June 12, 2024 • 17 mins
Today we're diving deep into a topic that affects many older adults but is often misunderstood: depression and anxiety.
While these mental health conditions are prevalent among older adults, they are not a normal part of aging and deserve our attention and care.
Episode Highlights:
- Understanding Depression and Anxiety in Older Adults:
- Depression and anxiety are prevalent but not normal aspects of aging.
- These conditions need to be recognized and treated to prevent serious health impacts
- Effective Treatments Available:
- A combination of medications and psychotherapies can effectively treat anxiety and depression in older adults.
- Encouraging older adults to seek help can significantly improve their quality of life.
- Impact of Untreated Mental Health Conditions:
- Untreated depression and anxiety can worsen medical conditions, increase hospital stays, and lead to more functional impairments.
- The importance of addressing mental health to improve both psychological and physical well-being.
- Identifying Symptoms of Depression (SIGECAPS):
- Sleep: Changes in sleep patterns.
- Interest: Loss of interest in activities.
- Guilt/Despair: Feelings of hopelessness.
- Energy: Decreased energy levels.
- Concentration: Difficulty concentrating.
- Appetite: Changes in appetite.
- Psychomotor changes: Agitation or slowing down.
- Social isolation: Withdrawing from social interactions.
- Signs of Anxiety in Older Adults:
- Excessive worry, fear, and a sense of doom.
- Avoiding daily routines and social situations.
- Physical symptoms like a racing heart, shallow breathing, and muscle tension.
- Encouraging Medical Evaluation:
- Symptoms of depression and anxiety can also indicate medical problems or medication side effects.
- Starting with a primary care provider to rule out physical health issues is crucial.
- The Five D's of Suicide Risk:
- Depression
- Disability
- Disconnectedness
- Disease
- Deadly means
- Understanding these risk factors helps us intervene and provide the necessary support.
- Fostering Hope and Connection:
- Social engagement, cultivating meaning and purpose, and reflecting on past resilience are key protective factors against depression and anxiety.
- Respecting the autonomy and wishes of older adults in their mental health journey is essential.
Connect with Me:
- Visit my website: www.drreginakoepp.com
- Follow me on social media: Facebook | Twitter | LinkedIn
- Subscribe to the podcast for more insights on mental health and aging!
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
When asked, what are the mostimportant things to know about
(00:03):
anxiety and depression for olderadults.
Here's what I would say.
First is that while anxiety anddepression are some of the most
common mental health conditionsamong older adults, anxiety and
depression are not normal withaging and really deserve to be
investigated if, if older adultsare demonstrating signs of
(00:27):
anxiety and depression.
We know that there are actuallyvery good treatments for anxiety
and depression.
It can include a combination ofmedications like antidepressant
medications and psychotherapies.
And so it's really important ifyou're Noticing signs and
symptoms of anxiety anddepression among older adults
(00:49):
that you encourage the olderadult to get checked out, and
we'll talk about that in aminute.
Another important thing I wouldsay about anxiety and depression
is that when mental healthconditions go unrecognized and
untreated in older adults, itactually can have a huge impact
on the health and wellbeing ofthe older adult and not just
(01:12):
psychological health andwellbeing.
But physical health andwellbeing as well.
We know that when mental healthconditions go unrecognized and
untreated among older adults,this can result in worsening of
medical problems, the need formore medications for their
medical problems, longerhospital stays when somebody's
medically hospitalized for amedical condition, more family
(01:37):
strain because the caregivingneeds are higher.
more functional impairments,meaning that the person needs
assistance with ADLs and IADLs,like dressing and toileting or
transportation, and thenneedless suffering and caregiver
stress and strain, finallyincreased risk for suicide.
(01:59):
So it's really important that ifyou suspect the person might be
experiencing anxiety ordepression, that you Encourage
them to get an evaluation withtheir primary care provider.
