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Promoting the mental health of older people is becoming an activity of increasing importance. In the incoming decades, there will be an increasing the number of older people. There will be fewer young people and young adults. In the year 2050, 30 percent of the people will be older than 65 years of age, while 11 percent of the people will be 80 years old and above. The word old age has no agreed upon definition. In most countries, people retire at an age of 60 to 65 years. This is considered the age when one becomes an older person. According to the European commission, there are three age groups that older people can be divided into. The first group is older workers from the age of 55 to 64. The second group is older people from the age of 65 to 79 years while the third group is 80 years and above. These older age groups are the most diverse in terms of education, attitudes, family background, social background, hobbies, preferences and political attachments.
Mental health in later life – models and issues
There are six main factors that influence mental health. These are financial security, life span experiences, structural factors such as housing, employment, social support and individual coping skills. The mental health of older people as well as their well-being issues in older people are unique and have a greater relevance to them. Retirement is an issue that has great relevance to people who are 60 to 80 years age. As much as it means relief from responsibilities, retirement also mean a loss of status, less social relationships and a reduced role in life. This age group also suffers from health and physical deterioration, changing the environment from moving their home, loss of financial stability and a loss of sense of belonging.
People who are 80 years and above increasingly lose their friends, family members and spouses. They use their sense of purpose in life and their functional ability deteriorates. These people constantly deal with bereavement, death and the fact that their own life is ending. Not all of those older people are the same. They have different values, life experiences, health, economic status and culture. When planning the promotion of the mental health for older people, all of these factors should be put into consideration.
Continuity through the life course
A person’s continuity through life gives them a positive history filled with experiences. This continuity gives a person a set of values that guides their behaviour. When working with older people who have mental health needs, the strategies used should have a psychosocial and sociological perspective that can support the older people during their transition. Much of the work with older people relies on the continuity through their life. Every person has an internal and external self. In order for one to have a happy and successful old age, one needs to be supported in managing their life with a certain general framework. When it comes to the internal self, people should be allowed to make decisions like they have always done it, maintain their integrity and their self esteem. In the external self, people need to reciprocal relationships, continue in positive roles, preserve social support and compensate for mental and physical losses. Disruption of the internal and external elements is likely to heighten the unhappiness and poor self images of people.
Having links in the past, being meaningfully active, feeling embedded within society and having the ability to continue living a life that coincides with one’s personal beliefs can all contribute to living a successful and happy old age. No underestimation should be made when it comes to the significance of having social relationships and maintaining good mental health for the older people. Important factors that can prevent the risk of depression and social isolation in older people are intimate relationships, reciprocal relationships, quality of ties and the presence of a confidante. These factors should be available both at the community and in care homes.
In society today, there exists a negative and depreciating attitude towards older people. While ageism affects all age groups, it is found to be more profound with older people. Ageism exists in politics, consumerism, media, voluntary life, crime, design, civic life and many other area of life. Age discrimination is an abuse of human rights that causes personal hardship and suffering and economic and cultural problems. It is therefore necessary for politicians to ensure that a change in human rights is implemented for the sake of older people. There must be no tolerance whatsoever to any kind of discrimination. In promoting mental health, it is especially important to ensure that age equality is promoted. Older people have the right to fully participate in the political, social, economic and cultural decision making processes of their societies. To promote respect and understanding between the young and older people, intergenerational activities can be used. Employees who serve the public should also be trained and educated on how to respect and value the older people that they have direct contact with.
In a recent survey carried out by (reference), it was found that 29 percent of people had suffered age discrimination when compared to other kinds of discrimination. This survey also found that by the age of 55 years, age discrimination was twice as likely to have been experiences as opposed to other forms of discrimination. Moreover, it is believed by 30 percent of people that there is more age discrimination today than there was five years ago, and this trend is likely to get worse. This survey also found out that the demographic shift towards a society with older people than younger people will make life worse in terms of education, security, health, living standards and jobs. In fact, one of the respondents from this surveys said that they viewed those who were 70 years old and above to be incapable and incompetent.
On 1st October, 2006, a new law that was enforced by the Employment Equality Regulations came into effect in England, Scotland and Wales. This law protects people from age discrimination in employment, adult employment and training for people from all age groups. However, this new regulation does not provide protection from age discrimination in health care. It is therefore important for carers and social workers to describe their beliefs and values clearly and on a concise manner. Knowing one’s values is an important guide while caring for the older people. To create a common shared vision between the carers and the social workers, it is important that an exercise to clarify their values be carried out. This practice will give the carers and social workers a shared vision and purpose.
Promoting mental health and well being – what might be involved in practice
When working with older people, promoting their mental health should be seen as a part of everyday work and not as a special project. Since the older person might stay in the residential facility for a relatively short time, the activities dome to promote mental health should be both short term and long term. There are seven principles in promoting the mental health of oder people. The first principal is that the target group should be defined and how, when and where they can be reached is identified. The second principal is that the older people should be involved in developing a plan, implementing and evaluating the programmes and opportunities. The third principal is that the health and social needs for the older people should be addressed. The fourth principle is that the older people should be empowered and motivated to take initiatives to ensure their own health and wellbeing. The fifth principle is that barriers that affect the capacity of older people to participate in society should be identified. These barriers are social, economic and political in nature. After identifying these barriers, interventions should be done to overcome them. The sixth principle is that respect should be given to the independence and autonomy of older people. The last principle is that holistic and multi-faced interventions should be made to consider the mental, social and physical needs of older people. The relationship between these needs should also be considered.
