We need some better answers

Last week I spent a fair bit of time thinking about the mental health of older people.

It started when I supported Lucy, a colleague, to put the finishing touches to the new Reablement Service project page on this website. She talked to me a bit about the project. ‘Mainly I’m working with older people with long term conditions. They are having their physical health issues addressed in lots of ways, but the impact on their mental health is less obvious sometimes, and gets forgotten. Often experiences in hospital have left them confused, upset and traumatised. Other older people just need someone to talk to about how they are feeling’.

Co-incidentally in the same week I had an honest and heart breaking conversation with my Grandad. My Grandad Harry is 83 and by most people’s standards he lives a comfortable life. He has my Grandma, close family nearby and no real money worries. Following a series of physical health problems over the last few years I had noticed Grandad Harry becoming more withdrawn and depressed. He was often emotional or angry and he had lost his confidence. He didn’t trust his legs or his balance and the psychological effect this had on him was becoming significant.

This changed when Harry was referred for physiotherapy sessions, and following successful therapy his name was put forward for a new older person’s group in the hospital. This group met twice weekly and they had guest speakers giving them information about issues that were relevant to them, from crime prevention to how to choose the right shoes to prevent falling over. Then they did a session of exercise and physiotherapy together. Grandad Harry loved this group. He talked to me last week about the benefits of attending. This ranged from the more obvious ‘it got me out of the house on my own’ and ‘it was great meeting new people’ to the slightly less obvious (for me anyway) ‘I had to prove myself to the group, and keep up with the activities, I didn’t want to be the one who dropped the rugby ball or the one who sat down first’ which made sense as he was rugby player in his youth. Grandad Harry talked to me about the other people he met, the friends he made and the bond they shared. Then he became upset. The group ended two weeks ago and won’t continue as it was a time limited pilot. Apparently it is hard to find the right old people to get a group like this together. Grandad became emotional when talking about the gap there would now be in his life. He said he already feels less steady on his feet than he did when he was going to his group. He expressed his sadness that they couldn’t find a room, some chairs and tea making facilities for the group to continue. Grandad was more saddened by the fact that ‘everyone in the group wanted to keep meeting up, they were such a great bunch of people’. What struck me was despite the presence of a loving family he was describing himself in a way which I would usually term ‘socially isolated’. Naively It had never occurred to me before that he would benefit so much from peer support.

I did my best to explain. There were four medical staff involved in delivering the group, some of the older people required special transport to get there, and the money and time that this all costs. It was hard to see him upset and it was hard to see him already losing his confidence and motivation. Then I thought about the older people out there who are struggling with the same feelings that my Grandad is, some of whom are much more isolated with less natural support.

As Big Lottery Fund launch a new investment in England that will improve the lives of older people, with the aim to reduce social isolation among this group, there is hope that the issue of older people’s mental health is becoming more of a priority. As an organisation we have many services which support older people, with the reablement project spearheading the way as a local pilot. But we could also be thinking about new ways to engage older people in talking about their mental health so that we don’t make assumptions that we know what is best for them.

I have asked my Grandad to write down his experience of his group, how it helped him to recover and the impact now that it has ended, so that at least his voice can help those people holding the purse strings to understand what is important and what makes a difference.

The Mental Health Foundation estimates that Between 10–16% of people over 65 have depression. An estimated 2–4% have severe depression. The questions about whether we are doing enough to support people in their old age are not new, I think we just need some better answers.

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