Aged care residents at 'higher risk of mental illness' due to upheaval, isolation

Updated

When Dianne Street separated from her husband and developed a rare nerve-attacking condition soon after, she made the difficult decision to move into an aged care home.

Key points: Rates of mental illness are five times higher among aged care residents than those living independently

A new program is giving aged care residents access to mental health clinicians for the first time

Hearings into the Royal Commission into Aged Care Quality and Safety begin in Hobart on Monday

Ms Street developed Guillain-Barre Syndrome three years ago, leaving the then 64-year-old unable to move parts of her body.

"I was paralysed from the neck down. That took 10-and-a-half weeks to get me to a situation where I needed to go to a nursing home," she said.

The mother of two was also diagnosed with anxiety and depression, which added to the stress of leaving her possessions and independence behind.

"With my age, it was very scary. I was in a wheelchair and they pushed me around for the first 18 months and then I obtained this chair to get about," she said.

"I was getting depressed, you get frustrated with yourself that you can't do it and then you think, where do I go with that?"

'Sometimes you can't talk to your family'

Ms Street said she struggled to cope with her anxiety at times, but her friendship with fellow nursing home resident Neil Braithwaite helped her get through the tough times.

"Initially I was improving in leaps and bounds, but now this year I feel like it's been a bit slower, but I get anxious," she said.

"You need to go to somebody to talk to, sometimes you can't talk to your family."

Mr Braithwaite also lives with a mental illness and with no immediate family close by, he often feels isolated.

"I don't know how to describe depression, other than to say that sometimes I get a bit down, sometimes I get a bit lonely," he said.

The 85-year-old began researching aged care homes in the north of Tasmania three years before he decided on a facility.

"I couldn't look after myself, and I chose this place and it was the best thing I ever did," he said.

"It wasn't hard moving in here, the only thing I miss is my car, but I've got the scooter and that gets me out and about."

Depression often undetected

Mr Braithwaite requires insulin for his type 1 diabetes and wears a hearing aid, but that hasn't stopped him from forming a close friendship with Ms Street.

Their favourite pastime is creating "diamond paintings" and eating meals together in the dining room.

"We do diamonds together, we go shopping together, we go out for coffee, so it's good," he said.

Research by Primary Health Tasmania shows older people living in residential aged care facilities are five times more likely to develop a mental illness than those living independently.

Mental Health Council of Tasmania chief executive officer Connie Digolis said there were many reasons aged care residents were at higher risk of mental illness.

"They've been removed from their homes, their own environment and they're often there because they've lost a partner, so they've had some significant life changes," Ms Digolis said.

"That can all lead to a loss of identity and a loss of independence, which is very significant for people."

The Primary Health Tasmania research also shows while depression in people over 65 is common, it often goes undetected.

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According to the Mental Health Council, depression is harder to diagnose in older people because they often have other underlying conditions that hide the symptoms.

It noted people may become more withdrawn, they may not eat as regularly as they used to and they may not engage in conversations as readily as they once did.

"That can be put down to old age, when in fact it actually can be someone withdrawing because of depression," Ms Digilos said.

The Tasmanian hearings of the Royal Commission into Aged Care Quality and Safety begin in Hobart on Monday and run until November 15.

Ms Digolis said the hearings will provide an insight into what more can be done to improve care of aged care residents in Tasmania.

"I think as much as anything we'll probably hear some terribly sad, disturbing stories as we have throughout the life of the commission," Ms Digolis said.

"We need to acknowledge that it is happening and the experiences that people are having and how we can actually improve and acknowledge the needs of older Tasmanians."

It is hoped a new program will close the gap in mental health services in residential aged care homes.

Psychologist Sarah Elder said it would deliver a new model of care "never seen before in Tasmania".

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Dr Elder is one of the psychologists helping to run the program, along with nurses, occupational therapists and social workers.

Delivered by not-for-profit Richmond Fellowship Tasmania and commissioned by Primary Health Tasmania, the program will see mental health clinicians directly available to provide treatment to aged care residents.

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It began this month and will be available in all Tasmanian aged care homes on a referral needs basis.

"The clinicians will be delivering psychological services either one-to-one or in groups for residents of aged care facilities who have mild to moderate mental health concerns," she said.

"Anyone can refer to the program and then the clinicians will do an assessment and people will be eligible for up to 10 sessions per year."

Dr Elder said the program would help improve older Tasmanians access psychological assistance that catered to their needs.

"It's been recognised for many years that people living in residential aged care are at an increased risk of psychological distress and to date, have had reduced access to psychological services, so this is a really exciting opportunity," she said.

Dr Elder said she was optimistic the program could deliver "a reduction in the distress that people living in residential aged care homes or residential aged care are experiencing but also improved quality of life and hopefully increased social connectedness, and an increased sense of meaning".

The Glenview nursing home in Hobart has developed its own program to boost the mental health of its residents through an intergenerational playgroup.

Resident Daphne Jackson said getting to spend time with children was a great way to improve aged care residents' quality of life.

"I think it's lovely, it brings back memories of when mine were little," she said.

"They have a large variety of activities, we can choose what activities we go to each day of the week."



For Mr Braithwaite and Ms Street, life in an aged care home is a life worth enjoying.

"It's where I live and it's my home," Mr Braithwaite said.

"I'm happy here. I'm here for one reason, I'm going to die here and it doesn't bother me at all."

Topics: aged-care, mental-health, community-and-society, suicide, health, healthcare-facilities, launceston-7250, tas, hobart-7000

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