Sometimes symptoms of anxietyand depression, especially in
older adults, can be a symptomof a medical problem, can be a
(02:21):
symptom of a medication sideeffect, can be a symptom of a
medication interaction.
So when you're taking multiplemedications, how those
medications interact, and somany other things that might
actually be treated with medicalintervention alone.
If you're noticing changes inyour older clients, encourage
the older person to start withtheir primary care provider to
(02:43):
make sure all of theirhealthcare, medical healthcare
needs are addressed.
Okay, so what are the signs andsymptoms of depression?
I like to use an acronym.
The acronym is called SIGECAPS,S I G E C A P S.
And so what does this stand for?
The first is sleep.
(03:04):
Are there changes to theperson's sleep?
Are they sleeping too much ortoo little?
Has their sleep changedsignificantly in recent months?
I is interest.
Has the person lost interest inactivities they used to enjoy?
Have they stopped going to thesenior center?
Have they stopped participatingin their book club or volunteer
organizations?
(03:25):
Are they not having as manyphone calls with beloved family
members?
Those are signs that the personhas lost interest in things that
they used to enjoy.
G.
G stands for guilt, but in olderadults, I interpret this as
despair.
So despair can mean the completeloss or absence of hope, that
(03:46):
there's sort of a sense of doomand no purpose to go on living.
So instead of guilt, I look fordespair.
Then E is energy.
Have they lost the energy thatthey used to have?
Are they taking more naps thanusual?
This gets a little tricky amongolder adults because sometimes
as people, especially much laterin their older adulthood, like
(04:09):
90s and 100s, might need morerest time.
C is concentration.
Are they noticing changes totheir memory where in recent
weeks or months they feltmasterful.
A is appetite.
Are they eating more or lessthan they had been a couple of
weeks ago?
P are changes to their bodilymovements.
(04:31):
So it's psychomotor agitation.
Like are they restless?
and can't sit still, and maybeeven they're fidgeting when
they're talking with you, andit's not a result of
Parkinsonism or Parkinson'sdisease or another movement
disorder, or are they unusuallystill, so the opposite?
So are they blunted?
(04:51):
Are they really flat?
Are they not moving at all?
And then, S is, are theyisolating socially?
And so are they withdrawing fromsocial relationships and family
relationships that they used toreally enjoy?
So all of those symptoms aresomething to be mindful of.
Another ingredient of depressionto be mindful of among older
(05:13):
adults is that sometimes, Theperson might describe more
physical sensations and changesin their body than they will in
their psyche.
Like, instead of saying, I'm indespair, people don't tend to
use that word, they might say, Ijust don't feel good.
I'm fatigued.
I'm tired.
(05:34):
I don't have energy.
I just don't feel good in mybody.
I feel really uncomfortable.
I feel like something bad isgoing to happen.
I don't feel like myself.
I'm having a lot of GI upset orstomach upset or more chronic
pain.
And so this is why, as Imentioned earlier, it's really
helpful to encourage the personto get checked out with their
(05:55):
medical provider, their primarycare provider first because we
want to be sure we're addressingall the physical health needs in
addition to the mental healthneeds, but it will help us to
clarify it.
where the mental health needsare coming from.
Is it coming from a medicalcondition that needs care or
vitamin deficiency or amedication or a medication
(06:16):
interaction that can be changed?
Or is it coming from adepression disorder?
The good news about depressivedisorders among older adults is
that they're as treatable inolder adults as they are in
other age groups.
So it's really helpful andimportant to encourage them to
get checked out and thentreated.
Okay, so what are the signs ofanxiety in older adults?
(06:39):
The first is excessive worry orfear, sense of doom, a sense of
what's going to happen.
I don't know what's going tohappen.
What if it doesn't happen?
Another is refusing to do dailyroutines or being very rigid and
preoccupied with routines.
As you're noticing in theseconditions, people can fall on
(06:59):
either pole, either they'reeating too much or too little,
sleeping too much or too little,being rigid or avoidant
altogether.
