CHAPTER 24 COUNSELING OLDER ADULTS

1. CHAPTER 24 COUNSELING OLDER ADULTS

2. Older Adults • The population of older individuals in the United States is growing • During the past decade the 85-year-old and older group has increased by 38%, while those between 75 and 84 increased by 23% • Ageism has been defined as negative attitudes towards the process of aging or toward older individuals

3. Stereotypes of the Elderly • Women are more likely than men to be viewed negatively • Stereotypes and biases against the elderly are pervasive • Some stereotypes include rigidity, senility, lacking in health/intelligence and having no sexual desires

4. Mental Health • There is a perception that rates of mental illness are high among the elderly, however, this is not true • About 6% of older adults are in the community mental health system

5. Mental Deterioration or Incompetence • Only a small number of older adults have dementia • However, by the year 2040, it is estimated that 7 million people will have Alzheimer’s disease • Cognitive decline is a part of aging and should not be confused with senility

6. Sexuality in Old Age • It is thought that older adults do not engage in sexual activity, however, many older adults are sexually active

7. Guidelines for Clinical Practice • Obtain specific knowledge and skills in counseling older adults. Critically evaluate your own attitudes about aging and quality of life • Be knowledgeable about legal and ethical issues that arise when working with older adults (e.g., competency issues) • Determine the reason for evaluation and the social aspects related to the problem, such as recent losses, financial stressors, and family issues • Show older adults respect and give them as much autonomy as possible regardless of the issues involved or mental status. • Identify medical conditions and prescription and over-the-counter medications because mental conditions are often a result of physical problems or drug interactions or side effects

8. Guidelines for Clinical Practice • Presume competence in older adult clients unless the contrary is obvious • If necessary, slow the pace of therapy to accommodate cognitive slowing • Provide information in a manner that approximates the client’s level of reading and comprehension, using alternative methods such as simplified visuals or videotapes if necessary • Involve older adults in decisions as much as possible • Use multiple assessments and include relevant sources (client, family members, significant others, and health care providers) • Determine the role of family caregivers, educate them about the disorder, and help them develop strategies to reduce burnout

9. Guidelines for Clinical Practice • When working with an older couple, help negotiate issues regarding time spent alone and together (especially after retirement • Recognize that it is important to help individuals who are alone establish support systems in the community • Help the older adult develop a sense of fulfillment in life by discussing the positive aspects of their experiences • Determine the older adult’s views of the problem, belief system, stage of life issues, educational background, and social and ethnic influences • Assist in interpreting the impact of cultural issues such as ethnic group membership, gender, and sexual orientation on their lives • For adults very close to the end of their lives, help them deal with a sense of attachment to familiar objects by having them decide how heirlooms, keepsakes, and photo albums will be distributed and cared for