Promoting Mental health of Elderly

Mental health Promotion of the elderly may be defined as, “the process of enhancing the capacity of individuals and communities to take control over their lives and improve their mental health.”

Respect for culture, equality, social justice, interconnectivity, and personal dignity are at the heart of mental health promotion initiatives, along with a focus on building resilience and following best practice recommendations for mental health promotion programs. Methods that furnish the elderly with the means to satisfy their most fundamental need, such as:

• Providing security and freedom
• Adequate housing through supportive housing policy;
• Social support for elderly populations and their caregivers;
• Health and social programs are targeted at vulnerable groups such as those who live alone, in rural populations, or who suffer from a chronic or relapsing mental or physical illness.
• Violence or older adults maltreatment prevention programs; and
• Commonly development programs.

The goals of mental health promotion are to:

• To increase resilience and protective factors
• To decrease risk factors
• To reduce inequities.

Guidelines for improving mental health in elderly (Adapted from Practice Guideline for mental health promotion, Center for addiction and mental health, 2010)

Guideline 1: identify and address a specific population for the program/initiative by

• Determining a particular population’s needs (considering all aspects of mental and physical health)
• Considering the life transition specific to the population
• Identifying how, when and where the specified population can be reached
• Planning for ways to ensure the participation of the specified population in all aspects of program planning, development, and evaluation.

Examples of specific populations include older adults who are recently bereaved older adults living in poverty, visible minorities, older adults with a low level of education older adults with chronic diseases, and employees nearing retirement.

Guideline 2: Address and modify risk and protective factors, including determinants of health, that indicate possible mental health concerns for older people by

• Identifying relevant protective factors, risk factors, and determinants of health
• Assessing which factors and health determinants can be modified
• Developing a plan to enhance the protective factors, reduce the risk factors and influence the determinants of health relevant to the target population.

Examples of protective factors:

 Self-esteem, resilience, coping skills, social support, healthy lifestyle, access to support services, and positive health status.

Examples of risk factors include:

Stressful life events, loss of social roles and of self-esteem, acute or chronic physical illness, limited or no social support, isolation, depression, problematic substance use, and language barriers.

Examples of determinants of health include:

Housing, employment and working conditions, income

Guidelines 3: Intervene in multiple settings by

• Considering all aspects of the setting or environment that affect older adults
• Developing strategies to intervene in various settings
• Promoting and supporting independence
• Assessing and addressing accessibility issues
• Looking at how older adults use space and how this affects their mental health
• Aiming to improve and develop the overall physical and social environment of the setting.

Examples of settings:

Private homes, workplaces, retirement and long-term care homes, community settings, neighborhoods, city districts, and health services.

Guidelines 4: Support professionals and Nonprofessionals in establishing caring and trusting relationships with older people by

• Providing training in aging and age-related transitions
• Providing information and training about mental health and substance use problems
• Raising awareness about stigma and discrimination related to aging(ageism) as well as that associated with mental and substance use problems
• Involving and training older adults to be peer supports and educators where appropriate.

Guidelines 5: Provide a focus on employment and resilience by

• Providing skills training to older adults in Self-esteem, feeling management, social communication, physical activity, nutrition, memory enhancement strategies
• Advocacy and self-advocacy
• Providing skills training to family members, other caregivers, and peers
• Dealing with clients’ feelings in a respectful and dignified manner
• Enhancing active participation
• Promoting access to information
• Promoting lifelong learning, including literacy, for older adults through the education sector.

Guideline 6: Provide comprehensive support systems by

• Facilitating the development or improvement of a strong support network for older adults, including emotional, social, and physical support through community services, health services, and tangible assistance such as financial support and transportation.
• Facilitating networking and collaboration between services and organizations
• Making a comprehensive support system accessible

Examples include:

Counseling reassurance and sympathetic listening, friendly visiting programs, intergenerational programs, promoting caring and supportive relationships with family, friends, and service providers, accessible transportation networks, shopping, meals on wheels, financial services, etc

Guideline 7: adopt multiple interventions by

• Planning a comprehensive approach using multiple strategies, which include identifying gaps and-and barriers in services, building healthy public policy, creating supportive environments, strengthening community action, developing personal skills, reorientation health services, and developing and building new social networks.
• Using strategies to reach multiple audiences in formats appropriate to their needs and preferences.
• Using strategies that reinforce each other to reach a common goal
• Using a range of strategies such as outreach, home visiting, active lifestyle programs, empowerment, participation, and lifelong learning.

Examples of intervention include: Community social events, caregivers support groups, self-help groups to help older people handle stressful life events, skill-building workshops, workplace policy, community engagement, programs for older adults in libraries and other community settings, intergenerational activities, home visits, telephone counseling, train the trainer models

Guidelines 8: Ensure that information and services provided are culturally appropriate, equitable, and holistic by:

• Considering the person as a whole and taking into account the physical, emotional l, spiritual, religious, mental, and social factors that affect his or her mental health.
• Facilitating access for older adults to culturally relevant supportive social networks.
• Providing relevant information such as printed materials in an understandable and culturally appropriate manner.
• Facilitating participation from minority groups
• Directly addressing the needs of socially disadvantaged people
• Understanding the impact of stigma and working toward its elimination

Guideline 9 Involve multiple stakeholders by:

• Engaging with multiple sectors (e.g. education, public health, medical services, government, community, recreation, housing, financing, transportation)
• Connecting different players at all levels
• Involving different manners of the care team
• Enabling members of the target population to be involved in the planning and decision-making
• Achieving a joint vision for mental health promotion among multiple stakeholders.

Examples include: Establishing a periodic retreat or planning day with specific client groups, establishing and maintaining ongoing partnerships with community members, coalitions, and networks, including many stakeholders on programs advisory committees and community councils, providing transportation and paying honoraria for participant's time, making meetings accessible to older persons

Guidelines 10: Address opportunities for organizational change, policy development and advocacy by

• Mobilizing people over 55 to be advocates for themselves and others
• Being aware of and monitoring upcoming legislation and government initiatives to identifying and influence change that incorporates a mental health promotion approach
• Implementing client and/or staff surveys to assess the organizational climate of an agency
• Working with community members, with agency management and staff and with older adults themselves to create a health-promoting community and workplace
• Giving community members and older people opportunities to voice issues and engage in dialogue to solve problems.
• Identifying policy initiatives to influence all aspects of community living, including residential settings such as long-term care homes

Examples include an anti-ageism policy, networking, policies that promote healthy communities, advocacy for physical activity in the community, advocacy for green space and gardens, lobbying for legislative changes, advocating that the education system provides opportunities for lifelong learning.

Guideline 11 Demonstrate a long-term commitment to program planning, Development and evaluation by

• Conducting a situational assessment to inform the design of initiatives, taking into account the diversity of the population and their strengths and assets
• Clearly defining for whom the mental health promotion programs, interventions and policies are intended
• Involving members of the intended population in program design and implementation
• Ensuring that the length and intensity of the intervention are appropriate for the population of concern and will achieve the intended outcomes.
• Continually data collection methods and mechanisms are in place
• Outlining an evaluation process that states outcomes clearly and considers outcome and process indicators
• Drawing on a variety of disciplines
• Reviewing and using successful research-based programs, interventions, and policies

Examples

Monitoring systems to assess information on mental health assets and strengths as well as difficulties for older individuals Outcome and process indicators in mental health promotion Logic models for programs and evaluation plans Community advisory committees involved in designing and evaluating programs