Why is using a family therapist useful when dealing with an aging parent?

For some, the thought of using a therapist as a resource when dealing with an aging parent may be second nature, but for most, it is a series of valid “Why” questions. Why is this needed? Why is it useful? Why should I bring a stranger in to our family business?

While many families may recognize an aging parent needs help or may be in crisis, knowing what to do beyond an emotional response is sometimes lacking. It is in these moments where having an outside perspective not only proves beneficial, but may in fact become one of the most important decisions a family dealing with an aging parent will make.

What is a family therapist? Family therapists are mental health professionals who are trained and licensed to diagnose and treat mental health and substance abuse problems. They are trained in psychotherapy and family systems, and focus on understanding their clients’ symptoms and interaction patterns within their existing environment. Family Therapists treat from a relationship perspective that incorporates family systems. (Association of Marriage and Family Therapy)

Why are they useful to family caregivers and aging families? Families dealing with aging adults have many factors to deal with; the Caregivers perspective, the aging adult and the family dynamics in between. The role of a family therapist is not only to address the needs of the aging individual, but the family as well. So what would be the reasons for family therapy when helping an aging adult?

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When Suicide or Suicide Attempts Happen in our Older Adult Family Members

The topic of suicide has somewhat been a taboo subject in families all across the world. The idea that someone, of any age, would take their life is overwhelming. Even more devastating is the thought of an elderly person attempting to or taking their life, but it is happening at an alarming rate.

Suicides among the elderly has been on the rise and currently the highest increase has come among white males. Suicide not only affects the individual who are dealing with this mental health issue, but impacts family and friends connected to the victim.

Elderly Suicide Can be Destabilizing to the Family

The impact of someone attempting to or taking their own life can be a hard thing for people to deal with. Immediately questions arise, emotions run high, and moments of reflection are looking you right in your face. So what happens when an older adult family member attempts or commits suicide?
Often times the first emotion experienced by the family is Guilt:
• Was there care or negligence during the time of the suicide attempt or time of death?
• Who were main caretakers? How was that decided by the family?
• What was the family’s response? Conscientious or Dismissive?
• Red flag: compassion is absent

Next, the process of Blame and Accusations occurs:
• Sibling disagreements and difference of opinion
• Suspicion of neglect or are they/have been neglectful

While for some, many questions may exist without answers, there are a portion of people who feel the emotion of Relief:
• Sometimes families may feel a sense of relief after a loved one dies. This sense of relief can be expressed as healthy or dysfunctional.
o Was there long-term suffering: chronic illness or mental health.
o History of abuse? Sexual or emotional? Families may feel they no longer have that person to represent the pain associated with the abuse.

When a person commits suicide, the aftermath of the situation can potentially put people in a chaotic state that may be hard to press through. So what does a family feel after a person commits suicide?
Bereavement after suicide holds unique challenges that differ from those who have been bereaved by other types of death. It has been noted that those grieving from this type of death experience higher incidences of rejection, blaming, shame, stigma, and the need to conceal the cause of death among those bereaved by suicide as compared with other causes of death.

What is the family’s response?
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Generational Perspective on Getting Mental Health Help

Each generation has an identifying label that gives them a classification in time. Those born between 1922 – 1943 (ages 92-72) are considered the “Silent Generation. These are individual who have experienced the great depression, WWII, believe in conformity, a defined sense of right and wrong, and whose perspective of depression and mental health is often associated with embarrassment and avoidance. While this generation has longevity from an age perspective, it is in fact the age factor and time period of their birth that has shaped the way they look at the issue of mental health.

Now those born between 1946-1964 (ages 68-50) are considered the “Baby Boomers” and they are the generation of change. They believe in individual choice and self-actualization and were a part of the civil rights movement. They experience complicated legal issues related to aging relatives, have a high divorce rate and in regards to depression and anxiety, are referred to as the first real “sandwich generation.” Their biggest challenge in the area of mental health has been the issue of prescription drug use/abuse.

With different perspectives on an issue, that many can agree is a problem, mental health, regardless of age, how do we make sure that people get the help that is needed? Sometimes, getting an older adult to access mental health services can be challenging based upon their values and perceptions of mental health services.