Another is avoiding socialsituations or being preoccupied
with safety.
I work with many older adultswho use assistive devices like a
wheelchair or a cane.
And there can be fear like, whatif I fall?
(07:22):
Who will help me?
And so there's a fear about whatwill happen and needing to
maintain safety and integrity ofself.
Like you don't want to fall andget hurt.
And so then.
Avoid the situation and stayinside to avoid going out with
the possibility of falling andthen being stuck Racing heart,
shallow breathing, trembling,being revved up inside, feeling
(07:46):
a little restless.
Those can also be signs ofanxiety.
Here, again, the tricky thingis, they could be signs of a
medical condition as well.
So, again, with anxiety, westart with the primary care
provider.
More symptoms include poorsleep, as you can imagine if
you've ever been anxious and youhave those racing thoughts all
night long, and things likemuscle tension or feeling tense
(08:08):
and rigid and, unwell or, focuson pain and GI upset.
Again, those physical symptomsespecially the person's
experiencing racing heart orshallow breathing and it's due
to anxiety that can get veryscary if they also have a health
condition or a lung condition,or a pain condition.
(08:29):
And so, it's really importantthat you're encouraging them to
connect with their primary careprovider and then hopefully from
there, also a mental healthprovider because anxiety is also
treatable among older adults.
When anxiety goes untreatedamong older adults, This can
actually increase risk fordementia disorders, so we really
(08:50):
want to encourage older adultsto get connected to primary care
provider and to mental healthcare when they're demonstrating
mental health concerns.
The tricky thing with olderadults is that as we age, our
bodies become more vulnerable tomedical problems and conditions.
And we know that when people arediagnosed with a medical
(09:12):
condition, the rates ofdepression, And anxiety go up.
We also know that when peopleexperience functional
impairments, like they needassistance with transportation
or bathing and grooming andeating, rates of depression and
anxiety go up.
So what's really important toknow here is that a person often
can experience both.
(09:33):
They can experience a medicalproblem and a depression and
anxiety or anxiety, theirmedical problem and the
depression and anxiety eachdeserve attention and care.
Here's another strategy I wantto give you when working with
older adults who may bedepressed.
It's called the five D's ofsuicide risk.
(09:53):
This was developed by Dr.
Yates Conwell out of Universityof Rochester.
He and colleagues came up withthis five D's of suicide risk.
So the five D's are depression,disability.
So disability includesfunctional impairment, like
needing assistance withtransportation, bathing,
dressing.
grooming, toileting, preparingmeals, disconnectedness, so are
(10:17):
they not connecting with friendsor family or a community
disease.
So disease including conditionslike dementia disorders.
So a new diagnosis of a dementiadisorder, Parkinson's disease,
and other health conditions alsocan increase the risk of
suicide.
(10:38):
And finally, deadly means likestockpiling medications or
weapons, et cetera.
Those are the five D's ofsuicide risk.
If older adults are endorsingeach one of those, their risk
for suicide is higher.
And why this is so important isthat white men, 85 and older,
have the highest rate of suicidemore than any other age group.
(11:01):
The other reason it's importantto know these five D's is that
we can intervene in each ofthese areas to lower the risk of
suicide.
So we can intervene withdepression, it's treatable.
We can intervene withdisability.
We can provide supports in thehome to help the person function
and maintain independence aslong as possible.
(11:23):
We can intervene withdisconnectedness.
Meaning that we can encouragesocial participation, home based
primary care programs can behelpful with that, senior
communities can be very helpfulwith that.
We can intervene with disease,so we can be sure that we're
encouraging the older adult tooptimize their medical care so
that their health is asoptimized as possible.
(11:45):
And then finally, we canintervene with deadly means,
meaning that we can remove gunsfrom the home, talk with family
and friends to help, withdisseminating medication so that
the person's not stockpiling it,et cetera.
