Special Considerations and Services for Older People

Older individuals frequently attach primary importance to their health concerns and this helps explain why they use hospital services, physician services, and long-term care services more than any other age group (Rhodes, 1988). From a physician s perspective, dealing with clients who are 65 and older has become a practice reality because this age group now makes up more than one third of all primary care visits (Kane, Ouslander, Abrass, 1999). 

In an archival study conducted on 298 clients who were treated by a mental health center, three issues predominated among older clients family conflicts, poor physical health, and feeling as if they were not in control of their lives (Mosher-Ashley, 1994). 

Developing a chronic condition is generally an older person s worst fear, because this type of condition frequently results in a gradual loss of activity or unaided mobility (Rhodes, 1988). Chronic conditions found in the elderly are either of a physical (biological) or mental (psychological) nature. Although this is a simplistic distinction, it is important to note that physical and mental health conditions are often related and interdependent (Dziegielewski Harrison, 1996). 

According to Butler, Lewis, and Sunderland (1998) as many as 20% of those 65 years or older suffer from various mental health disorders. Depression in older people is sometimes difficult to diagnose and has traditionally been linked to physiological and medical changes resulting from the aging process. Difficulties in accurately assessing depressive 

All of the major depressant medications discussed in chapter 4 can be used with the elderly. Again, caution should always be exercised, and according to Apfeldorf and Alexopoulos (1999), the antidepressant medications that are generally used with older individuals include tricyclics 

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