Caring for older adults should be a responsibility of the community, including in Iowa.
Older adults are some of the most at-risk members of the community for mental illness. Limited interactions with the community, neglect from family members, and potentially abusive environments are all common factors that contribute to severe mental illnesses. These mental illnesses can include disorders such as depression, post-traumatic stress disorder, schizophrenia, and obsessive-compulsive disorder.
The National Institute of Mental Health defines a serious mental illness as “a mental, behavioral, or emotional disorder resulting in serious functional impairment, which substantially interferes with or limits one or more major life activities.”
Data published in 2019 by the Substance Abuse and Mental Health Services Administration, or SAMHSA, reveals that about 1.4 to 4.8 percent of adults over 65 years of age in the U.S. suffer from a severe mental illness.
SAMHSA also estimates that mental illnesses increase the risk of self-harm among older citizens, putting them at a higher risk of death due to self-inflicted injuries. Data published in 2024 by the National Council on Aging reveals that loneliness and disconnectedness from the community along with cognitive impairment and symptoms of clinical depression led to self-harm; the data also reveals that 10,433 people aged 65 and above took their own lives in 2022 due to self-inflicted injuries.
According to 2024 Pew Research Center Data, there are approximately 62 million older adults aged 65 and above in the U.S., which accounts for 18 percent of the population. According to the 2023 Iowa City Census, older adults make up 11.5 percent of the local population.
Despite a significant population of older adults in the community, their mental health issues that arise due to abuse, isolation, or neglect from family are often stigmatized.
Care for older adults has become increasingly difficult due to the lack of a trained workforce. As per data cited in the 2021 edition of Nature Aging journal, there are less than 1 percent of physicians certified in geriatrics and only about 8 percent of nurses certified in gerontology in the U.S. The lack of workforce combined with family neglect and abuse can lead to feelings of isolation in the older people population and increase the risk of severe mental illnesses.
The National Council on Aging estimates that one out of 10 older adults experience abuse, including emotional abuse such as inconsiderate comments, physical abuse such as assault, financial abuse such as forging signatures on documents, and psychological abuse such as verbal threats.
The World Health Organization, or WHO, states that social isolation affects about 25 percent of the older population, and is a contributing risk factor for mental illnesses such as depression and anxiety. It states that the older population living in abusive environments or suffering from chronic conditions such as dementia, cancer, or stroke, may be at an increased risk of developing mental illnesses.
Social support and community involvement can help older adults feel supported. These can involve encouraging the younger population to volunteer in activities involving older people and enabling more social activities for the older population at the community level.
WHO recommends reaching out to members of the older population and enabling better access to technological and communication facilities for those who suffer from chronic illnesses or live in remote areas.
WHO also suggests interventions by caretakers and community members to prevent abuse. These can include educating older people about resources such as the National Domestic Violence Hotline and information about abuse through the National Center on Elder Abuse. It can also involve educating people that elder abuse is a crime and can be reported to Adult Protective Services of the state.
The Iowa Health and Human Services lists resources such as the Dependent Adult Abuse Reporting toll-free number, to which anyone can report abuse of older adults. The Office of State Long-Term Care Ombudsman ensures quality care and volunteer activities for older adults in assisted living facilities.
The Retired and Senior Volunteer Program of Iowa organizes the Neighbor to Neighbor Call Program, wherein older adults socialize by engaging in conversations with volunteers over the phone. This service is free of charge. Volunteer callers are matched with older adults who wish to socialize on a temporary or long-term basis.
Considering issues of mental illnesses and abuse, the responsibility for the care of the older population lies not just in the hands of the geriatric workforce, but also with us, as a community.