1. Introducing Presenters Lis Cox, LMFT Ihande Weber, LCSW

2. 2 MENTAL & EMOTIONAL WELLBEING Learning Objectives Understand the causes and consequences of social isolation among elders Understand the causes and consequences of depression among elders Understand factors that cause stress and strategies for coping with stress Learn about resources available to improve mental and emotional well-being

3. 3 SOCIAL ISOLATION Social isolation occurs when an individual is cut off from social ties and activities At some point, many older adults will experience social isolation and feelings of loneliness due to changes in one’s network Social isolation or loneliness has many negative consequences on health and mental health.

4. 4 Impact of Social isolation Physical: has been linked to poor health, alcohol and substance use, and suicidal thoughts. Emotional: May result in reduced confidence in oneself, feelings of diminished self-worth, despair, depression, and worthlessness. Social isolation is one of the strongest predictors of depression in later life. Cognitive (mental): May experience a shortened attention span or forgetfulness as they may not see any reason or opportunity to remain aware and alert.

5. 5 Social Isolation -- Risk Factors Physical Disabilities that limit mobility and impact ability to participate in usual activities. Chronic illnesses and pain that leads to being homebound, bedridden. Hearing loss can lead to reduced participation in social activities and engagement with others.

6. 6 Social Isolation -- Risk Factors Social: loss of social networks due to retirement or joblessness may lead to a loss of personal and professional identity. Loss of family members or friends due to relocation, serious illness, or death. Other social factors: discrimination due to ageist attitudes, lack of a confiding relationship, loss of driving abilities, reduced independence, reduced income, and language and cultural barriers may increase risk for social isolation.

7. 7 Social Isolation -- Risk Factors Cognitive/Emotional: Individuals who suffer from depression, cognitive deficits such as problems with memory and attention, and personality factors such as shyness, discomfort with social relationships, are at risk for social isolation

8. 8 Signs/Symptoms of isolation Physical Signs of self-neglect such as unexplained weight loss, poor self- care Lethargy Emotional Feelings of loneliness Feelings of sadness Feelings of despair Cognitive Confusion Not oriented to time Nervousness Forgetfulness Social Social withdrawal never leaving home Lack of interest in or lack of social relationships

9. Case Presentation for Discussion

10. Interactive Discussion

11. Cultural Discussion

12. 12 DEPRESSION Is an emotional or psychological state characterized by feelings of sadness and despair. Is the most common psychological problem facing older adults in the U.S. About 8% to 20% of older adults in the community suffer from depression Depressive symptoms are often misunderstood or misdiagnosed to be the consequence of other age-related conditions Depression has many negative consequences for an individual’s health and mental health.

13. 13 Impact of Depression Physical: May lead to alcohol dependence, increased disability from medical illnesses, and increased death rates due to heart attack, stroke, and cancer. Increases the risk of death due to suicide. Emotional: May contribute to feelings of sadness, feeling low, anxiety, anger, worthlessness, hopelessness. Mental: May cause disorientation, a shortened attention span or cognitive impairment. Social: May cause withdrawal from family members and friends

14. 14 DEPRESSION – Risk Factors Physical: Illness, disability, and pain may cause stress that influences the onset of depression. Some medications have depressive side effects. Social: Death of a spouse Care giving for a family member with physical illness or dementia. Social isolation, relocation, and retirement. Lack of a confiding relationship and interpersonal disputes such as family conflicts.

15. 15 Signs/Symptoms of depression Physical Frequently tearful Restless/ Fidgeting Appetite change/ weight loss Fatigue/loss of energy Sleep disturbances Emotional Sad or downcast moods Feelings of: hopelessness and worthlessness Guilt Helplessness Cognitive Reoccurring thoughts about death and suicide Difficulty in decision making Lack of motivation to begin new projects Difficulty with memory or concentration Social Avoidance of social interactions Diminished interest in pleasurable activities and hobbies

16. Discussion Questions

17. Short Break 10 minutes

18. 18 STRESS AND COPING Stress is a physical, chemical, or emotional factor that causes bodily or mental tension and may be a factor in causing disease An acute state of stress where the individual feels threatened results in the hyper-arousal of the whole system, known as the “fight or flight response.” What is of serious concern is a state of chronic hyper-arousal Coping is “the response that emerges in the encounter between the person and the situation.” Coping responses can be restorative or destructive.

19. 19 Impact of Stress Physical: Chronic arousal of the stress-reaction cycle can result in hypertension, diabetes, arrhythmias, sleep disorders, chronic headaches, chronic backaches, and/or anxiety. Psychological: These conditions can be compounded by destructive behaviors and/or substance dependency. All of the above put the person at risk for a breakdown: emotional, and/or physical, resulting in a heart attack or life threatening disease.

20. 20 Cultural, Philosophical, Religious and Spiritual Factors Cultural: Pre and post immigration experiences, time and relational orientations. Philosophical: Taoist and Existential Philosophies Religious and Spiritual: “A search for significance in times of stress.”

21. Resources Internal (within the person): Cultural response or spiritual or religious practice. External (to the person): familial, or ethnic or religious community. External (to the ethnic or religious community):Senior Peer Counseling and Mobile Mental Health Team 21

22. Senior Peer Counseling

23. Mobile Mental Health Services for Seniors In-home assessment of mental health needs Individual and family therapy Medication management and support Linkage to community resources Crisis intervention

24. Thanks for your participation!