Geriatric Mental Health Alliance News
A bi-monthly newsletter to brief you on issues important to geriatric mental health
December 03, 2007 - Vol 1, Issue 27
December 03, 2007 - Vol 1, Issue 27
Interagency Geriatric Mental Health Planning Council Webcast
The next meeting of the Geriatric Mental Health Planning Council is on Friday, December 7th from 10:30am to 12:30pm. The agenda for this meeting is to have an in-depth discussion concerning the role of the Council in shaping public policy decisions concerning older adults in New York State. Therefore, several State Agency Representatives on the Council will provide a presentation of their agencies recent and/or current initiatives involving older adults. If you would like to participate, please click here when the event has begun.
Please click here for the agenda.
Please click here for the summary of the July 11, 2007 meeting.
Please click here for more information on the webcast.
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GMHA Upcoming Events
December 6, 2007 - Sex and Mental Wellness in Old Age: A Best Practices Presentation in Geriatric Mental Health hosted by the Geriatric Mental Health Alliance of New York and the Brookdale Center for Healthy Aging and Longevity of Hunter College.
The event will be held from 3:00 - 5:00PM at the Hunter College School of Social Work - Auditorium, 129 East 79th Street, NYC, (Between Lexington and Park Avenues). Please register by clicking here. If you have any questions, please email or call Yusyin Hsin at yhsin@mhaofnyc.org or (212) 614- 6356. The event is free but pre-registration is required.
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Articles
Life At 50 Still Filled With Dreams
By Glenn Liebman
First published: Sunday, November 25, 2007
Albany Times Union
A few weeks ago I received a piece of mail that I had been dreading for more than a year. It was information about joining AARP.
Yes, on Dec. 3, I will turn 50.
I would like to say that I am OK with 50. The cliches are dancing in my head. It's only a number. You're as young as you feel. Fifty is the new 35.
The reality is I have not figured out how I feel about turning 50.
On one hand, society says it's only a number. On the other hand, it is handled like a watershed event. Go into a bookstore and there are about 10,000 books published about life after 50, golf after 50, snorkeling after 50, dog grooming after 50, speed skating after 50, etc. Then you have all those pseudo- patronizing commercials for health care products for everything from hearing aids to acid reflux.
The downside of turning 50 is that it becomes a reality check. I now know that I will never be the Mets' center fielder, though I sort of suspected that when I was in high school and it took me about four bounces to hit the cutoff man from center field.
I will not be the quarterback leading the Jets to the Super Bowl. I will not likely be governor or a Broadway star. Sure, I knew this before, but at least I was young enough to dream.
Part of me wants to say "shut up" and not make 50 a "woe is me" rant. After all, I am very thankful that I have a great life -- a wonderful wife and son, great relatives and friends, a job that I love in which I work with terrific people for a great cause, a roof over my head, an iPod shuffle and so much more.
I am active. I walk every day; I coach basketball; I play fantasy sports (burn a lot of calories doing that). I write all the time and am thrilled to have had my books published. I love to eat and have what many would consider great culinary skills around the kitchen. (Anyone who has eaten my frosted blueberry Pop-Tarts can attest to that).
Maybe coming up to 50 has given me perspective and wisdom. Like others in my age group, I have witnessed some tough times. I have to watch my wife deal with chronic pain. I have lost my parents, my father-in-law and several other relatives and close friends.
You learn deal with the pain and frustration instead of lashing out at the world. I used to hold way too many of my own pity parties and believe me, there are no little hot dogs and Viennese tables at those parties.
On the positive side, I don't think turning 50 will change my outlook on life. I wake up every day enthusiastic about changing the world. Almost every day I am brimming with new ideas and almost every day my staff wishes that I was out of town.
I want to pass my passion and enthusiasm on to my son. He is a wonderful, smart, compassionate kid who has a great throwing arm. I want to build him up without embarrassing him. I want to show my love without smothering, but mostly I want to be able to beat him one-on-one on the basketball court like I did nine years ago, when he was 4. I want to support my wonderful wife who is courageous and resilient in the hope of finding new innovations to help deal with her daily pain.
I also want to be responsive to the needs of my other family and friends. I've spent my life building up a great collection of family and friends, and would never take that for granted. None of that changes at 50. It actually increases the intensity of relationships.
Maybe I'll be all right with 50. So what if I have a few more doctors appointments and have to acknowledge that I am in a new demographic category. There are worse things in the world like being a Met fan at the end of last season.
Maybe the cliche is right, 50 is only a number. Maybe I still have that shot at Broadway or maybe the Mets could use a good-field, no-hit, weak-arm, steroid- free, 50-year-old center fielder.
You never know. Why should possibilities end at 50?
Glenn Liebman of Guilderland is CEO of the Mental Health Association in New York state and the author of 14 books on the humor of sports.
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A Common Casualty of Old Age: The Will to Live
By JANE E. BRODY
November 27, 2007
Personal Health
Suicide is more common among older Americans than any other age group. The statistics are daunting. While people 65 and older account for 12 percent of the population, they represent 16 percent to 25 percent of the suicides. Four out of five suicides in older adults are men. And among white men over 85, the suicide rate - 50 per 100,000 men - is six times that of the general population.
Yet, says Dr. Gary J. Kennedy, director of geriatric psychiatry at Montefiore Medical Center in the Bronx, "If you consider only major depression as the antecedent of elder suicide, you'll miss 20 to 40 percent of cases in which there is no sign of mental illness."
