Struggling for existence—Life situation experiences of older persons with mental disorders

Abstract

Older persons with mental disorders represent a vulnerable group of people with extensive and complex needs. The older population is rapidly increasing worldwide and, as a result of deinstitutionalization in mental health care, older persons are remaining at home to a greater extent. Although they constitute a large proportion of the population, older persons with mental disorders have been neglected in research as well as in care organizations. As there is little previous knowledge concerning older persons’ experiences of their own situations, this study aimed to illuminate the meaning of the life situation as experienced by older persons with mental disorders (excluding dementia disorders). Interviews were conducted with seven older persons and the text was analyzed using a phenomenological hermeneutical research method, inspired by the philosophy of Paul Ricoeur. “Struggling for existence” emerged as a main theme in the older persons’ narratives, understood as a loss of dignity of identity and involving being troubled and powerless as well as yearning for respect. The older persons fought to master their existence and to be seen for who they are. The study highlights the importance for caregivers, both formal and informal, to avoid focusing on the diagnoses and rather acknowledge the older persons and their lifeworld, be present in the relation and help them rebuild their dignity of identity. This study brings a new understanding about older persons with mental disorders that may help reduce stigma and contribute to planning future mental health care.

Older Persons’ Experiences of Depressive Ill-Health and Family Support

“…Previous research on younger persons with mental disorders suggested that caregivers should foster a sense of belonging [32]. Martinsson et al's [8] study on older persons reaches a similar conclusion.…”

“…For older persons suffering from depressive ill-health, the potential need for family members to provide care and support might lead to the feeling of loss of independence for both the older person and the family. According to Martinsson et al [8], older persons suffering from depressive ill-health constitute a vulnerable group. However, depression in older persons is a complex health problem due to the difficulty of distinguishing between depression and symptoms of physical ill-health, dementia, normal aging, and grief  [9].…”

“…Depression is often accompanied by considerable social isolation and withdrawal from activities that are essential for providing emotional support and assistance [17]. In addition, Martinsson et al [8] highlighted some difficult existential components of old age such as the struggle against futility, decrepitude, and invisibility.…”

Older persons’ experiences and perspectives of receiving social care: a systematic review of the qualitative literature

“…,b, Tanner , Martinsson et al . ). This ambivalence results primarily from the conflict between the preference and recognised advantages of informal care and the worries of being a burden for the informal carers.…”

“…, Sutton & Coast ) and one exclusively of older persons with a mental disorder diagnosis (excluding dementia) (Martinsson et al . ). However, these conditions are not associated with any particular analytical theme or subtheme.…”