Emotional Problems in Later Life: Common Issues in Late Life Are Retirement, Divorce, Widowhood, Misues of Prescription Drugs, Suicide, and Neglect
pain, insomnia, anxiety, depression, cardiovascular problems, and respiratory problems. Drug dependence and drug interactions are a major concern for the elderly.
The aging body typically has a decreased ability to clear the system of drugs, leaving the older adult at risk for overdose or serious side effects. The same medication that is a blessing can also be a curse. Treatment for alcohol problems and the misuse of medications varies according to theoretical orientation. The counselor s belief regarding the etiology of alcohol dependence (disease or dysfunction) will inform the choice of treatment. Engaging the older adult in treatment may be difficult and may require the assistance of family and friends. Unfortunately, most alcohol treatment programs are designed for younger populations and seldom address the unique problems of the elderly.
Treatment for the misuse of prescription drugs commonly begins with an intervention.7 Interested persons express their concern for the one who is abusing drugs, explain
how the problem has affected their relationships, and encourage the person to seek professional help. This method (also used with alcohol related problems) addresses the denial that is typically present. The prescribing physician is often unfairly blamed for the problem (Well, he’s the one who got this started by giving the prescription). In some cases, physicians do contribute to the problem and need to be included in the solution. Having a significant person go to the doctor with the older patient can be helpful for understanding directions for medications. Also keeping a list of all medications for the physician to review can aid in correlating the drugs. There are containers specifically designed for organizing medications by the week and indicating the day and time to take the medication. As is the case with alcohol abuse, there are few drug treatment facilities that accommodate the elderly. Hospitalization is an alternative; however, managed care generally does not pay for the treatment.
*Abuse and Neglect of the Elderly*
Elder abuse is generally divided into four broad categories (physical, psychological, financial, and neglect), and the definition of abuse usually depends on intent, severity, intensity, and frequency. Currently, only four prevalence studies have been cited in the literature and the results are considered an underestimate of the worldwide occurrence of abuse.8 One of these studies9 surveyed over 2000 non-institutionalized elders in the United States and found that: The prevalence of elder abuse ranged from 4% to 10% of those 65 years and older; abuse was perpetrated more often by spouses (58%) than adult children (24%); victims were equally divided between men and women; and neither economic status nor age were related to risk factors.
According to Wolf, the risk factors include: the abusers dependence on the victim (i.e., financial support); the psychological state of the abuser (i.e., mental health, substance abuse); the physical and cognitive state of the victim (i.e., frailty, memory deficiency); and family social isolation (i.e., housebound).10 Although empirical studies are lacking with regards to the consequences of abuse and neglect, Wolf reports that depression, learned helplessness, alienation, guilt, distrust, withdrawal, fear, shame, and post-traumatic stress disorder appear to be responses to abuse. Similar to the victims of domestic violence and child abuse, the elderly tend to hide or minimize the abuse, fearing abandonment and rejection. Interventions for elder victims of maltreatment vary according to the individual case, from crisis intervention strategies to treatment of longer duration. Of course, the primary goal is to end the abuse. Counselors need to explore the elders view of the abusive situation, keeping in mind the fear of abandonment and rejection experienced by most victims.
*Conclusion*
As Christians, we are instructed to minister to the hurting and wounded that we encounter in our society. As Christian counselors, we have no less of an obligation. The elderly are a segment of society that is often neglected and ignored by the professional world. As we become aware of the numerous problems the elderly face, we have the opportunity to bring help and healing. Christian Counselor is always available to help you out.
One of my students recently told me that I need to help her overcome her resistance to working with the elderly. She is aware of her responsibility to minister to her clients but has not developed a willingness to open her heart to aging adults. As I have talked and listened to others, I realize that there are many who share her view. This may be the result of living in a society that does not