Aging and mental health -
honoring personal narratives & Needs
Tom Meuser, Clinical Psychologist & Applied Gerontologist

GeroPsych Maine LLC

Although age-friendly volunteers are not mental health professionals, you may encounter older community members facing emotional and other psychological challenges. Your community's support plays a crucial role in creating age-friendly environments that promote mental well-being and resilience.

Research suggests that the domains of social participation, respect and social inclusion, and civic participation and employment have roles in alleviating the effects of depression and anxiety. This is especially true for our oldest community members. Awareness of common factors in psychological wellness can help you connect people with resources and meaningful opportunities that will enhance their well-being. 

This chapter introduces mental health and aging and covers challenges you may encounter. It also discusses ways that age-friendly initiatives can increase awareness of resources, programs, and activities that support the mental health of older community members. 

Introduction - Ageism, Life Events, and Resilience

"Getting to know an older person, really allowing them to speak their truth, to share their perspectives, to feel valued is one of the most important aspects of working with older adults."

Resources - Ageism, Life Events, and Resilience

Relating to Older People Evaluation.pdf
recent-life-event-questionnaire.pdf
Brief Resilience Scale.pdf
UNE Ageism Scale.pdf

Note on languaging: The ROPE questionnaire uses the phrase "old people". We prefer the phrase "older people" to promote a sense of our communities as homes to a wide variety of age ranges, all of which have important roles to play in making our communities livable. For more information, we suggest exploring the Ageism Chapter. 

Activity - Ageism, Life Events, and Resilience

We all bring attitudes about our own aging and the aging of others to our age-friendly work. This exercise gives you the opportunity to learn how ageism, losses, and resilience affect the ways we interact with other older people. It also provides an opportunity to consider how these factors influence an older person's interest in receiving services and being engaged in the community.

Note: This is a self-evaluation. We do not expect you to administer psychological tests to the people in your community. 

Reflection - Ageism, Life Events, and Resilience

Reflect on what you’ve learned about ageism, life events, and resilience. How do those factors influence the way you connect older community members to resources and social opportunities? Click here to complete the first of three reflections in this chapter. Entering the reflection will also record your progress. Important: Complete each section before moving on to its corresponding reflection. When you return to the form, you will automatically be taken to where you last left off. 

Positive Mental Health and Personality

Positive mental health is a crucial aspect of overall wellbeing for older adults. It encompasses more than just the absence of mental illness; it involves a state of emotional, psychological, and social well-being that allows individuals to cope with life's challenges, maintain fulfilling relationships, and continue to grow and develop. For older adults, positive mental health can be fostered through various means, such as maintaining social connections, engaging in meaningful activities, continuing to learn and acquire new skills, and practicing mindfulness or spirituality. Regular physical exercise, a healthy diet, and adequate sleep also play significant roles in promoting mental wellness. Importantly, positive mental health in older age is associated with increased resilience, better physical health outcomes, and a higher quality of life. By focusing on strategies to enhance positive mental health, older adults can experience greater life satisfaction and maintain a sense of meaning, purpose and vitality in their later years. 

Activity: Positive Mental Health and Personality

Now, let's start a conversation. Click on the plus button in the Padlet below to share an example or two of ways that age-friendly activities, services, and programs in your community contribute to positive mental health. 

Note: if the Padlet does not work here, click here to visit and contribute. 

Resources - Positive Mental Health and Personality

8_dimensions_of_wellness_assessment.pdf
UNE Mattering Scale.pdf
Flett & Heisel 2021 Mattering.pdf
UNE Wellness in Aging Measures Booklet 5-26-24.pdf
Defining Wellness in Older Adulthood_ Toward a Comprehensive Framework.pdf

Activity - Positive Mental Health and Personality

"Wellness is the pursuit of lifestyle balance and quality of life across a variety of domains, such as social, spiritual, physical, vocational, intellectual, and emotional wellness. Wellness can be attained by all people, regardless of age, medical conditions, or other circumstances. Wellness is a lifelong pursuit and is important even for those who feel satisfied with their well-being." 

--Matthew Fullen, PhD

Reflection - Positive Mental Health and Personality 

Mattering refers to the feeling of being valued by others and knowing that people care about you. How does your Age-Friendly initiative foster this sense of importance among older adults with diverse aging experiences? Consider those living with physical or cognitive disabilities, or on fixed, lower incomes. What strategies can you implement to ensure all community members feel they truly matter? 

