Let’s face it, ageing into your “golden” years is not for the faint of heart. Many of us picture ourselves living the life that has been depicted in ads for RRSP’s, leading us to believe that older adulthood will be filled with comfort, travel, fun activities and joyful moments surrounded by friends and family.
The reality however, is that ageing can be a distressing process for many people. Forced retirement, loss of purpose in life, loss of income, Illness, deaths of friends and family, change of home; all these things and more would cause any adult, much less older adults, to become depressed or experience debilitating anxiety.
Untreated anxiety later in life raises the likelihood of disability, stroke, heart failure, autoimmune and heart diseases, and memory disorders (dementia). It’s also tied to faster brain aging.
Yet despite anxiety being the most widespread mental health problem for adults over the age of 65, no guidelines have been developed for medical practitioners or older adults to help manage this debilitating disorder – until now.
Canadian Coalition for Seniors Mental Health Initiative
The Canadian Coalition for Seniors Mental Health (CCSMH) has collaborated with a group of multidisciplinary leading subject matter experts and a lived experience group to develop the first-ever clinical guidelines for anxiety in older Canadians.
Produced by the CCSMH and led by geriatric psychiatrist Dr. Andrea Iaboni (associate professor at the University of Toronto) along with psychologist Dr. Sébastien Grenier (associate professor at the Université de Montréal), the guidelines provide new, evidence-based recommendations for the prevention, assessment, diagnosis and treatment of anxiety in seniors.
“Part of our work at CCSMH is also making best practice information readily accessible and easy to understand for older adults, care partners and the general public. We develop tools and resources to help them (or a loved one) connect with their health care providers and make informed decisions,” explains Claire Checkland, executive director at CCSMH.
“Anxiety is not a normal part of aging and misconceptions about anxiety in older adults have led to it being underrecognized and undertreated. It is a treatable mental health condition and evidence-based interventions exist and can be helpful” shares Dr. Grenier.
Symptoms of Anxiety in Older Adults
Older adults may downplay or blame symptoms on illnesses or physical conditions. There are indeed certain conditions that can increase anxiety such as chronic obstructive pulmonary disease (COPD), heart or thyroid diseases, or diabetes.
Medications such as steroids, stimulants and inhalers can also have anxiety-inducing side effects. Additionally, family history is a risk factor, as well as stress and challenging childhood experiences.
The most common anxiety disorder in older adults is General Anxiety Disorder, however there are certain anxieties associated with older adults. These include phobias and fear of falling, agoraphobia and panic, health anxiety, social anxiety and PTSD.
Symptoms can include:
- Avoiding beloved activities
- Eating less
- Restlessness and trouble focusing
- Easily alarmed
- Intrusive thoughts
- Racing heart
- Muscle tension
- Stomach aches
- Shortness of breath
- Choking feeling
- Chest pains
- Heart palpitations
If these symptoms are present for weeks or carry on for months or more, it’s time to visit a health professional.
How to Get Help
The first step is to speak with your healthcare provider if you feel that your symptoms are interfering with your life. With the new diagnostic tools that medical professionals now have at hand, diagnosis and treatment specially tailored to older adults should be available to you.
If you do not have a family doctor, do not fret, you have many options available to you such as walk-in clinics, nurse practitioners or virtual care.
Make sure you have your medical records on hand and bring them to your appointments. Any medical practitioner you turn to will need to see a full history to assess the best path forward for your needs, particularly if you are on medications or are managing any illnesses or conditions.
“Considering the health human resource shortages we are experiencing within the Canadian health care system, including those in primary and specialist care, it is clear that all health care professionals play a role in supporting the mental health of older adults. These guidelines will help all nurses across any setting to learn more about the specific signs and symptoms of anxiety in older adults and what they can do to help manage it. I will reference these guidelines in my classroom moving forward.” – Carly Whitmore, RN, PhD, CPMHN, Assistant professor, School of Nursing, McMaster University.
Treatment plans may include cognitive behavioural therapy, mindfulness, medication or physiotherapy if the anxiety is centred around falling.
Lifestyle alterations can also play a big part in breaking the anxiety cycle.
Sometimes the most effective changes are the ones you make in your life to help yourself. To reduce anxiety, try limiting substances like caffeine and alcohol.
Try to integrate relaxation exercises such as progressive muscle relaxation, guided imagery (see below for helpful video), and box breathing; find self-help tools and learn more on Anxiety Canada’s Free Downloadable PDFs page.
More Resources – The Anxiety Stories Podcast
Listen to Anxiety Canada’s “Our Anxiety Stories” podcast featuring Dr. Andrea Iaboni. In this episode, Mark Antczak, Anxiety Canada’s in-house Registered Clinical Counsellor and Clinical Educator, interviews Dr. Iaboni.
Dr. Iaboni shares her experiences and expertise in the field of geriatric psychiatry as well as her story about advocating for her father’s mental health as he navigated the health care system in older age.
The Health Insider applauds this new initiative and the work the CCSMH is doing to reduce stigma around mental health for older adults.
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