Dr. Kennedy, who is also affiliated with Albert Einstein College of Medicine, recently directed a symposium in New York on preventing suicide in older adults, designed to alert both mental health and primary care practitioners to the often subtle signs that an older person may try to end it all.
The Warning Signs
In interviews, he and other symposium presenters noted that detecting suicidal impulses in older people often depended on the ability of family members and friends to recognize warning signs and act on them. According to Gregory K. Brown, a suicide specialist at the University of Pennsylvania, in studies of what preceded elder suicides, "suicide ideation" - the wish to die or thoughts of killing themselves - appears not to have been taken seriously. In 75 percent of cases, the suicide victims "had told family members or acquaintances of their intention to kill themselves," Dr. Brown said.
Dr. Kennedy put it this way: "This is not simply a doctor's problem. We need to think of elder suicide more as a social problem and look out for individuals at risk."
Primary care practitioners are also crucial to suicide prevention among the elderly because older people, and especially older men, are unlikely to seek out and accept mental health services but are often seen by family doctors and nurses within days or weeks of a suicide. Among suicide victims 55 and older, 58 percent visited a general physician in the month before the suicide. In fact, 20 percent see a general physician on the same day and 40 percent within one week of the suicide.
While major depression is the main precipitant of suicide at all ages, social isolation is an important risk factor for suicide among the elderly. And older men, more so than older women, often become socially isolated.
Widowers are especially at risk because older men in the current generation tend to depend on their wives to maintain social contacts. When wives die, their husbands' social interactions often cease.
"Older males who live alone are an endangered species," Dr. Kennedy said - particularly "in states like Wyoming, Montana and Nevada, where the social distance is great and firearms are a part of the culture."
Many men are poorly prepared for retirement, and don't know how to fill in the hours and maintain a sense of usefulness when they stop working. "They often sit around watching TV," said Martha L. Bruce, a professor of sociology and psychiatry at the Weill Medical College of Cornell University in White Plains said.
And Dr. Kennedy said, "After retirement a lot of older men start drinking heavily, a sign of increased aggression turned inward." He called heavy drinking or binge drinking a risk factor for suicide among the elderly.
A particularly vulnerable time may be after the diagnosis of a life-threatening disease like cancer. Older men who were recently discharged from the hospital are also at high risk, Dr. Kennedy said. They need to be periodically screened for depressed mood, loss of interest in life and thoughts of killing themselves.
Serious personal neglect is another warning sign; people can commit a kind of passive suicide by failing to eat, letting themselves become dangerously sedentary or not taking needed medication.
Dealing With Depression
Contrary to what many people think, depression is not a normal part of growing older. Nor is it harder to treat in older people. But it is often harder to recognize and harder to get patients to accept and continue with treatment.
"Most people think sadness is a hallmark of depression," Dr. Bruce said. "But more often in older people it's anhedonia - they're not enjoying life. They're irritable and cranky."
She added: "Many older people despair over the quality of their lives at the end of life. If they have a functional disability or serious medical illness, it may make it harder to notice depression in older people."
Family members, friends and medical personnel must take it seriously when an older person says "life is not worth living," "I don't see any point in living," "I'd be better off dead" or "My family would be better off if I died," the experts emphasized. "Listen carefully, empathize and help the person get evaluated for treatment or into treatment," Dr. Brown urged. He warned that "depressed older adults tend to have fewer symptoms" than younger adults who are depressed.
The ideal approach, of course, is to prevent depression in the first place. Dr. Brown recommended that older adults structure their days by maintaining a regular cycle and planning activities that "give them pleasure, purpose and a reason for living."
He suggested "social activities of any type - joining a book club or bowling league, going to a senior center or gym, taking courses at a local college, hanging out at the coffee shop."
Dr. Bruce suggests taking up a new interest like painting or needlework or volunteering at a place of worship, school or museum.
Dr. Brown notes that any activity the person is capable of doing can help to ward off depression and suicidal ideation. And he urges older people to talk to others about their problems.
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Other Upcoming Events
December 18, 2007 - Medication Side Effects Matter: Let's Deal with Them! A workshop sponsored by the NYC Dept of Health and Mental Hygiene Office of Consumer Affairs. The workshop will take place from 3-5pm at 80 Centre Street, 1st Floor Training Room
April 12, 2008 - Save the Date: The Paradoxes of Aging: Psychotherapy with Older Adults A conference sponsored by The Met Chapter of the New York State Society of Clinical Social Workers and co- sponsored by the Geriatric Mental Health Alliance and Fordham University Graduate School of Social Service.
Educational Activities for Healthcare Professionals Focusing on Older Adults sponsored by the Consortium of New York Geriatric Education Centers. Programs include reinventing senior centers and senior programs, new trends in discharge planning, falls prevention and more. Programs are from 8:45am -4:30pm and registration is $50.
Educational Seminar Series at Service Program for Older People (SPOP) This training opportunity features SPOP clinicians who have extensive experience with older adults and mental health. It is offered to the professional geriatrics community and all who work with seniors. Each seminar is held at: 302 West 91st Street at West End Avenue, New York, NY. Seminar fee: $15. Discount for 3 or more attendees from the same organization. Space is limited. Please register in advance by mail or online at www.spop.org or call: 212-787-7102 ext.515.
For topics, dates, and registration information, click here.