So knowing these risk factors isreally, really helpful.
So that we know where we canintervene.
(12:05):
Of course, there are additionalrisk factors like substance use
and chronic pain that alsoincrease the risk.
So those need to be attended toas well.
But these five D's of suiciderisk are really key.
Knowing these five D's and thatwe can intervene to improve the
quality of life of the olderperson can possibly help to
inspire hope for that personwhat helps to protect people
(12:29):
from depression and anxiety andsuicide in the first place.
Social engagement is reallyimportant.
Making sure that the person hasoptimal health care is also very
important.
Making sure that the personunderstands their medical
condition to the extent thatthey want to.
And that their mental healthcare is taken seriously.
(12:52):
I've worked with many people whomay be bed bound or, have other
limitations and are not able togo out into the community in
terms of being as social as theywould like to be.
And so we work together onidentifying what else brings the
person a sense of meaning andpurpose in their life.
Another protective factor ishelping the older person to
(13:13):
think back over the course oftheir life when they moved
through hardship.
And what about them?
What did they use internallythat got them through previous
hardships in their life in thepast?
And so those are three thingsthat could be helpful in helping
to foster some protectivefactors for older adults.
So one is social connection.
(13:34):
Two is developing andcultivating a sense of meaning
and purpose in your life.
And three is reflecting on othertimes in your life that you
moved through hardship and howyou got through them.
So how can we have betterconversations that de stigmatize
mental health for older adultsand encourage care?
When it comes to having betterconversations that de stigmatize
(13:55):
mental health and substance usetreatment for older adults, I
first start with the spirit withwhich I'm approaching this
conversation and this work.
So inside of myself, I trulybelieve in my core that every
person at every age with everyability is worthy.
(14:17):
Of healing and transformationand love, and that there is no
expiration date on this process.
And so when I'm havingconversations with people about
mental health I approach theconversation with that spirit
and that spirit, which comesfrom inside of myself holds that
(14:38):
we are human and that we are inthis together and that you don't
have to do it alone.
And that there is hope for amore peaceful tomorrow.
You might not be able to removemedical illness.
But we can help people to find agreater sense of peace and
belonging and hope for a bettertomorrow for themselves.
(14:59):
And so that's sort of how Iapproach these, the spirit with
which I approach theseconversations.
The other is to really.
Respect the person's autonomy.
What do they really want?
I think often with older adults,we project our wish onto them
and it sometimes doesn't matchwhat they want for their life.
And so to really be curious.
(15:21):
about what the person wants fortheir own health?
What are they actually seekingin terms of what they need for
addressing their mental healthconcerns?
Do they need more informationabout their medical condition?
Do they need more support in thehome?
Do they need mental health careand to speak with a doctor?
And so, really to get curiousabout what the person needs and
(15:43):
wants, and what they want theirlife to look like, and what they
want their their life toinclude.
It is a beautiful thing to be onthe journey with anybody.
You have to do that in a waythat doesn't infantilize, that
doesn't condescend, thatsupports, that is curious and is
(16:03):
a supportive presence and guide.
When asked, what are the mostimportant things to know about
(00:03):
anxiety and depression for olderadults.
Here's what I would say.
First is that while anxiety anddepression are some of the most
common mental health conditionsamong older adults, anxiety and
depression are not normal withaging and really deserve to be
investigated if, if older adultsare demonstrating signs of
(00:27):
anxiety and depression.
We know that there are actuallyvery good treatments for anxiety
and depression.
It can include a combination ofmedications like antidepressant
medications and psychotherapies.
And so it's really important ifyou're Noticing signs and
symptoms of anxiety anddepression among older adults
(00:49):
that you encourage the olderadult to get checked out, and
we'll talk about that in aminute.
Another important thing I wouldsay about anxiety and depression
is that when mental healthconditions go unrecognized and
untreated in older adults, itactually can have a huge impact
on the health and wellbeing ofthe older adult and not just
(01:12):
psychological health andwellbeing.
