How Do I Help My Elderly Friend?
Colleen has a 78 year old friend who fears crowds and other social situations yet is too afraid to see a doctor. He struggles with complex information and has difficulty making himself understood. At social gatherings or in social situations he feels like everyone is looking at him (see ‘How Can I Help a Friend . .' ).
HealthCentral Expert, Eileen Bailey, has offered some good ideas for preparing for a visit to the doctor and ways to make the process easier. However, it later transpires that friend Colleen lives in a different State and this has an influence on the level of support that can be offered.
Anxiety in the elderly is a scenario I feel we're going to come across more and more. First, we have an increasingly elderly population. Secondly, their closest friends and nearest family have possibly died, or live in other locations. Thirdly, older adults have more reason to feel anxious due to their increased social isolation, dependence on others, health problems, financial difficulties and fear of being a burden on others - often traded against fear of abandonment.
It isn't clear from Colleen's question just how long this has been a problem for her friend. If it's a long-standing issue the diagnosis and treatment may be different than if relatively recent. If Colleen can support or encourage her friend to see the doctor there are likely to be benefits, some of which may be unexpected but helpful. For example, hearing loss, visual impairment and early stage dementia are all associated with a greater incidence of anxiety. A general physical examination may spot the signs of physical conditions that frequently accompany psychological symptoms. For example, panic disorder has been discovered in as much as 83 percent of patients with cardiomyopathy. Upwards of 75 percent of patients with pancreatic cancer exhibit both anxiety and depression.
I don't mean to suggest that Colleen's friend has a medical condition, only that medical disorders, including neurological disorders, do increase the risk of anxiety disorders and anxiety symptoms. As people age, so the likelihood of medical conditions increases.
When it comes to possible treatments for anxiety in the elderly the picture becomes a little blurry. Technically, there is no reason why an older person should not benefit as much from medications or psychological treatments as anyone younger. In practice, this may not be so straight forward. Many elderly people may not tolerate some of the powerful drugs prescribed for anxiety or depression. There may also be a higher risk of side effects or contra-indications due to medication they may be taking for other medical conditions. There is some evidence to suggest that simple behavioral treatments can help to reduce anxiety, but there remains some skepticism over the feasibility of cognitive-behavioral techniques with patients who are cognitively impaired.
Colleen recognizes anxiety in her friend and despite his apparent difficulties in communication she has been able to determine the nature of the problem and some of the circumstances where it affects him the most. Colleen may not be able to accompany her friend to the doctor, but she has the gift of being able to advocate on his behalf. For example, she might consider writing a short ‘dear doctor' letter. She could send it to her friend, and so long as he agrees with the content, he can simply hand it to the doctor. This spares him the stress of having to think what to say. The logistics of getting the friend to see the doctor is a separate issue.
Do you have an elderly friend or relative with similar problems? Can you suggest others ways Colleen might help from a distance? Do you have any additional thoughts or comments?