Improving mental health for older Vermonters saves lives and money

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Today marks National Older Adult Mental Health Awareness Day, creating an opportunity to raise recognition in our communities around the importance of supporting older Vermonters in maintaining good mental health.

Twenty years ago, a one-year experiment concluded, and it was deemed a success. The year prior, $15,000 of state funds were allocated to purchase mental health expertise from Northeast Kingdom Human Service. This fortuitous collaboration was intended to fill a gap in services to some of the area's most vulnerable citizens—homebound older Vermonters with mental health needs. Interested parties followed the experiment, and at the conclusion of the trial year, the Vermont State Legislature set aside a small sum of money to fund a continuation of the project throughout the state. The Eldercare program - as it is known, was born, and although underfunded, remains active in most counties in Vermont today.

These services make a real difference in people's lives. Take the story of Frida for example, based on a real-life case study of a client. Frida was referred to an eldercare clinician after overdosing on pain medication to escape her physical and emotional pain. She had a history of trauma and long-term physical abuse, and had tried drinking to relieve her suffering. Frida was depressed, anxious, ashamed and angry with herself as her doctor would no longer prescribe pain medication due to the overdose. Frida lived in a rural setting, was estranged from her family and had no peer supports. With the support of the clinician who met with her, Frida worked on mindfulness techniques to assist her in coping with chronic pain. She also learned to think about her experiences in new ways which were less painful. The clinician taught Frida to offer herself support and self-compassion, and to focus on her strengths and capabilities. Frida adopted a dog who became her constant companion, bought herself a computer, and subscribed to the Boston Globe. She also joined a church where she did public speaking. She became interested in the world rather than focusing on her pain level. Ultimately, she became a part of her family again. At the conclusion of her treatment she told the clinician who worked with her, "I have learned not to focus on the pain and bad memories. Now I focus on all that is in my life and I feel grateful."

With a growing population of older Vermonters comes a greater demand for these critical mental health services. There are various reasons for this: some older citizens experience a loss of roles, a sense of purpose, or increased isolation - or a combination of all these factors. Others lose supports through moves or death which causes grief to mount.

Some older Vermonters experience significant changes in functioning and health which can lead to anxiety, depression, mood dysregulation and grief. Individuals with breathing disorders often experience considerable levels of anxiety, especially upon exertion. Studies also show that physical disability and illness can trigger mental health disorders and mental health disorders can lead to worsening physical health. Loss of mobility, chronic pain, the onset of Parkinson's disease, dementias, complications of diabetes, strokes, and vision and hearing loss can demand big adjustments that older folks may need assistance making.

Currently, the specialized knowledge needed to begin to adequately address the intertwined mental and physical health needs of our older neighbors is limited, yet growing. Programs and funding to expand mental health care for this population are sorely needed, including the need to support family caregivers in Vermont who shoulder most of the load for older Vermonters who have experienced disabling conditions. Ultimately, proper treatment of mental health concerns for our older citizens will not only improve the overall health of this state, but will also bring down health care costs.

Cinda Donton is an eldercare clinician with the Southwestern Vermont Council on Aging.

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