Several opportunities for involvement in activities that are meaningful for older people should be provided. Creative activities that older people can participate in are museums, arts, performances, libraries and other cultural events. The personal and social realisation of the older people can be fostered by lifelong learning programmes. Volunteering and community development initiative that older people can participate in can offer an additional form of beneficial participation. This participation will increase the mental health of the older person who is volunteering as well as the people receiving the services.
Healthy lifestyle choices among older people should also be promoted. To have a good quality life, one must have good health. Having good physical health depends on a variety of factors. These factors include lifestyle, genetic makeup, choices, environmental factors and socioeconomic factors. Despite their daily activities being restricted by having a limiting long term illness, many older people consider themselves to be in good health. Adopting a healthy lifestyle can prevent or delay many of the chronic conditions that are found to affect people in their old age. A healthy lifestyle can be adopted by exercise, reducing alcohol intake, eating a balanced healthy diet and avoiding smoking. Aids and adaptations can be provided to help people keep mobile. Positive mental health can be promoted by providing encouragement, information and opportunities for older people to make healthy choices in their lifestyle.
Physical actuivity and exercising opportunities should be provided. By exercising, a person has better physical health, increased psychological benefits, increased mental wellbeing and better functional ability. By engaging in different types of exercise, a person has different benefits to their mood, stress, self-esteem, sleep and alleviating or preventing the symptoms of anxiety and depression. Safe and healthy outdoor and indoor environments should be adopted for older people’s participation.
An important measure in supporting the mental health in older people is enhancing their participation in the community. Older people should be enabled in engaging in the social activities at the wider community or at their residences. Ensuring the social participation of older people can be done by providing them with opportunities for participating in lifelong learning and political, cultural and economic decision making of their community.
Secure and positive relationships that older people have with their relatives, friends or neighbours should be strengthened. These relationships are important because they contribute to good mental health of older people. The wellbeing of an older person can also be positively influenced by having a pet. Access to activities such as spiritual belief and faith communities should be ensured and recognised as important. The good mental health of older people is also ensured by having a satisfying sexual life. Poor mental health is risked when older people are isolated from society. For some older people, it is a positive experience for them to live alone because it means autonomy, self-support and independence for them. However, other people might find living alone to be a lonely experience especially if getting out of their home is difficult. Therefore, the community should organise befriending programmes that help older people in their everyday lives. Feelings of isolation and loneliness can be avoided by different kinds of clubs, social networks and recreation centres. Isolation can further be avoided by recognising the knowledge and skills contributed by older people and the provision of opportunities where the older people can share their skills with people from other age groups.
Independent and safe living opportunities should be provided. Many older people want to live in their own homes for as long as they can because it provides them with feelings of autonomy band independence. These feelings can be enhanced by providing equipment that can facilitate mobility and communication in the support of smart home establishment solutions. Independent living can be enabled by providing domiciliary services such as home help, home adaptation assistance and providing adequate amenities through assistance with home improvements. Older people who have been victims of violence should be supported and any violence or abuse that affects older people should be tackled. In supporting them, the older people will be able to cope with the resulting psychological and physical ill effects.
Appropriate social and health services should be provided. It is evident among older people that general health and mental health are strongly interrelated. Mental ill health is risked by poverty and poor physical health. It is therefore important that a social and health care system be provided. This care system will give easy access to psychiatric help, high quality primary and specialty health services, necessary social services, transport services and other benefits. To afford decent housing, travel, heating, occasional treats and social activities, older people want to have enough money. These activities help older people to fully participate in their families and communities. To maintain an increase in their income, older people should join individual retirement schemes that allows them to continue working even later in life.
Mental well-being and carers
Traditionally, it has been the role of some family members to provide care for older people at home. However, in this day and age, the social framework all over the world is changing. Caring for an older person, a person with disabilities and for a child in the family is a usual way of life even in the most developed information society-type society. In the European Union, millions of people are seen taking care of their partners or relatives. It is common to find that an elderly person is in charge of taking care of a frail older person. Nowadays, frail wives are taken care of by their husbands and vice versa. The experience of taking care of a spouse, child or a close friend is rewarding and mentally positive. The carer finds that their life has purpose and is more meaningful.
On the other hand, being a care giver has psychological, financial, physical and social strains that may lead to feelings of loneliness and social isolation. Cares are at a high risk of developing psychological and physical ill health that shows that the carers need opportunities for respite and more effective social, financial and practical support. Those carers taking care of older people with dementia are likely to be burdened and have high levels of stress, depression and fatigue. Family caregivers should also be targeted when promoting mental health activities for older people to ensure that the carers’ needs are met as well.
We are all affected by wellbeing and mental health in later life. The reasons why we should pay attention to issues surrounding mental health in old age are economic, social and humanitarian in nature. Each one of us benefits from good mental health and wellbeing in later life because we are ensured that we will be able to lead long healthy lives that are fulfilling and enjoyable. Good mental health promotion for older people is a means by which we can maximise older people’s valuable contribution to economy and society. The costs that arise from poor mental health care are minimised at the same time.
Social workers have been working for a long time with older people in promoting mental health. The mental social work profession is founded on the skills of mental social work. The work of social workers has been to stop disintegrating forces in families, individuals and social groups. Society needs the work done by social workers to continue because these disintegrating forces are still around us. A social worker is able to take up the challenge and help in promoting mental health in older people.
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