Geriatric Psychotherapy: A Growing Need

Therapists need to start focusing on elder mental health

Thanks to active lifestyles, healthier diets, exercise, and advances in medicine and healthcare, Americans are living longer. That trend, coupled with historically low birth rates, is transforming the United States into an older population. In fact, by 2030, it’s expected that every baby boomer will be at least 65 years old and that seniors will account for one out of every five US citizens.  
This growing population presents a great opportunity for those who practice geriatric psychotherapy to help an increasing number of seniors live their golden years to the fullest. Keep reading to learn more about the issues that affect the older generations, why therapists need to start focusing on elder mental health, and how geriatric psychotherapy can help your practice get to the next level. 
Just because they’ve been on the planet longer than most people doesn’t mean seniors have it all figured out. In fact, it’s not uncommon for mental health issues to manifest as individuals get older as they leave their jobs, their kids move away, and they find themselves with more time on their hands than they’re used to. With that in mind, let’s take a look at some of the common mental health issues that older folks struggle with. 
Due to a confluence of factors — a lack of exercise, an uptick in medications, and a less-than-optimal diet, for example — many seniors have problems getting a good night’s sleep. In fact, research suggests that nearly half of the elder population experience insomnia at one point or another. Unfortunately, sleep issues can translate into a host of other problems — like irritability, exhaustion, and drug addiction. 
Drug addiction 
When you think of people addicted to drugs, the older population might not be the first group that pops into mind. Believe it or not, research suggests that 5.7 million seniors are suffering from drug addiction today. Moreover, 6 million seniors consume alcohol, 132,000 use marijuana, and 4,300 use cocaine on an average day. On top of this, there’s been an increase in opioid use among this age group in recent years. Add it all up, and drug addiction among seniors is a growing crisis. 
As people age, it’s not uncommon for them to have more time to think about their lives and their place in this world. Someone might begin to dwell on a mistake they made two decades ago and ruminate on it obsessively because they have more time on their hands than they’re used to, for example. Another individual might wish they pursued a different career. Either situation is an example of someone worrying about something they have no control over. 
While some seniors have a natural propensity toward depression, others began developing the issue in the wake of the COVID-19 pandemic. The abrupt transformation of our lives — coupled with fear over the virus itself and profound social isolation — was particularly difficult for certain seniors to process, causing them to become depressed. 
When you live long enough, you see a lot of people you care about die. Whether it’s an old colleague, a childhood friend, a family member, a spouse, or even a child, losing a loved one can be an incredibly difficult period for everyone, including our elders. Depending on how the individual experiences it, bereavement can ultimately turn into profound, almost crippling grief. 
Bereavement can also cause a slew of other thoughts and behaviors, including guilt, anger, and regret. For this reason, many seniors seek out professional help to process these feelings of loss and overcome bereavement-induced pain and sadness. 
Struggling with growing older 
As people age, many of them begin having problems with the process of aging itself. On one hand, an individual might develop mental health issues because they’re forced to deal with chronic pain and deteriorating health. On the other, someone might have self-esteem issues as they see themselves getting older and losing their place and influence in the world. Many of these folks choose to talk to therapists to improve their outlook and live happier lives. 
While this list is by no means exhaustive, it should give you a better idea of the variety of different mental health issues that impact seniors. 
If you’re a therapist who hasn’t considered geriatric psychotherapy before, here are some reasons why you might want to rethink that and give it a try: 
•	The population isn’t getting any younger. With declining birth rates and an aging population, more and more Americans are skewing older. By preparing to treat this group of seniors, therapists can do their part to promote the health of older adults — much to the benefit of family, friends, communities, and the seniors themselves.
•	The stigma around mental health is disappearing. While Americans have traditionally kept quiet about the importance of talking to therapists to work through mental health issues, that’s all changing. As the stigma around mental health continues to dissipate, it follows that more and more seniors will be willing to give geriatric psychotherapy a try if for no other reason than it’s socially acceptable.
•	There aren’t many therapists specializing in this area. There’s a reason that as many as 90 percent of seniors don’t get the treatment they need to live their best lives: There is a dearth of therapists that treat older folks. To some extent, this is due to the misconception that you can’t teach the proverbial dog new tricks. This ageist outlook is simply untrue.  
Now that you have a better idea of some of the reasons why you should start sharpening your geriatric psychotherapy skills, let’s turn our attention to the business part of the equation: how treating older patients impacts your practice. 
At a very basic level, offering geriatric psychotherapy services can benefit your practice by enabling you to target an entirely new slate of clients — and grow your bottom line because of it. After all, this is a traditionally underserved population. If there aren’t many therapists in your area who treat seniors, you may be able to become the only show in town — which could be particularly lucrative. 
On top of this, seniors can also help you grow your practice via word-of-mouth referrals. If an elderly client really enjoys your services, you can bet that they’ll tell their friends and loved ones about you. At the same time, you might even be able to get some of their friends or family members as clients, too, as you all work together to navigate the complex issues that come with aging — and how they impact the entire family.  
Depending on how your experience goes, you might even find out that geriatric psychotherapy is your true calling. This could make your work more engaging while helping you reach your full potential as a therapist. 
If you’re a GoodTherapy member who sees geriatric clients or is planning to give it a shot after reading these words, be sure that you have “Elders” selected as one of the ages you treat in your profile. That way, older folks will be able to find you more easily when they begin their search for a therapist. 