How do we get our older adults paired up with Mental Health Services?

Family caregivers and loved ones are the number one vehicle for pairing older adults with mental health services. This connection can help bridge the gap, PAIRing (Proper, Approach, In, Receiving, Services). In fact, 67% of family members provide care for someone ages 75 or older. And family members are necessary trusted partners for older adults receiving available mental health services.
Mental health service options for older adults and family members include:
• Individual Phychotherapy:
• Family and Therapy Couples Counseling:
• Medical Doctors-
• Support Groups/Group Therapy-
• Inpatient Hospitalization-

Mental Health Providers Resources:
The Link Counseling Center – Enriched Living: A Program for the Aging, Their Families & Caregivers-www.thelink.org Continue reading

How Can I Help my Aging Parent with Depression

Depression is often a difficult topic for people and families to deal with. Recognizing the signs, searching for services, simply dealing with the day to day affects of it can be challenging. When you see someone struggling with depression, in particularly an aging parent, the first question that comes to mind is, “How can I help my aging parent?”

Contrary to what some people think, depression is not a normal part of the aging process. In fact, it is:
• Less diagnosable MDD than midlife, but more overall depressive symptoms – Sub-syndromal
• More common in women, but narrower gap than younger years
• Often co-occurs with other medical conditions
• Under diagnosed and under treated

While depression is not a normal part of the life process, the fact is, many are living with this condition and don’t know what to do. People are watching the ones they love suffer with depression, and sadly, have no idea how to help. So what is the answer?

First, it’s important to pay attention and recognize the symptoms of depression. According to statistics, older adults suffering from depression range from 5% to 13.5%, including home healthcare and hospital patients. Several factors (genetic, biological and environmental) play a role fueling the symptoms of depression. What are the symptoms?
• Depressed or sad mood
• Loss of interest or pleasure
• Loss of appetite and/weight or overeating and/or weight gain
• Fatigue or loss of energy
• Difficulty sleeping and over sleeping
• Difficulty concentrating, making decisions or remembering
• Irritability, restlessness or lethargy
• Feelings of worthlessness or guilt
• Frequent thoughts of death, suicidal ideation, or a suicide attempt

How can you help?
Becoming knowledgeable of the symptoms and signs of depressions is one of the first ways an individual can help if they think their aging parent is suffering from depression. Seeking out treatment or resources for their loved one is another way to help those dealing with this issue. A number of treatment methods currently exist for those dealing with depression.
• Antidepressants
• Psychotherapy – including Cognitive Behavioral Therapy (CBT), and Interpersonal Therapy (IPT)
• Mindfulness
• Electroconvulsant Therapy (ECT)

For more information about dealing with depression and an aging adult follow us on Facebook at Leslie Sessley, LCSW.

The Look of Depression in Men, is it Really Different?

Depression is often under diagnosed, under-treated and at times misdiagnosed in people. Because depression is not one of those conditions that look the same regardless of gender, age, ethnicity, etc., it can sometimes be hard to fully diagnose.
While the symptoms, signs and some treatments can be similar in men and women, working with each population is different.

So what are some of the challenges of working with aging men dealing with depression?
• Older men are less likely to acknowledge symptoms of depression and less likely to be treated – fear of stigma
• Older men are less likely to report emotional symptoms of depression (crying, sadness, guilt, worry, fatigue)
• Older men are more likely to see depression as a moral weakness that can be “toughed out”
• Many older men have been exposed to lifelong traditional norms: “I must be self reliant; I must be tough; I must work”
• Older men have an increased risk for suicide

Each of these factors play a role in effectively being able to diagnose, treat and help older men who are dealing with depression. This is one reason why it is so important that if someone close to you or in your inner circle is exhibiting signs of depression that you do not IGNORE IT. Often time, with men it is more about observation that verbal communication, so it is important to pay attention.

