Emotional Problems in Later Life: Common Issues in Late Life Are Retirement, Divorce, Widowhood, Misues of Prescription Drugs, Suicide, and Neglect
friends. The support that follows a divorce or the death of a spouse tends to diminish over time, leaving the older adult vulnerable to loneliness, isolation, anxiety, and depression. Connecting with others and developing new support networks facilitates the adjustment to the single lifestyle. At a time in their lives when they anticipated that life’s demands would
decrease, the widowed and divorced are faced with life’s most demanding transition.
*Suicide and the Elderly*
The suicide rate in most countries is higher for older adults than for any other age group. In the United States, suicide in the 65+ group is twice the rate of the rest of the population, with older males at highest risk. Although women attempt suicide three times more often than men, they are less successful than men, who typically choose more lethal means like firearms. Older adults commit approximately 20- 25% of all suicides.4 The risk factors for suicide among older adults are numerous. Depression is, of course, a major predictor for suicide and is generally correlated with significant changes in the aging adults life. The deterioration of physical health, cognitive dysfunction, stressful life events, substance abuse, relationship problems, bereavement, and genetic predisposition are contributors to later life depression. Suicide is most likely a response to the panorama of life’s circumstances rather than to a single factor or incident. Older adults commit suicide with
less warning than younger adults and are less likely to express suicidal intent. Previous attempts are significant predictors, but for men who tend to be very successful, this predictor may rarely appear. Treatment for the suicidal older adult may be difficult because the elderly (especially men) generally do not seek mental health services. Identification of suicidal older adults by others who have contact with the potential victims is essential. Because most elderly suicide victims have visited their primary care physician in the month prior to their suicide, recognition and treatment of depression in the medical setting is a promising way to prevent elderly suicide.5 Psychiatric hospitalization can provide an opportunity to involve suicidal older adults in therapy. A hospitalized patient who fit the high-risk profile was referred to me for therapy. He was an over-65 male who had lost his farm and his wife, had stopped going to church, had become a heavy drinker, and exhibited warning signs for potential suicide. Helping him reconnect with his previous spiritual foundation brought a fresh awareness of Gods love and opened the door for developing a treatment plan.
*Misuse of Alcohol and Prescription Drugs*
Alcohol and prescription drug misuse affect over 17% of the 60+ population. Substance abuse lowers the quality of life at any age, and it can have a devastating impact on the lives of older adults. Older adults consume alcohol for some of the same reasons younger adults use alcohol to numb psychological or physical pain. Several studies have indicated that about one third of alcoholism among the elderly began after entering later life. This suggests that a significant group of older adults had alcohol problems prior to entering the last third of their lives. Late onset occurs more frequently with women; men more
commonly were drinking at an earlier age. Alcohol consumption tends to decrease over the life span; older adults drink less than their younger counterparts, but the drinking patterns are similar for all age groups.
The effects of alcohol on older adults differ from younger adults. Due to the aging process, tolerance for alcohol decreases with age. Health problems, social problems with family and friends, grief and loss, and mental problems exacerbate drinking patterns or are factors in late onset alcohol abuse. A significant danger exists when alcohol and prescription drugs are mixed. The ability of the aging liver to metabolize alcohol and medications is a concern. Accidental overdose can occur. Whereas older men are at greater risk for alcohol abuse, older women are at greater risk for the misuse of prescription drugs.
The National Center on Addiction and Substance Abuse reports that 2.8 million women over age 60 are addicted to psychoactive prescription drugs. Older women are more likely to visit family physicians and receive prescriptions, especially for psychoactive drugs. Although older adults make up about 15% of the general population, they consume 2535% of prescription drugs and a disproportionate amount of over-the-counter drugs.6 Misuse of prescription drugs can occur when the elderly patient does not understand the directions for the medication, forgets to take the medication, or accidentally or deliberately takes extra doses. The elderly experience numerous physical and emotional problems that require medications, such as chronic