Emem Omokaro PhD, Director General, National Senior Citizens Centre
By Benita Dooshima Aki
Globally, the aging population is fast outnumbering the population of young people.
The World Health Organization, (WHO) estimated that the growing number of old people would double by 2050.
Old age is not devoid of physical and psychological adversaries demanding medical and psychological management.
The United Nations (UN) described old persons as people over the age of 60 years. Old age in itself should come with invaluable life experiences, a period where the older persons sit back, reflect and enjoy the dividends of their life struggles, etc.
Rowe and Kahn (1997) in their successful aging model described successful aging as an interplay of the factors of avoidance of disease, active participation in life activities and high levels of physical or cognitive function.
Other factors include effective management of both physical and psychological health, and security among others.
Unfortunately, the older persons in Nigeria like other developing countries face a range of distressing situations including comorbid physical and psychological problems without adequate care and attention.
Aging especially in Nigeria can be very stressful culminating in physical, economic, and psychosocial health conditions such as diabetes, arthritis impaired vision, cardiovascular diseases, economic hardship, changes in family dynamics, increased healthcare demands without adequate access to health care, poverty, increased dependence on family, neglect, loneliness, grief, multiple physical illnesses co-occurring in one individual, inability to adapt and cope with late-life transition, insomnia, inaccessibility of retirement benefits, name-calling of the older persons such as “witches and wizards, being victims of theft and rape, etc.
Ideally, no one ought to be afraid of ageing as it is a privilege beyond description.
But these and other stressors encountered in late life are overwhelming to the old and significantly lead to poor psychological outcomes such as suicidal ideation, anxiety and depression, stigma, and decline in cognitive functions including memory among others.
Depression/Suicidal Ideation
Depression is a psychological disorder that can affect anyone including the older persons.
However, depression in the older persons is often overlooked and taken as a normal process of aging.
This may be because very often depression co-occurs with medical conditions and may be difficult to identify.
Depression is also a risk factor for suicide. Depressed older adults very often contemplate suicide owing to the many predicaments that befall them.
Psychologists can successfully assess, diagnose and treat depression in the older persons despite their medical conditions.
Anxiety-related disorders such as generalized anxiety disorder, post-traumatic stress disorder, panic disorder, and obsessive–compulsive disorders are common among the older persons and can also be identified and treated with the use of psychotherapy and other relaxation techniques.
Late-life Transition/end-of-life Syndrome
Psychologists help older adults who may have issues navigating through the stressors that accompany the transition into old age.
Such as the death of a spouse or other loved ones, multiple health challenges, transition into another living condition, etc.
Older adults may be diagnosed with various terminal illnesses leading to anxiety and depression.
Psychologists manage the distress associated with the illness minimizing its adverse effect on the aged.
Decline In Cognitive Functioning
Old age is associated with a decline in cognitive functions including memory.
The task on cognitive functions reduces causing cognitive skills to experience ‘wear and tear’ which results in a decline in cognitive performance.
Because human beings including the older persons have the capacity to learn and relearn, activities involving cognitive training and stimulation can be engaged to help the older persons regain their cognitive abilities.
Insomnia is a sleep disorder also prevalent among the old.
It is characterized by the inability to initiate and maintain quality sleep.
This may be due to the adverse effects of medications and cognitive impairments.
These too can be effectively managed by psychologists with the use of psychotherapy.
Psychosocial Intervention
Psychosocial intervention is aimed to manage the symptoms of psychological disorders and improve the day-to-day functioning and quality of life of the older persons.
Mental health issues faced by the older persons are effectively handled by psychologists with the use of evidence-based psychotherapies.
Some of these include; interpersonal and psychodynamic psychotherapy, cognitive behavioral therapy, behaviour modification, cognitive training, disease management strategies, relaxation techniques, etc.
Identifying mental health challenges in the old and managing them will significantly reduce the frequency of physical health problems including hospitalization and deterioration of physical health conditions faced by the older persons as physical and psychological health are interwoven.
For instance, the older persons with a physical condition such as heart disease has higher chances of coming down with depression than those without heart disease.
Again, an older adult who has heart disease co-occurring with untreated depression would rather compromise the effective management of the disease.
Depression has been shown to lower immunity against infections and other diseases.
Very important to note is, Non-pharmacological treatments such as psychotherapy are often preferred by senior citizens as they are often on many medications as a result of physical health challenges which may also predispose them to adverse side effects.
Psychologists work independently or in collaboration with other mental health teams to ensure the provision of comprehensive health care service to older persons under the auspices of geropsychology.
Geropsychology is a subfield of psychology devoted to the study of aging and providing mental health services to the aged.
Solutions
It is a glaring fact that aging in Nigeria and other developing countries is quite distressing as aging comes with comorbid physical and psychological problems.
While the physical health issues seem to be somewhat receiving attention, the psychological problems suffered by the senior citizens are very often ignored.
Psychotherapy is an effective treatment method used by psychologists to manage mental health issues in older adults and is often preferred over medications.
It is recommended that the government, family members, and significant others associated with the older persons should provide the necessary support as well as ensure that they have access to mental health services in order to age gracefully.
Benita Dooshima Aki is a Clinical Psychologist and Mental Health Advocate
Whatsapp: +2348187780299 Email: [email protected]