But physical health andwellbeing as well.
We know that when mental healthconditions go unrecognized and
untreated among older adults,this can result in worsening of
medical problems, the need formore medications for their
medical problems, longerhospital stays when somebody's
medically hospitalized for amedical condition, more family
(01:37):
strain because the caregivingneeds are higher.
more functional impairments,meaning that the person needs
assistance with ADLs and IADLs,like dressing and toileting or
transportation, and thenneedless suffering and caregiver
stress and strain, finallyincreased risk for suicide.
(01:59):
So it's really important that ifyou suspect the person might be
experiencing anxiety ordepression, that you Encourage
them to get an evaluation withtheir primary care provider.
Sometimes symptoms of anxietyand depression, especially in
older adults, can be a symptomof a medical problem, can be a
(02:21):
symptom of a medication sideeffect, can be a symptom of a
medication interaction.
So when you're taking multiplemedications, how those
medications interact, and somany other things that might
actually be treated with medicalintervention alone.
If you're noticing changes inyour older clients, encourage
the older person to start withtheir primary care provider to
(02:43):
make sure all of theirhealthcare, medical healthcare
needs are addressed.
Okay, so what are the signs andsymptoms of depression?
I like to use an acronym.
The acronym is called SIGECAPS,S I G E C A P S.
And so what does this stand for?
The first is sleep.
(03:04):
Are there changes to theperson's sleep?
Are they sleeping too much ortoo little?
Has their sleep changedsignificantly in recent months?
I is interest.
Has the person lost interest inactivities they used to enjoy?
Have they stopped going to thesenior center?
Have they stopped participatingin their book club or volunteer
organizations?
(03:25):
Are they not having as manyphone calls with beloved family
members?
Those are signs that the personhas lost interest in things that
they used to enjoy.
G.
G stands for guilt, but in olderadults, I interpret this as
despair.
So despair can mean the completeloss or absence of hope, that
(03:46):
there's sort of a sense of doomand no purpose to go on living.
So instead of guilt, I look fordespair.
Then E is energy.
Have they lost the energy thatthey used to have?
Are they taking more naps thanusual?
This gets a little tricky amongolder adults because sometimes
as people, especially much laterin their older adulthood, like
(04:09):
90s and 100s, might need morerest time.
C is concentration.
Are they noticing changes totheir memory where in recent
weeks or months they feltmasterful.
A is appetite.
Are they eating more or lessthan they had been a couple of
weeks ago?
P are changes to their bodilymovements.
(04:31):
So it's psychomotor agitation.
Like are they restless?
and can't sit still, and maybeeven they're fidgeting when
they're talking with you, andit's not a result of
Parkinsonism or Parkinson'sdisease or another movement
disorder, or are they unusuallystill, so the opposite?
So are they blunted?
(04:51):
Are they really flat?
Are they not moving at all?
And then, S is, are theyisolating socially?
And so are they withdrawing fromsocial relationships and family
relationships that they used toreally enjoy?
So all of those symptoms aresomething to be mindful of.
Another ingredient of depressionto be mindful of among older
(05:13):
adults is that sometimes, Theperson might describe more
physical sensations and changesin their body than they will in
their psyche.
Like, instead of saying, I'm indespair, people don't tend to
use that word, they might say, Ijust don't feel good.
I'm fatigued.
I'm tired.
(05:34):
I don't have energy.
I just don't feel good in mybody.
I feel really uncomfortable.
I feel like something bad isgoing to happen.
I don't feel like myself.
I'm having a lot of GI upset orstomach upset or more chronic
pain.
And so this is why, as Imentioned earlier, it's really
helpful to encourage the personto get checked out with their
(05:55):
medical provider, their primarycare provider first because we
want to be sure we're addressingall the physical health needs in
addition to the mental healthneeds, but it will help us to
clarify it.
where the mental health needsare coming from.
