The impact of age-related risks and inequalities on mental health in later life

2020 ◽  
pp. 81-104
Author(s):  
Alisoun Milne
Keyword(s):  
Mental Health ◽  
Older People ◽  
Later Life ◽  
Age Discrimination ◽  
Psychological Wellbeing ◽  
Physical And Mental Health ◽  
Care Services ◽  
Age Related ◽  
Indirect Discrimination ◽  
The Impact

In broad terms there are two sets of age-related risks to mental health. The first set are those arising directly from experiences and losses common to later life, including physical ill health and/or disability, being a carer, retirement, and bereavement. These are associated with impaired psychological wellbeing and heightened risk of depression, particularly amongst older people with few economic or social resources. The second set of risks arise from ageism and age discrimination, and their intersection with other types of discrimination such as sexism for older women. Direct and indirect discrimination is widespread; it is located in all areas of society including health and social care services. It is profoundly damaging to older peoples’ psychological wellbeing and is associated with fear, helplessness, low self-esteem, anxiety and depression. It is also linked to exclusion, marginalisation and abuse. In recent years there have been efforts to ensure that older people are overtly included in policies intended to improve the population’s physical and mental health; this includes access to treatments e.g. for depression. There has also been a focus on addressing age discrimination in specific arenas e.g. in employment and mental health services. These initiatives have had mixed success.

Socio-economic disadvantage and poverty

2020 ◽  
pp. 105-114
Author(s):  
Alisoun Milne
Keyword(s):  
Older People ◽  
Later Life ◽  
Poverty Line ◽  
Developed Countries ◽  
Economic Disadvantage ◽  
Fundamental Building Block ◽  
Age Related ◽  
The Uk ◽  
State Pension ◽  
The Impact

Chapter 5 is the first of three chapters exploring the impact of age related risks affecting particular sub populations of older people. Socioeconomic disadvantage in later life tends to reflect a lifecourse status. It amplifies what is already present. In 2016/17 one million older people were living in poverty; an additional 1.2 million were living just above the poverty line. These numbers are rising. Those aged 85 years or over, frail older people, older women and single older people are particularly at risk. Poor older people are also more likely to live in poor housing and be exposed to fuel poverty. Being poor - and its concomitants - compromises mental health in a number of profound ways. It undermines an older person’s capacity to make choices, retain independence, save for a crisis, maintain social contacts and be digitally included. It is linked with worry, loss of control over life and shame. Poor older people are at heightened risk of isolation and loneliness, stress, anxiety and depression. The UK has a weak policy record, compared with other developed countries, of sustainably and coherently addressing poverty in later life. One of the cornerstones of doing so is a continued commitment to the basic state pension as a fundamental building block of a secure old age. Addressing poor housing is also pivotal.

Mental Health in Later Life

2020 ◽  
Author(s):  
Alisoun Milne
Keyword(s):  
Mental Health ◽  
Older People ◽  
Life Course ◽  
Mental Health Problems ◽  
Later Life ◽  
Health Issues ◽  
Mental Health Issues ◽  
Age Related ◽  
Health And Social Care ◽  
Life Course Studies

Focusing on mental health rather than mental illness, this book adopts a life course approach to understanding mental health and wellbeing in later life. Drawing together material from the fields of sociology, psychology, critical social gerontology, the mental health field, and life course studies, it analyses the meaning and determinants of mental health amongst older populations and offers a critical review of existing discourse. The book explores the intersecting influences of lifecourse experiences, social and structural inequalities, socio-political context, history, gender and age-related factors and demands an approach to prevention and resolution that appreciates the embedded, complex and multi-faceted nature of threats to mental health and ways to protect it. It foregrounds engagement with the perspectives and lived experiences of older people, including people living with dementia, and makes the case for a paradigmatic shift in conceptualising, exploring and researching mental health issues and supporting older people with mental health problems. The book is essential reading for policy makers, health and social care professionals and students, third sector agencies, researchers and all of those concerned to more effectively and collaboratively address mental health issues in later life.

scholarly journals The Impacts Of Socio-Economic Challenge On Long-Term Physical and Mental Health In Retirement Age

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 1057-1058
Author(s):  
Ilan Kwon ◽  
Sojung Park ◽  
BoRin Kim ◽  
ByeongJu Ryu
Keyword(s):  
Mental Health ◽  
Latent Class Analysis ◽  
Latent Class ◽  
Later Life ◽  
The United States ◽  
Class Analysis ◽  
Physical And Mental Health ◽  
Term Care ◽  
The Impact