What are the symptoms in older men?
• Physical Symptoms:
• Aches, pains, stomach upset, backache, insomnia, low energy, exhaustion
• Cognitive/Affective Symptoms
• Irritability, pessimism, guilt, problems with concentration, anhedonia, restlessness, agitation
• Anxiety is a greater predictor of depression in men than in women
• Behaviors
• Isolating, arguing, blaming, attacking, difficulty initiating tasks
• Men are more impacted by loss of a spouse than women
What are the Risk Factors?
• Increase in physical health problems – cardiovascular disease, prostate cancer, chronic pain, loss of mobility, sexual dysfunction
• Heart attack – depression rates 20% with 20% more experiencing depressive symptoms
• Decreased testosterone levels
• Loss of muscle mass, weight gain, hair loss, decreased sexual functioning, anxiety, increased risk for depression
• Retirement often brings loss of connection, loss of purpose, loss of structure, lower self-worth
As important as it is to identify and recognize the signs and symptoms of depression in older men, it is even more important that treatment is given to those who are dealing with this issue. Continue reading

Depression in the Aging Population

Depression affects millions of people and may look vastly different in the elder population. Many of our elders live with undiagnosed depression, to the point that they adapt it as normalcy for their lives, but it is not normal.

Did you know?
• Over 20% of adults 65 and older met criteria for a mental disorder during the previous 12 months
• 1 in 8 persons over 65 has Alzheimer’s Disease
• 15-20% of older adults have experienced depression

Depression is defined as: “feelings of severe despondency and dejection,” and impacts individuals of all ages. These feelings are sometimes misinterpreted or confused with other symptoms, but it is important recognize signs that may be a warning to more serious issues.

So what are the warning signs?
Red Flags for Elders Dealing with Depression:

Cognitive Symptoms:
– Memory loss
– Disorientation
– Distractibility
– Often confused with “old age” or dementia
– Depression likely to have insight into memory issues than dementia
Somatic Symptoms
– Dizziness
– Chronic aches and pains
– GI complaints
– Appetite or weight changes
– Insomnia
– Fatigue
– Headache
– Easily confused with medical conditions
Affective Symptoms:
– Sadness
– Anxiety
– Guilt
– Dysphoria
– Loss of motivation
– Older adults less likely to accept affective symptoms than younger
– Functional Changes:
– Changes in hygiene
– Grooming
– Reading
– Decline in instrumental activities of daily living
– (telephone use, paying bills, cleaning)
– Hobbies
– Socializing

Each of these areas provides signs that show a change in behavior that if ignored, could possibly cause someone their life. Exhibiting one of these signs may not necessarily be cause for alarm, but when multiple signs exist it is time to take action.

How do you help?

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Who is at Risk for Suicide in our Older Adults: What to look for

By Leslie Sessley, LCSW

 Do you know an older person who has suffered from depression? Have they experienced increasing social isolation in recent years, the death of loved ones, or feelings of hopelessness? If the answer is yes, they may be at risk for suicidal thoughts or actions.

The topic of suicide is one that affects people of all ages, genders and ethnicity. All people can be at risk for suicide, but there are certain characteristic that may attribute to a person being more at risk than others. For example, individuals experiencing depression, mental health disorders or substance abuse may put a person at greater risk.

According to statistics, elders are 13% of the overall population, but make up 18% of suicides. Within this category, white males have the highest suicide rate, but of those reported, suicides are more common in women.  Mental health disorders are a factor in this area. In fact, 15- 20% of older adults have experienced depression and more than  20% of adults 65 years and older meet criteria for a mental health disorder.

So how do you know if the elder in your life is dealing with this issue?

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Surviving the Holidays, Finding Ways to Cope

Leslie Sessley, LCSW

As I look out my window, I can already see the seasons changing, the fluctuation of temperature, the brisk nights and even the bright colors of the leaves evolving. These are not only signs of the change in season, but also a reminder that the holidays are fast approaching.

While the holidays may be joyous for many, for others, it is a challenging time that many have trouble coping with. For some, surviving the holiday season is one of the most challenging times of the year.

Why can the holiday season be challenging?