Is it coming from a medicalcondition that needs care or
vitamin deficiency or amedication or a medication
(06:16):
interaction that can be changed?
Or is it coming from adepression disorder?
The good news about depressivedisorders among older adults is
that they're as treatable inolder adults as they are in
other age groups.
So it's really helpful andimportant to encourage them to
get checked out and thentreated.
Okay, so what are the signs ofanxiety in older adults?
(06:39):
The first is excessive worry orfear, sense of doom, a sense of
what's going to happen.
I don't know what's going tohappen.
What if it doesn't happen?
Another is refusing to do dailyroutines or being very rigid and
preoccupied with routines.
As you're noticing in theseconditions, people can fall on
(06:59):
either pole, either they'reeating too much or too little,
sleeping too much or too little,being rigid or avoidant
altogether.
Another is avoiding socialsituations or being preoccupied
with safety.
I work with many older adultswho use assistive devices like a
wheelchair or a cane.
And there can be fear like, whatif I fall?
(07:22):
Who will help me?
And so there's a fear about whatwill happen and needing to
maintain safety and integrity ofself.
Like you don't want to fall andget hurt.
And so then.
Avoid the situation and stayinside to avoid going out with
the possibility of falling andthen being stuck Racing heart,
shallow breathing, trembling,being revved up inside, feeling
(07:46):
a little restless.
Those can also be signs ofanxiety.
Here, again, the tricky thingis, they could be signs of a
medical condition as well.
So, again, with anxiety, westart with the primary care
provider.
More symptoms include poorsleep, as you can imagine if
you've ever been anxious and youhave those racing thoughts all
night long, and things likemuscle tension or feeling tense
(08:08):
and rigid and, unwell or, focuson pain and GI upset.
Again, those physical symptomsespecially the person's
experiencing racing heart orshallow breathing and it's due
to anxiety that can get veryscary if they also have a health
condition or a lung condition,or a pain condition.
(08:29):
And so, it's really importantthat you're encouraging them to
connect with their primary careprovider and then hopefully from
there, also a mental healthprovider because anxiety is also
treatable among older adults.
When anxiety goes untreatedamong older adults, This can
actually increase risk fordementia disorders, so we really
(08:50):
want to encourage older adultsto get connected to primary care
provider and to mental healthcare when they're demonstrating
mental health concerns.
The tricky thing with olderadults is that as we age, our
bodies become more vulnerable tomedical problems and conditions.
And we know that when people arediagnosed with a medical
(09:12):
condition, the rates ofdepression, And anxiety go up.
We also know that when peopleexperience functional
impairments, like they needassistance with transportation
or bathing and grooming andeating, rates of depression and
anxiety go up.
So what's really important toknow here is that a person often
can experience both.
(09:33):
They can experience a medicalproblem and a depression and
anxiety or anxiety, theirmedical problem and the
depression and anxiety eachdeserve attention and care.
Here's another strategy I wantto give you when working with
older adults who may bedepressed.
It's called the five D's ofsuicide risk.
(09:53):
This was developed by Dr.
Yates Conwell out of Universityof Rochester.
He and colleagues came up withthis five D's of suicide risk.
So the five D's are depression,disability.
So disability includesfunctional impairment, like
needing assistance withtransportation, bathing,
dressing.
grooming, toileting, preparingmeals, disconnectedness, so are
(10:17):
they not connecting with friendsor family or a community
disease.
So disease including conditionslike dementia disorders.
So a new diagnosis of a dementiadisorder, Parkinson's disease,
and other health conditions alsocan increase the risk of
suicide.
(10:38):
And finally, deadly means likestockpiling medications or
weapons, et cetera.
Those are the five D's ofsuicide risk.
If older adults are endorsingeach one of those, their risk
for suicide is higher.
