Let’s focus on older veterans’ mental health

To mark mental health awareness week The Age Scotland Veterans’ Project highlights the mental health needs of older veterans.

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First, a myth to bust.  It’s not common for military veterans to have combat-related Post Traumatic Stress Disorder.  Yes, it happens, and can be debilitating for those living with it.  Yet according to Scotland’s Veterans’ Commissioner ‘the vast majority of those leaving the military do so without severe mental health problems and cope well with the transition to civilian life.’

 

So, no need for concern?  Wrong.  There are almost a quarter of a million veterans in Scotland who have their share of mental health problems common in the wider population, including depression, general anxiety or stress related disorders.  Almost half of those veterans are aged 75 or older, and so are at more risk of experiencing loneliness and isolation as a result of the big life changes ageing can bring.

While mental health awareness is increasing in the military, older veterans will have left service at a time when understanding and support was much more limited.  The Veterans’ Commissioner has also highlighted how the ‘military is historically associated with a culture of heavy drinking’ and that, while much has been done within the military to shift behaviours, ‘alcohol misuse is still significantly higher than amongst the general population.’  And then there is the pride, stoicism and self-reliance instilled by military life: qualities that are advantageous while in service, but potentially disadvantageous when it comes to admitting vulnerability and seeking help in civilian life.

The good news is that there is a wide range of help and support to enable older veterans enjoy the best possible mental health and wellbeing, including Combat Stress and Veterans First Point.  Comradeship, the strong bonds forged in military service, can also support mental wellbeing among veterans.  Many of our partners in Unforgotten Forces make huge contributions to enabling isolated older veterans to enjoy comradeship, including Legion Scotland, Luminate, Poppyscotland, Music in Hospitals & Care, Erskine and Fares4Free.

Older veterans who have mental health problems arising from, or made worse by, their service, may be eligible for compensation from the Ministry of Defence.  Under the War Pension scheme, which applies to conditions related to service before 2005, there is no time limit for claims.  For such conditions veterans are also entitled to priority healthcare, meaning that they should be prioritised over to other patients with the same level of clinical need.  The Armed Services Advice Project can give advice where that may not have been the case.

Pre-order your free copy of The Veterans’ Guide to Later Life in Scotland call 0800 12 44 222 or email publications@agescotland.org.uk.

Don’t fear the D word

Dementia is a word that strikes terror in many.  And no wonder: newspapers regularly feature headlines that sensationalize the ‘misery’ of dementia ‘sufferers’.   Yet there is a growing number of people with dementia who are active as campaigners, and they reject such language as stigmatizing.  Instead, they call themselves people who are living with dementia.  In one survey more than two thirds said they were living well with dementia.

Does the way we talk about dementia matter?  Yes.  A recent survey of the general public by the Alzheimer’s Society asked: “if you had a physical symptom, would you see a doctor right away?”  60 per cent of the sample said they would.  However, asked whether they would see a doctor right away for a non-physical symptom, such as a memory problem, only 2 per cent said yes.  For many people, fear of discovering that they have dementia will keep them from talking to their GP.

It’s beneficial for people who are worried about their thinking to get it checked out as soon as possible.  They may learn that their symptoms aren’t caused by dementia.  Did you know that memory loss, the symptom most associated with dementia, can also be caused by other things such as stress, depression, infections, nutritional deficiencies and even lack of sleep?  Moreover, with around 100 types of dementia that can affect the brain in different ways, memory loss is not necessary the first sign.  The range of early dementia symptoms includes reading problems, difficulty judging distance, less fluency when speaking, and even becoming less kind and caring.  Because of this a diagnosis can take time to reach: other possible causes need to be ruled out.

Getting a diagnosis is worthwhile, as without it you won’t be able to get support to live well with dementia.  In Scotland everyone who receives a diagnosis is entitled to personalized support which, if their dementia is in its early stages, will be from a Dementia Link Worker.  Link Workers can help someone understand and adjust to their diagnosis, to plan for the future, and to get the support they need to live well with dementia.

That support can come from a range of sources, including other people with dementia, and opportunities to enjoy supported activities, from singing to sport.  Did you know that many of the things that help people to live well with dementia are the same as those that make it less likely someone will get dementia in the first place?  Physical exercise, eating well, staying within safe alcohol guidelines, stopping smoking, socialising and challenging the brain can all play a part.

Age Scotland’s Early Stage Dementia project offers free guide booklets on a wide range of dementia related topics.  You can request these from the Age Scotland Helpline: 0800 12 44 222.

Time for a wee ramble

Ramblers Scotland has 56 walking groups across Scotland and the number is increasing. So what is it about walking that’s got so many people heading outdoors?

