It’s Time to Acknowledge the Senior Mental Health Crisis — and Ways We Can Help

About Camille Jordan

SVP, Clinical Services

Camille Jordan is Senior Vice President of Clinical Services at Brookdale Senior Living

It’s not news that there’s a mental health crisis in this country. A pandemic abruptly kept us inside; made many of us ill; took away social gatherings, travel, hobbies, and daily work and school routines. The pandemic required sudden and unexpected changes to our lives, followed by perseverance in an unstable economy, with little time for reflection and adjustment until now. It also left waves of grief in its path.

Camille Jordan is Senior Vice President of Clinical Services at Brookdale Senior Living

Now, let’s consider the transitions that we ask seniors to make with changes in housing and lifestyles, and how quickly we expect them to adapt. This is sometimes over the course of a few months, weeks or even days. The evidence for how poorly we help seniors manage life’s transitions can be seen across the senior population in how anxiety and depression frequently go untreated, undiagnosed or unacknowledged. There’s a concerning mental health crisis among seniors, and many who work and care for seniors aren’t aware of it. We underestimate the amount or severity of anxiety and depression that seniors have; and, unfortunately, as a result, there’s been an uptick in suicides.

As many as 15% of those 65 and older living outside of a nursing home or assisted living community have diagnosable anxiety. Half experience symptoms such as irritability, fatigue, avoidant behaviors, sleep changes, worry and restlessness. But what causes anxiety evolves as we get older to include illness, retirement, losing family and friends, and cognitive declines. And only a third with generalized anxiety disorder receive treatment. There is a compounding effect to these stressors that, when left untreated, puts seniors in an increasingly vulnerable position.

One of my senior family members was recently diagnosed with diabetes, and after a hospitalization, he has had to adjust his eating habits. This may seem like a small adjustment, but he has been acting differently, and it’s understandable. His experience in having to set aside the foods he once loved illustrates how micro-stressors can compound to become bigger problems in our lives. We need to continue to keep an eye on him, because we may overlook larger behavioral shifts as we try to address more immediate health and safety concerns. When not properly acknowledged or addresed, the tradeoffs of these transitions for seniors can be serious mental and behavioral health problems with a direct impact on their health and outcomes — the very issues the initial changes were intended to address.

Whether it’s something as relatively small as changing your diet or as big as moving into a senior living community, change is hard. I’ve worked as a nurse for 29 years, with 10 years of experience in behavioral health and geriatric psychiatry in nursing homes and long-term care facilities. I’ve watched seniors be forced to let go of a lot of things at once, all because their care teams and caregivers are trying to improve their quality of life and enhance their well-being. But my experience in psychiatric management, memory care and neurocognitive disorders has shown that a lot of suffering comes in the midst of change. Assisted living plays an important role in managing seniors’ health. But transitions, the loss of independence, an unfamiliar environment, a new community — all of these can trigger anxiety, depression and delirium. This, coupled with the loss of loved ones, chronic conditions, or other health complications, can severely impact an individual’s mental well-being and can even make those other conditions worse. But it doesn’t have to be this way.

It takes self-awareness to get help, and socialization is often a key factor. Most individuals, including seniors, thrive on relationships. Because of this, at Brookdale we try to set residents up for success in what may be extraordinarily challenging moments by providing opportunities for true connection. Our engagement model focuses on pairing up individuals with similar interests and aspirations. It’s a friendship-first, program-second model. Instead of filling our residents’ calendars with generic programs and forced social groups, we intentionally create moments for authentic connection. This fosters deeper, more personal relationships among our residents, which creates a greater sense of belonging and joy. Being in community with others with the right mix of individual, small- and large-group activities curated for each individual can help residents better achieve optimal behavioral health outcomes by giving them purpose.

It’s also the little details that Brookdale fills in — the extra steps that we take for our residents — that help them with the transition to senior living. Because we know that life transitions can be triggering for anxiety and depression, in our initial move-in assessments we look for patterns that would indicate someone is suffering from anxiety or depression. Our Welcome Program, called CARE, enables us to get to know the resident and their personal preferences, and it allows the resident to get to know their care team and the other residents. We look for symptoms that might be overlooked at home. We utilize Clinical Care Reviews (CCRs) to address holistic needs from social to clinical, and these include partnerships with outside providers. Once residents are settled, our clinicians review each resident on a periodic basis to look out for symptoms that could flag a change in condition. For example, if a resident refuses to go to breakfast, limits their water intake, loses interest in their hobbies or isolates themselves from their friends, this would prompt an additional assessment for signs of anxiety or major depressive disorder.

Self-care also plays a large role in helping our seniors manage their mental health. The pandemic increased our awareness of self-care, not only in terms of our physical health, but also our psychosocial health, as we managed the waves of change it forced upon our lives. Brookdale brings mental and physical prevention together through our Optimum Life® programming, a holistic emotional and physical wellness model that encompasses six dimensions: purposeful, emotional, physical, social, spiritual and intellectual. In addition to clinical interventions, Optimum Life® incorporates exercise, nutrition, and spiritual well-being into resident engagement. At Brookdale, self-care is about setting up opportunities for joy. For some residents, this means going for daily walks, taking cooking classes or playing in chess tournaments; for others, it’s joining a prayer group with individuals of the same faith. These are all holistic alternatives to medication that help reinforce mental health and enrich overall well-being. It’s what we do best.

While transitions are a normal part of life, they don’t have to lead to a crisis. Addressing seniors’ mental and behavioral health begins with acknowledging and appreciating the details of their lives that are changing. Then, it takes finding them a compassionate, supportive and healthy environment in which they can experience transition. It’s up to all of us to prioritize their mental and behavioral health, before the little things grow to become bigger problems.

Camille Jordan RN, BSN, MSN, APRN, FNP-C, CDP, joined Brookdale Senior Living as the senior vice president of Clinical Services in the fall of 2022. As an experienced nurse executive with more than 29 years of experience in acute, psychiatric, and mental health care, Jordan is skilled in nursing management, disease management, nursing education, medical devices, medication administration and clinical education. Prior to joining Brookdale, Jordan served as the senior vice president of Clinical Operations & Innovations for Signature HealthCARE in Louisville, Kentucky.

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