Zoomersmagazine.com takes a hard, factual look at the sensitive and often difficult subject of Caregiving. We welcome Dr. Irving Hellman for his viewpoint on Caregiving matters in the beginning of the new millennium. We also extend invitations out to our readers to share their views stories with us on this matter. Feel free to submit your thoughts at any time regarding this topic to our submission link located on the home page!

In the later years, everyone will face stresses that are typical of the later stages of life. There are narcissistic blows, social isolation, loneliness, being marginalized by an Ageist culture, personal loss, grief, sensory changes, and physical vulnerability. Symptoms may include depression, anxiety, and somatic complaints. Problems like as alcoholism, drug abuse (which can involve abusing prescribed medications), and threats of suicide, may complicate matters further. The most vulnerable are those who have unresolved lifelong conflicts.

Approximately five percent of those over 65 will succumb to some form of dementia, such as Alzheimer's Disease. The prevalence almost doubles every five additional years, such that by the time people are older than 85 their chances of developing a dementia is 50%. This represents a potential epidemic since the fastest growing segment of the population is those older than 85 years. In addition, as people age, the chances of their being disabled by a range of chronic and progressive medical conditions increases dramatically. In the later years there is a great intermingling of bio-psycho-social impact on the integrity of the older person.

The effects of such ongoing, progressive diseases on the family can be dramatic. Currently, our health care system aims our resources toward helping the sick and disabled older adult.

However, there are often two parties at risk: those who are ill or disabled and those who care for them. Little support has been available for caregivers that are substantially at risk. Caregivers are oftentimes strained physically, emotionally, and financially. Such caregiver stress not only has a negative impact on personal and home life, but it can take a toll on work life as well. Employers, large and small are beginning to appreciate the potential loss in productivity of their employees struggling with caregiving issues and they seek assistance from the mental health community regarding these issues.

Without assistance, such caregiving strains can push some caregivers to the point of acting abusively toward the older adults in their charge. Many professionals who serve the elderly are mandatory reporters, required to report suspected elder abuse (i.e., sexual, physical, emotional, financial, and neglect) to Adult Protective Services or Ombudsmen, and it is in everyone's best interest to familiarize ourselves with this growing problem. Late onset elder abuse is often related to substance abuse and psychopathology of both the abused and the abuser, requiring the services of mental health professionals for assessment and treatment.

Family members or caregivers often seek referrals for themselves or for an aging relative within the context of their own psychotherapy or a visit to their own primary care physician. geropsychologists, often have an opportunity to assist overwhelmed caregivers to resolve old and new problems, seek concrete solutions, deal with the onslaught of day-to-day stresses, learn how to negotiate with siblings, accept the parent with their losses, retain a sense of balance. They also work collaboratively with psychotherapists, health care professionals, case managers, and legal professionals to assist with consultations and treatment of elders and their caregivers, and to provide training in required areas of proficiency to professionals serving older adults. Indeed, the demand for competent mental health professionals to provide coordinated services to a growing population of elders and their families is increasing.

Irving Hellman, PhD is a Licensed Psychologist and Geriatric specialist in private practice in Sacramento since 1985. A graduate of Yale University, he is an Assistant Clinical Professor in the Department of Psychiatry at the University of California, Davis Medical School.

Feel free to contact him at 916-731-7278 or email him at IDHellman@aol.com with your comments, questions, or interests in ElderCare Adviser.