Into The Big World

Bringing up the topic of senior care with a loved one can difficult, but the situation is even more fraught when that person suffers from a mental illness. Many family caregivers are left wondering how to approach the subject, worried about upsetting their elderly parent, or even fearful of an irrational or violent reaction.

Unfortunately, this is by no means an unusual situation. According to a report by the Institute of Medicine of the National Academies, between 14-20% of the nation’s senior population have one or more mental health issues, including bipolar disorders, depressive issues, dementia-related symptoms and substance abuse problems.

In combination with the natural physical and cognitive impairments that occur with aging, psychological issues can endanger a senior’s health and place stress on family members.

The Benefits of Community Living – why is it important for people with severe mental illness?

Research indicates that, for people who are adequately supported and have the functional capacity, transitioning to living in a community setting is an important step in attaining recovery. The standards for treatment of severe mental illness are undergoing a sea-change; rather than settling for a remission of visible symptoms, health-care providers and consumers are now looking at returning to the previous ability to do the things that one was able to do before becoming ill as the ultimate goal of treatment. For many people with schizophrenia, bipolar disorder, and other psychiatric disabilities, living in the community can be a part of returning to a healthy level of functioning.

Causes of Mental Problems

• Life involvements such as mistreatment or shock
• Family history of psychological health problems
• Natural factors like the brain chemistry and the genes

Early Caution Signs in Seniors

If you are not sure if your loved one is living with a mental health problem, the following behaviors can be a first sign of an issue:

• Shouting or fighting with friends and families
• Feeling desperate or helpless
• Having mysterious pains
• Feeling emotionless or nothing matters
• Feeling strangely confused, angry, upset, worried or scared
• Thinking of hurting yourself or others
• Prolonged depression
• Substance abuse
• Changes in sleeping and eating patterns

Home Care and Assisted Living for Seniors

Home care is for older adults who want to lead an independent lifestyle but need assistance with their personal needs. Seniors may feel more relaxed at home. Supported living facilities are homes that are also suitable for elderly patients who want to preserve some level of independence and need assistance with their day to day living.

How do quality community housing facilities help recovery? Consider the following findings from research:

Community living reduces stigma. According to the report in US National Library of Medicine, people with severe mental illness living in apartments or community housing are more accepted, less lonely, and have a greater quality of life (as compared to those in specialized treatment facilities).

• There is a relationship between quality of housing options for people with severe mental illness, overall global functioning, and quality of life. A comparison of psychiatrically disabled residents of boarding homes vs. private homes with family or alone found that residents of boarding homes had greater measures of cognitive problems, social problems, overall disability, and reduced levels of self-care. However, their overall psychiatric symptoms were no more severe than those living in private homes; this implies that the causal factor is the difference in housing situation, not a fundamental difference in disease severity between the two groups.
• A key determinant for readmission rates in schizophrenia patients is the type of situation to which they are discharged. The report said people discharged to lower-quality housing situations had higher rates of readmission to the hospital. Lack of quality housing options can contribute to the “revolving door” phenomenon experienced by so many people with mental illness.
• The quality of housing has a critical effect on relapse rates: The researches from Community Psychol conducted a study in which the followed the outcome of patients discharged from in-patient care, concluded that when patients are in need of both residential and psychiatric services, “housing interventions are more important than psychiatric services for patients’ ability to stay in the community” (measured by the rate of rehospitalization during a six-month period).

Finding Housing for the Mentally Ill

It’s frustrating that supportive housing is difficult to find. Programs are competitive, often with long waiting lists. The housing system is difficult for anyone to navigate; add mental illness to the equation and finding housing can be daunting, overwhelming, and seemingly impossible.

Thankfully, finding homes for the mentally ill is not impossible. Resources for finding supportive housing are very similar to resources for finding types of group housing.

• Consider behavioral assisted living – behavioral assisted living can provide a wide range of services to meet the medical and behavioral needs of each resident. Services that may include toileting, bathing, dressing, eating, mobility, social interactions, behavior modification, medication management, etc.
• Talk to mental health providers and/or primary care physicians as they often know their community resources.
• Many communities have mental health organizations. The Depression and Bipolar Support Alliance (DBSA) and the National Alliance on Mental Illness (NAMI) are two examples. A visit to their offices can point you in the right direction for finding housing.
• Connect with a social worker or case worker (the above people and groups can help you find one). These professionals do many things to help people, including help with finding housing.
• State mental health boards (online, search “mental health board” and add your state), can be a source of information about agencies and programs.

Finding housing for the mentally ill is crucial in helping people manage mental illness and decreasing the amount of disability and impairment they’re experiencing. Stable housing is an important step toward mental wellness.

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