World Mental Health Day was initiated by World Federation for Mental Health (WFMH) in 1992 to highlight the importance of mental health. This year, the WFMH Board of Directors decided on the theme of “Mental Health and Older Adults”. Running on 10 October, the day focused on highlighting the mental health issues experienced by older people in their communities, and encouraged people to consider their needs for support and services. There is no denying that people are gradually living longer, as improved healthcare and standards of living have made this possible. In fact, the current number of people aged 60 years and over is more than 800 million, and projections indicate that this figure will increase to over two billion by 2050 (World Federation for Mental Health, 2013). It is thought that people aged 60 years can now expect to survive an additional 18.5 to 21.6 years (United Nations Population Fund, 2012). According to this statistic, soon the world will have a higher number of older adults than children.
It is therefore of the utmost importance that healthcare systems evolve so that they can manage this changing demographic. Increased awareness and education of common mental health problems of the elderly is a means in which this can be achieved. Whilst many associate elderly mental health problems simply with the effect of diseases such as Alzheimer's, there are far more elements to bear into consideration.
Depression is common in old age. Whether this is related to grief at the loss of a close friend or member of family, anxiety as a result of a fear of approaching the end of life, or due to mistreatment by family or carers and a subsequent feeling of helplessness, these are just some of the many potential contributing factors that may affect the mental wellbeing of an older person.
For paramedics, there are many situations where they may be dealing with patients approaching the end of life. While this is not limited to older people, it is likely that they will make up a notable part of this group. As Mike Brady (2013) discusses in this issue of the Journal of Paramedic Practice, while paramedics may be comfortable with the practical and clinical elements of practice associated with a patient facing imminent death, such as pain relief, the conceptual and philosophical elements may be less well known.
Brady's article highlights the importance of ensuring end of life patients receive what he terms a “good death”. While this is undeniably important, the general mental wellbeing of the elderly before they approach the end of life cannot be ignored. As mental health problems can have a high impact on an elderly person being able to carry out even the most basic of activities, awareness of any means to reduce these negative consequences is of great significance.