense that this is what is expected at their stage of lie.

Not surprisingly the use of adaptive coping strategies are associated optimism and active engagement and result in less loneliness and less depression.

Engaging in therapy to learn and practice adaptive coping skills is a pathway to overcome loneliness.  Practical strategies are offered:  how to distinguish between loneliness and solitude, volunteering & teaching opportunities, finding other sources of nurturing (caring for pets, plants), figuring out what is missing from your life, and taking steps to connect with others.

Kerri Schroder is a licensed psychologist who specializes in geriatric mental health. 

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