Generally, holidays are filled with family and friends, food and other things that symbolize a time when people come together. The holidays represent a myriad of memories accumulated during a person’s lifetime that for many, provide a point of reference for times directly connected to an emotional period. Many people start off with the memory of good thoughts during the holiday season, but through the impact of life, the loss of a loved one, financial hardship, or a sick family member, what was once a good memory is now one that is associated with pain. For many, holidays force people to realize how just how much life has been impacted and changed by the loss of a loved one.

Grief during the holiday season
What is grief?
“Grief is the reaction to a loss of any kind. A normal expression of a loss.”

Losing a loved one is one of the most difficult things an individual will ever have to deal with, and the affect transcends every barrier that exists within society. This grief is compounded and emotions heightened during certain times throughout life. For some it can be a special song that triggers this intensity, for other riding by a familiar place, for others, the simple onset of the holiday season in which so many memories were shared.
Even at the best of times, the holidays are stressful — but when there’s an additional emotional burden, they’re especially difficult.

If you are reading this and can identify with any part……………….

Here Are some Tips for Coping with Grief during the Holidays

Set realistic expectations for yourself. Remind yourself that this year is different. Decide if you can still handle the responsibilities you’ve had in the past. Examine the tasks and events of celebrating and ask yourself if you want to continue them. Take others up on offers to cook, shop, decorate, etc. Consider shopping by phone, Internet or catalogs this year.
Surround yourself with people who love and support you. Share your plans with family and friends and let them know of any intended changes in your holiday routine. Memories can sometimes be a source of comfort to the bereaved. Share your memories with others of holidays spent with your loved one by telling stories and looking at photo albums.
Try to avoid “canceling” the holiday despite the temptation. It is OK to avoid some circumstances that you don’t feel ready to handle, but don’t isolate yourself. Allow yourself some time for solitude, remembering and grieving, but balance it with planned activities with others.
Allow yourself to feel joy, sadness, anger – allow yourself to grieve. It is important to recognize that every family member has his/her own unique grief experience and may have different needs related to celebrating the holidays. No one way is right or wrong. Experiencing joy and laughter does not mean you have forgotten your loved one.
Draw comfort from doing for others. Consider giving a donation or gift in memory of you loved one. Invite a guest who might otherwise be alone for the holidays. Adopt a needy family during the holiday season.
Take care of yourself. Avoid using alcohol to self-medicate your mood. Try to avoid the hustle and bustle of the holiday season. Physical exercise is often an antidote for depression. Writing in a journal can be a good outlet for your grief. Buy yourself something frivolous that you always wanted but never allowed yourself to indulge in.
Create a new tradition or ritual that accommodates your current situation. Some people find comfort in the old traditions. Others find them unbearably painful. Discuss with your family the activities you want to include or exclude this year.

Some examples of new rituals and traditions include:
• Announce beforehand that someone different will carve the turkey.
• Create a memory box. You could fill it with photos of your loved one or written memory notes from family members and friends. Young children could include their drawings in the memory box.
• Make a decorative quilt using favorite colors, symbols or images that remind you of the person who died.
• Light a candle in honor of your absent loved one.
• Put a bouquet of flowers on your holiday table in memory of your loved one.
• Visit the cemetery and decorate the memorial site with holiday decorations.
• Have a moment of silence during a holiday toast to honor your loved one.
• Place a commemorative ornament on the Christmas tree.
• Dedicate one of the Chanukah candles in memory of your loved one.
• Write a poem about your loved one and read it during a holiday ritual.
• Play your loved one’s favorite music or favorite game.
• Plan a meal with your loved ones’ favorite foods.
The most important thing to remember is there is no right or wrong way to celebrate the holiday season after the death of a loved one, and that the best way to cope with that first holiday season is to plan ahead, get support from others and take it easy.

Life Tip:
Be kind to yourself, show yourself some compassion:
Acknowledge, what you are feeling? Take time to attend to it:

A Self- Compassionate Reminder-
This is a moment of suffering.
Suffering is part of life.
May I be kind to myself in this moment?
May I give myself the compassion I need?

For more information about coping with grief follow us on Facebook at Leslie Sessley, LCSW.