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Wouldn’t it be great if there was an easy activity that would improve your physical and mental health, lower your risk factors in a range of illnesses, give you a chance to enjoy quality time with old friends and to make new ones, and that you could do throughout most of your life? Well, there is, and it’s as simple as going for a walk.

Walking is an excellent all-round exercise. Almost everyone can do it, anywhere and at any time – and it’s free. You don’t need special clothing and it’s easy to fit into your daily routine. Older adults should aim to walk for around half an hour on most days of the week, but doing any exercise at all is better than nothing. If you’re unfit you can start slowly and build up gradually.

There are real health benefits from being more active; it helps protect the body from many illnesses and conditions, such as heart disease, strokes and osteoarthritis, and also helps to lift depression and improve mental health. But never mind all the health benefits, it’s also enjoyable. Walking helps you to collect your thoughts and appreciate the changing
seasons as you walk throughout the year, and it’s also a sociable activity. Walking in a group helps reduce feelings of loneliness and isolation and increases social contact. It also means you may be more likely to turn out on a cold morning, and to keep up the activity over time.

Ramblers Scotland has 56 walking groups across Scotland, all with walk programmes led and organised by volunteers, and they often also include social events. Non-members are welcome to go on a few walks for free before deciding whether you’d like to join us. You can be sure of a warm welcome and a good chat with like-minded people. As Dot, one of our members in Dalgety Bay, says, “I joined the Ramblers when I first retired as I was looking for something to do. I never expected I would get so much pleasure out of walking with my group. As well as being much fitter now and making lots of friends, I’ve loved getting to visit Scotland’s fantastic countryside.”

If you want to explore your local neighbourhood, our Medal Routes project has gathered over 600 short, circular routes of 15, 30 and 60 minutes – bronze, silver and gold medal routes – from Dumfries to Shetland, which help you to get out and about. They are all available from our website. We also have a routes database, Ramblers Routes, which has route suggestions across Scotland, with shorter walks free to download for non-members.

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For information on finding your local group, call 0131 472 7006 or email scotland@ramblers.org.uk. or visit our website. 

“Looking After You” – February’s Hot Tips

Our free calendar “Hot Tips” aims to ensure everyone in Scotland knows about the organisations and services available to them, and how to make the most of later life.

February’s theme is “Keeping mentally well” and offers tips on dealing with stressful events and challenges. In this blog, Age Scotland’s Karyn Davie looks in more detail at some of the things people should be aware of with their own mental health and wellbeing.

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Your mental health is like an escalator, you can go up or down depending on life’s events. When things are going well you might move up, but if something comes along to upset the balance, like changes to physical health, relationships problems or worries about family or money, you might find yourself sliding down.

Sometimes, there’s no clear reason why we feel like this. Changes in our mental health can happen to anyone at any age and, sometimes, regaining the balance can prove difficult.

The stigma around mental health means people don’t always talk about it.  Many older people find it particularly hard to talk about their feelings, perhaps due to a sense of shame or embarrassment, not knowing why they feel the way they do, or simply not wanting to admit they’re aren’t coping.

Men, and older men in particular, typically hide or deny mental health problems, preferring to keep feelings to themselves or not to reveal perceived signs of personal weakness.

We often find it easier to talk about physical health problems than the way we feel.  Anyone can experience a mental health problem, so talking about it really is important.

If you notice a friend or family member withdrawing, try understanding what they’re going through. Their difficulties may be only temporary. If you’re concerned, you could ask (in your own words):

• How are you feeling?
• I’ve been worried about you, how are you?
• You seem down, is there anything I can do to help?
• Avoid cliché phrases like ‘Cheer up!’ or ‘I’m sure it’ll pass’.

Give them time and space until they’re ready to talk and ensure they know they can contact you when they’re ready. Just knowing they don’t have to avoid the issue with you is helpful.

Remember that the person hasn’t changed, they’re just going through a bad patch with their mental health, so keep talking about the things you always talked about. Just spending time with the person lets them know you care.

Further information can be found from the following organisations:

• www.mentalhealth.org.uk
• www.samh.org.uk/home
• http://oldermenswellbeing.co.uk – contains information for older men

If you don’t have access to the internet, or if you experience feelings of loneliness and don’t have the social contact you feel you need, contact Silver Line Scotland for help on 0800 4 70 80 90.

Download your 2015 Hot Tips Calendar here and get information and advice throughout the year. Here’s what you’ve thought about Hot Tips so far:

• “Thank you for the calendar – useful & attractive”
• “I do not think you could do any better. This is wonderful”
• “Thank you for caring”

Download yours today!