 Click here to complete the second of three reflections in this chapter. Entering your reflection will also record your progress. Important: Complete each section before moving on to its corresponding reflection. When you return to the form, you will automatically be taken to where you last left off. 

Challenges to Mental Health

You might wonder why it's important to discuss the issues described in this chapter, given that many older adults are hesitant to seek help for fear of being labeled with a mental health problem. This reluctance is precisely why we must emphasize that loneliness, depression, suicidal thoughts, anxiety, and delusions or paranoia are not normal parts of aging. Effective treatment is available, and seeking help can lead to significant improvements in quality of life.

If you notice signs of distress in an older community member, you can play a crucial role by gently encouraging them to speak with a healthcare professional, such as a counselor, social worker, or their primary care physician. This seemingly small step can be the beginning of a transformative journey towards better mental health and overall wellbeing.

By fostering open conversations about mental health and promoting help-seeking behavior, we can support older adults in maintaining their emotional wellness and enjoying their later years to the fullest.

Resource Activity - Challenges to Mental Health

At the end of the video, Tom described a very simple ranking chart that can be used to track our concerns about community members who participate in age-friendly. 

Of special note, suicide among older adults is a serious public health concern that often goes underrecognized. While older individuals attempt suicide less frequently than younger age groups, they have a higher completion rate due to more lethal means and fragile health. Risk factors include social isolation, loss of independence, chronic illness, and untreated depression. Recognizing warning signs and providing support through mental health services, social connections, and purposeful activities can significantly reduce suicide risk among older people. Communities play a crucial role in creating an environment where older residents know about available resources and feel safe talking about their mental health concerns. 

These are a few resources that can be shared in your community. Many of these resources can also provide advice about a situation. None of these are emergency resources. If someone is in immediate danger, please call 911. 

 Resources - Challenges to Mental Health

4. geriatrics_depression_scale.pdf
Penn State Worry Questionnaire - Abbreviated 8.pdf

 Resources - Suicide

Suicide is a leading cause of death in the US. Men over the age of 65 die by suicide at almost triple the overall rate. Women are not immune. Since 2001, the rate for women aged 65-74 has increased by 44%.

In our chapter on ageism, we explored how detrimental negative perceptions of aging can be. The National Alliance of Mental Health reports out that ageism raises suicide risk by weakening protective factors, such as self-esteem, self-efficacy, and hopefulness. This, in turn, may make someone feel like a burden or feel disconnected from their support system. These factors can lead to suicidal ideation and suicidal intent.

Talking to someone about suicidal thoughts is hard at all ages but becomes even more challenging with an older person. Stereotypes about aging suggest that depression is a normal part of aging, that older adults are preoccupied with a litany of illnesses, and that suicide is an escape. Even though rates are highest among older people, suicide prevention tends to focus on young people. We can shift the conversation and learn about the tools and resources available. Watch this video to learn more. It could save a life. 

This video is shared with us by the TriState Learning Collaborative on Aging. It is a snippet from a longer webinar on sucide prevention. Click here to watch the full webinar

Reflection - Challenges to Mental Health 

Thinking about your own community, what are some ways that your team can foster conversations about mental health?  Click here to complete the final reflection in this chapter and record successful completion of the Mental Health chapter.  Note: Clicking will bring you back to where you left off when you completed your last reflection. When you have finished, please click "submit" to record completion of the Mental Health and Aging chapter. 

Conclusion - Mental Health and the Whole Person

You will meet all kinds of people in your age-friendly initiative. This video describes some personality types you may encounter and then introduces the "Ability Balance" tool. 

"Ultimately, your interview with an older community member will help you develop a picture of their overall wellness. This takes into account many factors – their mental health, physical health, social engagement, etc. – which will provide the context for your suggested resources, supports, and interventions.

An Ability Balance can help you organize your thoughts…"

Resources - The Whole Person

Life Strengths Interview Guide.pdf
Ability Balance.pdf

Activity - The Whole Person

As a Community Connector or age-friendly volunteer, your role is to thoughtfully balance an individual's strengths with their needs. This balanced approach allows you to:

By considering both strengths and needs, you can make more personalized and effective connections between community members and available resources. This approach ensures that the support provided is not only practical but also respectful of each individual's dignity and autonomy.

Your challenge is to see the whole person - their capabilities as well as their challenges - and use this holistic understanding to guide your recommendations and connections.

