Every Thursday, the doctors at the department of psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, dedicate their time and expertise to senior citizens, lending a patient ear to their issues, encouraging them to communicate, and feel comfortable in reaching out to the doctor.
The weekly geriatric clinic, a new initiative of the department, focuses on the mental care of the elderly. Dr Aseem Mehra, assistant professor, psychiatry, said mental health issues in the elderly are rising steadily and studies by the department in the last three years indicate that more men than women and those above 60 years of age are susceptible to mental health issues.
“We realised the need for an exclusive facility for the elderly, who may not get the attention they deserve, and also for practical purposes, it is easier for them to come on a particular day and meet their doctors, without waiting for too long, as many travel from outside the city. We also have to remember the social reasons why more males get help, as a wife will immediately bring her husband to the hospital, while many women may not be even diagnosed,” said Dr Mehra, adding that the clinic here sees more than 20 new patients weekly on an average.
Depression, anxiety, sadness, and stress are the major reasons why the elderly seek help, and these, says Dr Mehra, are a result of diseases, loneliness, being away from family and children, a lack of self-worth after retirement, financial issues, not engaging in physical, social and mental activities. With nuclear families on the rise, many senior citizens feel a lack of care and no one to talk to, and with diseases like diabetes, arthritis, heart problems, blood pressure, pains and aches, they feel more dependent and less active.
“The population is shifting towards the elderly, and it is a vulnerable population. A myth that we need to dispel is that dementia is a natural outcome of old age. It is not. It is a disease that needs immediate medical help and treatment for forgetfulness, limited social skills, and reduced thinking abilities that interfere with the daily functioning of a person. We have to identify dementia, treat it and improve a person’s quality of life,” adds Dr Mehra.
Counselling, medicines, behavioural therapy and family support, adds the doctor, are integral parts of the treatment, which requires a regular follow-up and a change in lifestyle, including positive thinking, exercise, a better diet and time and patience of family and friends. “In most cases, the spouse is the main caregiver, and then the children.”
Many senior citizens are referred to the department of psychiatry from the departments of general medicine and general surgery of at the PGI, as after extensive investigations, doctors are unable to find the cause of pains, gastro issues, fatigue, and lethargy. “Stress and emotional issues manifest in many ways, and every person has a different way to cope with stress, and we strive to assess every individual according to his or her personality. So, the role of a primary physician is paramount in this regard, as the physician is the first contact of a patient and appropriate reference is a vital part of treatment.
A recent study by the department on psychosomatic disorders on a sample size of 160 — 39 males and 101 females — indicated that many after being referred to the psychiatry department by other departments said they had no illness and were here because the doctor asked them to seek counselling.
“Majority said they do not want any psychiatric treatment, have no stress and don’t care about it. The sigma, both internal and external, stops them from accepting their condition and seeking psychiatric help, which needs to change if we want a healthier society. There has to be a shift in attitudes, and that’s our constant effort,” says Dr Mehra.