Mental Health and Older People

Today is World Mental Health Day – a day the world celebrates mental health education, awareness and advocacy. Guest blogger Karyn Davie, Age Scotland’s Health & Benefits Project Worker, shares her findings from recent group discussions on mental health and older people, and the barriers to people seeking help.

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Earlier this year I met with some of Age Scotland’s member groups to talk about mental health and wellbeing; access to treatments, and their own personal experiences.

It was clear that self-stigma remains a strong barrier to people in older age seeking help to mental health issues, with individuals being concerned about being judged by others.

‘My neighbours didn’t know why I was in hospital- it would be different if it was a heart attack or something, they would stop me in the street and ask if I was ok- but they would look strange and think I was a ‘loony’ who had been in a ‘loony ward’. I couldn’t cope with that’.

Another common theme that was discussed by the groups was loss of social networks and the effect this has on self-esteem, and sense of social standing. One gentleman told me: “I have been to four funerals already this year- that’s my social life! I worry there’ll be no one left to come to mine”.

Other Common Losses discussed were:

• The impact of retirement, and the loss of structure to the day
• Moving home; close friends or family moving away;
• Living on reduced income
• Not being able to take part in activities enjoyed for many years because of difficulties getting there, health problems or hearing/sight problems that affect them
• Sense of vulnerability due to sudden health changes i.e. stroke or heart attack

All of these losses were discussed as having a significant impact on the person’s self-esteem, with many people advising that they made them feel isolated and lonely.

While visiting the Mood Project in West Lothian, the Men’s Group were very honest and open about issues for them. They made the following observations:

• Men don’t generally pick up leaflets to seek advice unless; directly given to them by a health professional; forced to by a partner; or it says ‘free’ on the cover!
• Men tend to talk about ‘problems’ rather than emotions.
• They would rather be actively ‘doing things’ rather than talking i.e. walking groups, outings, men’s sheds.
• Mental health problems affect their sense of masculinity- they should be the strong one; the protector and provider and this is challenged by feelings of being ‘weak’.

Many people I spoke to that described physical symptoms such as heart palpitations and headaches that don’t go away were unaware that the way they felt could be due to their mental health. They also preferred to use terms like ‘funny turns’ rather than panic attacks.

Much of the terminology used in modern day mental health services such as ‘mental resilience’ or ‘coping strategies’ was unrecognised, and had a very negative impact. There was also very little awareness or understanding of treatment options such as psychological therapies, and social prescriptions. Both of these factors presents a real barrier to people seeking help, as the fear remains that it will lead to admission to a psychiatric hospital.

In general written resources are not age friendly, often using bright fonts with modern slang and terminology or advocating use of mobile apps or computer programmes which can isolate older audiences. Information is also not always presented in a way that takes into account differing needs due to sensory and cognitive functions.

We also found that concerned friends and family struggled to find resources about ‘how to have that difficult conversation’ and how they could help.

With the learnings from these visits, I am currently developing information resources for people who are concerned about their mental health, with the aim to make it more accessible and age appropriate.

For more information on Mental Health visit:

• The Scottish Association for Mental Health (SAMH) http://www.samh.org.uk
• NHS inform: http://www.nhsinform.co.uk/MentalHealth

Or call Silver Line Scotland on 0800 4 70 80 90

 

Are pensioners drinking themselves to death? (Tomorrow’s fish and chip paper)

Problem drinking in later life has become an epidemic, according to newspapers this week.  Doug Anthoney responds.

New government figures show that last year almost 10,500 people aged 60 and over in Scotland needed hospital treatment for alcohol, one in three of all such admissions and a 62% increase in the last five years.  By contrast there were just over 8,000 incidents for the 35 and under age group.

We agreed that the high incidence of alcohol misuse among older people is of real concern.  Later life sometimes brings bereavement and isolation, which in turn can affect mental health and well-being.  Older people are more likely to drink at home, every day and on their own, suggesting that some use it as ‘self-medication’ to deal with life’s stresses; perhaps without an awareness of just how much they are drinking.

So what’s the solution? Families, health and social care professionals need to be aware of the issue, and be able to tell the signs of problem drinking from those of the natural ageing process.  We also need to ensure that older people can access the kind of social and support opportunities offered by Age Scotland’s member groups; from lunch clubs to Men’s Sheds.  But let’s try to keep it in perspective; it’s by no means an issue for every older person! You might be interested in the views of regular guest blogger Pat Craig on this issue.

Doug Anthoney is Age Scotland Communication and Campaigns Officer.  ‘Tomorrow’s fish and chip paper’ is off on holiday but will be back on 19^th July.