Abstract Despite consistent evidence on the negative effect of social and economic challenges on health, little is known about the pattern of economic difficulties people experience and the impact of those challenging patterns on long-term health in later life. This study used the national data, Mid Life in the United States (MIDUS 3 in 2013-2014), to identify the different patterns of socio-economic challenges that older Americans (50-64 ages old) experienced during the Recession in 2008 and to examine the impact of past challenging experiences on physical and mental health in their later life. Socio-economic challenges included twenty-six items such as losing or moving a job, missing rent, selling or losing a home, bankruptcy, having debts, and cutting spending. We conducted the latent class analysis and regression while controlling other social determinant factors (e.g., education, employment status, poverty, etc.). The latent class analysis result found five patterns during the Recession: people who experienced various difficulties during the Recession, who moved their jobs, who experienced financial difficulties, who bought a home with decreased debts, and who experienced no difficulty. Compared to people with no challenging experience, those who needed to move their jobs but could make debt off during the Recession reported physically healthier, but not mentally healthier in later life. Interestingly, among this group, women reported more long-term physical health problems than men. The findings suggest the close connection between physical and mental health and the importance of long-term care for mental health among older adults in recovering from socio-economic challenges.

Visual Hallucinations in Older People: Appraisals but not Content or Phenomenology Influence Distress

2015 ◽  
Vol 44 (6) ◽  
pp. 705-710 ◽  
Author(s):  
Stephanie Lai ◽  
Vicki Bruce ◽  
Daniel Collerton
Keyword(s):  
Mental Health ◽  
Older People ◽  
Later Life ◽  
Structured Interview ◽  
Visual Hallucinations ◽  
Physical And Mental Health ◽  
Younger Adults ◽  
Significant Difference ◽  
High Distress

Background: A previous study (Gauntlett-Gilbert and Kuipers, 2005) has suggested that distress associated with complex visual hallucinations (CVHs) in younger adults with psychosis may more strongly relate to appraisals of meaning than to the content of the hallucination. However, visual hallucinations are most commonly seen in the disorders of later life, where this relationship has not been investigated. Aim: To establish if there is a relationship between appraisals of CVHs and distress in older, non-psychotic people with CVHs. Method: All variables were measured using a semi-structured interview and were compared between a high distress group (n = 16) and a low distress group (n = 19). Results: The high distress group rated their hallucinations as more malevolent and omnipotent, with greater negative implications for physical and mental health. There was no significant difference between groups on ratings of hallucination content (independently rated), frequency, awareness or control. Conclusion: Appraisals of CVHs are linked to distress.

scholarly journals The impact of shielding during the COVID-19 pandemic on mental health: Evidence from the English Longitudinal Study of Ageing

2021 ◽  
Author(s):  
Giorgio Di Gessa ◽  
Debora Price
Keyword(s):  
Mental Health ◽  
Longitudinal Study ◽  
Older People ◽  
Social Contact ◽  
Human Interaction ◽  
Linear Regression Models ◽  
Physical And Mental Health ◽  
The Impact ◽  
English Longitudinal Study ◽  
At Home

Background: During the COVID-19 pandemic, older and clinically vulnerable people were instructed to shield or stay at home to save lives. Policies restricting social contact and human interaction pose a risk to mental health, but we know very little about the impact of shielding and stay at home orders on the mental health of older people. Aims: Understand the extent to which shielding contributes to poorer mental health. Method: Exploiting longitudinal data from Wave 9 (2018/19) and two COVID-19 sub-studies (June/July 2020; November/December 2020) of the English Longitudinal Study of Ageing we use logistic and linear regression models to investigate associations between patterns of shielding during the pandemic and mental health, controlling for socio-demographic characteristics, pre-pandemic physical and mental health, and social isolation measures. Results: By December 2020, 70% of older people were still shielding or staying at home, with 5% shielding throughout the first 9 months of the pandemic. Respondents who shielded experienced worse mental health. Although prior characteristics and lack of social interactions explain some of this association, even controlling for all covariates, those shielding throughout had higher odds of reporting elevated depressive symptoms (OR=1.87, 95%CI=1.22;2.87) and reported lower quality of life (B=-1.28, 95%CI=-2.04;-0.52) than those who neither shielded nor stayed at home. Shielding was also associated with increased anxiety. Conclusions: Shielding itself seems associated with worse mental health among older people, highlighting the need for policymakers to address the mental health needs of those who shielded, both in emerging from the current pandemic and for the future.