To enhance your knowledge about structuring conversations with older residents seeking resources and support, explore
"Interviewing for Advocacy: Purposeful Engagement, Respecting Boundaries, & Creating Mutual Direction."
Note: Each of these chapters counts as 1 unit to the required 10 chapters to achieve a certificate of completion. 

Additional Resources

Eric Einhart, Judith Flynn, and Roberta Flowers. Solo Agers Can Find Independence in Planning and Advocacy.
"Solo agers" refer to older adults who are aging alone, without a spouse, partner, or adult children to provide care and support as they grow older. This demographic is growing, as declining marriage and fertility rates, increased geographic mobility, and other societal shifts lead to more individuals facing their later years without a built-in support network. Although solo agers face unique challenges, they can also develop strong independent living skills and cultivate rich social networks beyond traditional family ties. 

Lisa Furst and Kimberly Williams. Mental Health Literacy Among Elders: What Do We Know, What Can We Do?  
Addressing ageism is an important step in promoting the mental health and wellbeing of older people. This requires challenging negative stereotypes, improving access to age-friendly mental health services, and fostering more positive, inclusive attitudes towards aging in society. One of the first steps is to promote mental health literacy so that older adults can become their own best advocates.  

Tracey Gendron. The Impact of Ageism on Elders' Mental Health.
Ageism - the stereotyping, prejudice, and discrimination against people on the basis of their age - can have significant negative impacts on the mental health and wellbeing of older adults. Older individuals who experience ageism are more likely to suffer from depression, anxiety, low self-esteem, and other mental health issues. 

Elahn Little and Eunhwa Yang. Cognitive Aging in Place: Guides To Enhance Safety, Independence, and Comfort at Home.
The authors explore "how home environments can be adapted to improve the daily lives of people with mild cognitive impairment." Their Home Design Guidelines put their research into practice so that people can identify the home design modifications that work best for their situation. 

National Council on Aging. Suicide and Older Adults: What you should know.
In addition to describing risks and warning signs, the article highlights five action steps anyone can take if they suspect an older person is contemplating suicide. 

Jeremy Nobel.  Alleviating Loneliness in Older Adults through Creative Expression.
Creative pursuits can be a powerful antidote to the loneliness that often affects older adults. Activities like painting, writing, music, and crafting can provide a sense of purpose, improve mood, and facilitate social connection. When older adults engage in these forms of creative expression, either individually or in group settings, it allows them to explore their emotions, connect with others who share their interests, and feel a renewed sense of identity and self-worth.

SAMHSA. Promoting Emotional Health and Preventing Suicide: A Toolkit for Senior Centers
Although this is not written for age-friendly communities, it has ideas that can be applied in community initiatives. This toolkit helps senior centers integrate suicide prevention into activities that support well-being. It describes activities that increase protective factors, and explains how to recognize the warning signs of suicide. 

Louis Tentenbaum and Susan Kimmel. Overcoming Inertia to Jumpstart Home Modifications for Aging in Place.
The prospect of making home modifications to facilitate aging in place can feel overwhelming for many older adults, leading to inertia and inaction. Feelings of uncertainty about the process, concerns over cost, or simply a reluctance to change the familiar home environment can prevent people from taking the first steps. However, it's important to overcome this inertia before safety issues or declining mobility make modifications an urgent necessity. The key is to start small - focus on low-cost, high-impact changes like adding grab bars, improving lighting, or rearranging furniture for better accessibility.

Meet Your Chapter Guide - Dr. Tom Meuser

Tom Meuser retired recently from the University of New England where he was the Founding Director for the Center for Excellence in Aging & Health (2018-2024). He is presently self-employed as a geriatric psychologist specializing in cognitive change and functional wellness in aging. Tom also works as a contract researcher for the Maine Bureau of Motor Vehicles. Early in his career, he was a co-investigator and translational educator for the Knight Alzheimer's Disease Research Center at Washington University School of Medicine in St. Louis, Missouri, one of ~30 federally funded centers around the US. He's a Fellow of the Gerontological Society of America (2011-present), a Maine Commissioner for Community Service (2022-present), a Trustee of The Park Danforth Retirement Community (2023-present), and a longtime volunteer for the Alzheimer's Association (1999-present). Tom lives in Portland with his wife, Christy, an Occupational Therapist at Maine Med, and their three rescue dogs. He enjoys tennis, reading, camping, home repair, and board games in his spare time.

During this chapter, we hope you gained tools to frame your work within an understanding of mental health and aging.
If you have any questions as you are going through the material, please email: lifelong@maine.edu.