Improving services and support for older people with mental health ...

Improving services and support for older people with mental health problems
Bereavement may be the cause of isolation and loneliness. The loss of a spouse,
partner, family, friends and pets, to illness or death, can result in the loss of
companionship and wider social networks.
“Since my husband died it has been worse. I don’t have a
sense of purpose or meaning. Being on my own [makes
things worse]”. 238
Loss of friends can be devastating for older lesbians, gay men and bisexuals who tend
to rely on friends more than family for social support. 239 Black and minority ethnic
(BME) older people must be allowed to grieve in culturally appropriate ways. Other
effects of bereavement, such as sudden responsibility for unfamiliar household tasks
and disruption to daily routines, can be distressing. Those who do not learn new skills
to handle these tasks are at increased risk of long-term mental and physical health
problems. 240 Bereavement is a particularly important issue in care homes, where
turnover of staff and residents is high and relationships are frequently disrupted.
Unpaid carers are at heightened risk of developing mental health problems due to
stress, pressure and lack of financial and social support. They may cherish their caring
roles but also feel loss, frustration and sadness as their relationship with the person they
are caring for changes. Many carers of older people with mental health problems are
older themselves and their caring responsibilities can have detrimental impact on their
own physical and mental health. Carers of people with dementia are at particular risk;
one-third of this group has depression.
Moving into a care home can be a relief but may also involve the loss of
neighbourhood and community. Leaving a family home is another loss to be dealt
with. Depression is more common in people who have recently moved into a care
home, especially if they have moved there from their own home. 241
Wider factors such as age discrimination, lack of opportunities to participate in society,
poverty and social exclusion also impact negatively on mental health in later life. These
themes were explored in the Inquiry’s first report. They provide the backdrop for
individual experiences of depression and anxiety.
“Suddenly here I am, a shadow of the person I used to be and
sometimes not even feeling that person… and this awful feeling
as I say once you are old you are on the scrap heap really,
nobody wants you.” 242
4.2.2 Preventing depression and anxiety
Reducing the risk factors. Depression and anxiety can be prevented by minimising
the occurrence of risk factors such as physical disability and illness, sensory impairment
and social isolation. Physical activity 243 and healthy eating 244 protect against depression
for people of all ages and should therefore be encouraged. Regular vision and hearing
tests can identify potential problems at an early stage and prevent people from being
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