Barriers and facilitators to accessing psychological therapies for severe mental health difficulties in later life

2019 ◽  
Vol 48 (2) ◽  
pp. 216-228
Author(s):  
Katherine Berry ◽  
Jennifer Sheardown ◽  
Uma Pabbineedi ◽  
Gillian Haddock ◽  
Catherine Cross ◽  
...  
Keyword(s):  
Mental Health ◽  
Older People ◽  
Health Care Professionals ◽  
Later Life ◽  
Past Research ◽  
Ageing Population ◽  
Attitudinal Barriers ◽  
Psychological Therapies ◽  
Age Related ◽  
Mental Health Difficulties

AbstractBackground:The number of people growing older with severe mental illness (SMI) is rising, reflecting societal trends towards an ageing population. Evidence suggests that older people are less likely to seek help, be referred for and receive psychological therapy compared with younger people, but past research has focused on those with mild to moderate mental health needs.Aims:This research aims to identify the specific barriers faced by older people with SMI.Method:We interviewed 53 participants (22 service users with SMI aged over 50 years, 11 carers of people with SMI, and 20 health care professionals) about their views and experiences of accessing therapy for SMI in later life.Results:Thematic analysis revealed five themes: organizational and resource issues; myths about therapy and attitudinal barriers; stigma; encouraging access to therapy; and meeting age-specific needs.Conclusions:Barriers faced by older people with SMI are not only age-related, but also reflect specific issues associated with having a SMI over many years. Improving awareness of the benefits of psychological therapies is important not only for older people with SMI themselves, but also for their carers and staff who work with them.

scholarly journals Preceived age descrimination in the job search process in later life

2021 ◽  
Author(s):  
Ricardo Twumasi ◽  
Cheryl Haslam
Keyword(s):  
Job Search ◽  
Later Life ◽  
Academic Community ◽  
Age Discrimination ◽  
Search Process ◽  
Job Seekers ◽  
Application Process ◽  
Legislative Change ◽  
Age Related ◽  
The Impact

Purpose - The purpose of this paper is to explore the impact of legislative change to extend working lives and protect against age discrimination on the experiences of older job seekers following a period of economic decline.Design/methodology/approachThe research was informed by two focus groups. The research followed an inductive and iterative approach, interviewing 27 older job seekers to explore the barriers to seeking employment they faced. Themes from these interviews were then used to create a representative case study video to further highlight, share, and educate people on the barriers to employment that older job seekers face, and the strategies they use to overcome them.Findings - Perceived age discrimination, change of identity, motivation and insufficient feedback were identified as significant barriers to finding employment. Social support, coping strategies for identity change and detailed feedback were reported as positive facilitators of the search for work. The findings suggest that older job seekers face significant age related barriers to securing employment, which require age specific support to overcome. A statutory requirement for minimum standards of feedback provided to job applicants may increase transparency, and reduce the prevalence of discrimination in the job application process. Originality/value - This paper adds to the limited literature investigating the psychological impacts of the job search process in light of age related legislative change. With each new protected characteristic there is a lag between change in legislation, and change within employer attitudes and behaviour. This research investigates the impact of legislative change on the identity, morale and strategies of the older job seeker. The case studies from this research may also reach an audience beyond the traditional academic community offering a voice and new audience to the barriers older job seekers face.

Mental health, psychological well-being, successful ageing and quality of life

2020 ◽  
pp. 33-52
Author(s):  
Alisoun Milne
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Older People ◽  
Later Life ◽  
Well Being ◽  
Psychological Wellbeing ◽  
Successful Ageing ◽  
The Core ◽  
Good Mental Health

Positive mental health is a prerequisite for a good quality of life across the whole lifespan. It is an overarching concept, which intersects with a number of related concepts, psychological wellbeing, successful ageing and quality of life. Good mental health is increasingly understood as a combination of an individual’s personality, environment and lifecourse; it is also dynamic. Older people consider it to be characterised by: a sense of wellbeing, capacity to make and sustain relationships, ability to meet the challenges which later life brings, and ability to contribute both economically and socially. Mental health is viewed as equally important as physical health. Research identifies the core dimensions of mental health, and its sister concepts, as: resilience, remaining active and involved, having a purpose or role, being able to engage in social relationships, independence, keeping fit, having an adequate income, autonomy and self-efficacy. Survey evidence consistently shows that more than 85 per cent of older people have ‘good’ quality of life. One of the challenges of assessing and measuring quality of life, and related constructs, is capturing the intersection between the subjective and the objective. The promotion of mental health is increasingly recognised as a legitimate goal of social policy.

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