Characteristics of Older Adults With Serious Mental Illness Enrolled in a Publicly Funded In-Home Mental Health Treatment Program

Abstract

In-home mental health services for older adults will likely become increasingly utilized as the population ages. Little is known about older adults with serious mental illness who receive in-home services through the public mental health system. This study examined the demographic and clinical characteristics of this population. A total of 148 clients were included. Mood disorders were present in 75.7% and schizophrenia spectrum disorders were present in 23.6%. A history of problematic substance use was documented in 47.3% of clients and 31.8% reported suicidal ideation prior to enrollment. A total of 25% of clients utilized psychiatric emergency services during the year prior to enrollment and 15.5% of clients were hospitalized for psychiatric treatment. Older adults who receive in-home mental health services are vulnerable and have complex treatment needs.

Elder’s life course theory and person‐centered research: A lens for conducting ethical nursing research and mental health nursing practice with older adults aging with the diagnosis of schizophrenia

“…Their perceptions of being stigmatized may make it difficult for them to be fully honest in sharing their life experiences. In addition, the diagnosis of a stigmatized illness may be associated with depression and behavioral isolation (Brooks et al., 2019; Penkunas et al., 2015). In research and clinical practice, both confidentiality and privacy can prevent further stigmatization that might lead to increased depression, affecting both morbidity and mortality (Touriño et al., 2018; Yanos et al., 2008).…”

The Life Course Paradigm as a Lens for Holistic Nursing Research in Older Adults Diagnosed With Schizophrenia

“…Today, individuals who live with schizophrenia and also live longer face both common geriatric syndromes (Brown-O’Hara, 2013; Smith & Shah, 2017) and other geriatric syndromes more common among OADWS, which can result in double stigmatization due to the combination of older age and mental illness (Al Jurdi et al, 2014; Gauillard, 2016). The increased vulnerability of older adults with mental illness has been associated with issues or syndromes also common among OADWS such as higher fall rates, substance and alcohol use, trips to the emergency department, less treatment for physiological health issues, and longer hospital stays (Brink et al, 2017; Crawford, Jayakumar, Lemmey, & Zalewska, 2018; Hendrie et al, 2013; Penkunas, Friedman, & Hahn-Smith, 2015). Potential complications of increased longevity in the mentally ill may include physical comorbidities such as cardiovascular and lung diseases (Almeida et al, 2014; Hendrie et al, 2012; Laursen et al, 2014; Olfson, Gerhard, Huang, Crystal, & Stroup, 2015; Seow et al, 2017), as well as psychiatric manifestations such as depression and suicidal thoughts (Brooks et al, 2019; Cohen, Abdallah, & Diwan, 2010; Siddi et al, 2019).…”

“…Many complications are associated with being OADWS. Often, individuals diagnosed with schizophrenia who reach older adulthood develop many ailments and comorbid disorders (Laursen et al, 2014; Olfson et al, 2015), substance use disorder (Brink et al, 2017; Ogden, 2014b), isolation (Penkunas et al, 2015), persistent depressive feelings, and suicidal ideations (Kasckow, Golshan, & Zisook, 2011; Siddi et al, 2019). It is also highly likely that the ubiquitous experiences of societal judgment (Leutwyler, Hubbard, Slater, & Jeste, 2014) and difficulties in making and keeping friends (Prince et al, 2017; Robustelli, Newberry, Whisman, & Mittal, 2017) persist as persons diagnosed with schizophrenia age.…”