I Can’t Live Without Her: When Grieving Men Die

A new study finds differences between men and women in the “widowhood effect.”

The death of a spouse affects people differently, but many experience negative health effects.
Men and women are affected differently by the death of a spouse.
Man have a higher likelihood of dying themselves after the death of their spouse than women do.
What is the worst thing that you could imagine happening to you?

For many people, it's the death of their spouse. Accordingly, many people experience grief, stress, and negative physical health effects when their spouse dies. Others, however, are largely unaffected by such a tragic event. Which factors determine how somebody is affected by the death of their spouse is not well understood in psychological research.

A new study on differences between men and women in the widowhood effect
One commonly investigated phenomenon in the context of the death of a spouse is the so-called "widowhood effect." The widowhood effect postulates that if one spouse dies, the other one has an increased chance of also dying, compared to other people of the same age. The widowhood effect reflects that the death of a spouse is a highly stressful life event that increases the chance of negative health events like heart attacks in the surviving person.

A study just published in the scientific journal PLOS ONE investigates whether the widowhood effect may be influenced by the biological sex of the surviving spouse (Katsiferis et al., 2023). In the study, led by scientist Alexandros Katsiferis from the University of Copenhagen in Denmark, the research teams analyzed data from a large Danish study on more than 900,000 people over the age of 65. The scientists looked at the amount of money spent on healthcare by people who suffered the loss of a spouse and the amount spent by people who didn't. This was done to assess whether the loss of a spouse was associated with an increase in health problems. The researchers also analyzed whether people who experienced the loss of their spouse had a higher chance of dying compared to people who did not lose their spouse.

Men are more likely to die after the death of their spouse than women
Overall, about 8.4 percent of people in the study experienced the loss of their spouse. About 65.8 percent of these people who lost their spouses were women, reflecting that, on average, men die earlier than women.

For healthcare costs, there was a clear difference between men and women. Men who lost their spouse spent an average of 42 Euros per week more, while the increase for women was only 35 Euros, suggesting that men experience more health problems after the death of their spouse than do women.

A difference between men and women was also observed in the chance of dying after the death of a spouse, but here age also had an influence. The scientists found out that among those 65 to 69, men had a 70 percent increased chance of also dying in the first year after the death of their spouse. For women in the same age group, the increase was much lower, only 27 percent. This general pattern of males having a higher chance of dying after their spouse’s death remained the same in all other age groups in the study (70 to 74 years, 75 to 79 years, 80 to 84 years, older than 85), but the overall percentages got lower with increasing age.
Taken together, the study showed that men aged 65 to 69 years are most strongly affected by the widowhood effect. In general, men experience a stronger widowhood effect than women. Interestingly, an analysis of timing effects showed that men also showed an increase in the probability of dying after their spouse’s death for much longer than women. The scientists suggested that this reflects increased problems in men returning to a normal, functioning state after experiencing the loss of their spouse. Women seem to show higher resilience to stress in the situation and better psychological coping mechanisms to return to a normal life. These findings clearly suggest that men (and women) who experience the loss of their spouse should seek help and support from family, friends, or a therapist to deal with stress and grief and not “tough it out.”

Katsiferis A, Bhatt S, Mortensen LH, Mishra S, Westendorp RGJ. (2023). Sex differences in health care expenditures and mortality after spousal bereavement: A register-based Danish cohort study. PLoS One, 18, e0282892.