And why this is so important isthat white men, 85 and older,
have the highest rate of suicidemore than any other age group.
(11:01):
The other reason it's importantto know these five D's is that
we can intervene in each ofthese areas to lower the risk of
suicide.
So we can intervene withdepression, it's treatable.
We can intervene withdisability.
We can provide supports in thehome to help the person function
and maintain independence aslong as possible.
(11:23):
We can intervene withdisconnectedness.
Meaning that we can encouragesocial participation, home based
primary care programs can behelpful with that, senior
communities can be very helpfulwith that.
We can intervene with disease,so we can be sure that we're
encouraging the older adult tooptimize their medical care so
that their health is asoptimized as possible.
(11:45):
And then finally, we canintervene with deadly means,
meaning that we can remove gunsfrom the home, talk with family
and friends to help, withdisseminating medication so that
the person's not stockpiling it,et cetera.
So knowing these risk factors isreally, really helpful.
So that we know where we canintervene.
(12:05):
Of course, there are additionalrisk factors like substance use
and chronic pain that alsoincrease the risk.
So those need to be attended toas well.
But these five D's of suiciderisk are really key.
Knowing these five D's and thatwe can intervene to improve the
quality of life of the olderperson can possibly help to
inspire hope for that personwhat helps to protect people
(12:29):
from depression and anxiety andsuicide in the first place.
Social engagement is reallyimportant.
Making sure that the person hasoptimal health care is also very
important.
Making sure that the personunderstands their medical
condition to the extent thatthey want to.
And that their mental healthcare is taken seriously.
(12:52):
I've worked with many people whomay be bed bound or, have other
limitations and are not able togo out into the community in
terms of being as social as theywould like to be.
And so we work together onidentifying what else brings the
person a sense of meaning andpurpose in their life.
Another protective factor ishelping the older person to
(13:13):
think back over the course oftheir life when they moved
through hardship.
And what about them?
What did they use internallythat got them through previous
hardships in their life in thepast?
And so those are three thingsthat could be helpful in helping
to foster some protectivefactors for older adults.
So one is social connection.
(13:34):
Two is developing andcultivating a sense of meaning
and purpose in your life.
And three is reflecting on othertimes in your life that you
moved through hardship and howyou got through them.
So how can we have betterconversations that de stigmatize
mental health for older adultsand encourage care?
When it comes to having betterconversations that de stigmatize
(13:55):
mental health and substance usetreatment for older adults, I
first start with the spirit withwhich I'm approaching this
conversation and this work.
So inside of myself, I trulybelieve in my core that every
person at every age with everyability is worthy.
(14:17):
Of healing and transformationand love, and that there is no
expiration date on this process.
And so when I'm havingconversations with people about
mental health I approach theconversation with that spirit
and that spirit, which comesfrom inside of myself holds that
(14:38):
we are human and that we are inthis together and that you don't
have to do it alone.
And that there is hope for amore peaceful tomorrow.
You might not be able to removemedical illness.
But we can help people to find agreater sense of peace and
belonging and hope for a bettertomorrow for themselves.
(14:59):
And so that's sort of how Iapproach these, the spirit with
which I approach theseconversations.
The other is to really.
Respect the person's autonomy.
What do they really want?
I think often with older adults,we project our wish onto them
and it sometimes doesn't matchwhat they want for their life.
And so to really be curious.
(15:21):
about what the person wants fortheir own health?
What are they actually seekingin terms of what they need for
addressing their mental healthconcerns?
Do they need more informationabout their medical condition?
Do they need more support in thehome?
Do they need mental health careand to speak with a doctor?
And so, really to get curiousabout what the person needs and
(15:43):
wants, and what they want theirlife to look like, and what they
want their their life toinclude.
It is a beautiful thing to be onthe journey with anybody.
You have to do that in a waythat doesn't infantilize, that
doesn't condescend, thatsupports, that is curious and is
(16:03):
a supportive presence and guide.
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