“DON’T AIR YOUR DIRTY LAUNDRY”

Supporting Resident Mental Health

Senior Retirement Project

Dr. Melinda Spohn, LMHC

Executive Director

509-638-9044

Mission Statement

To provide adjustment and mental health counseling to

seniors and elders in the comfort and privacy of their

own home.

www. SeniorRetirementProject.org

G.I. Generation 1901-1924

Silent Generation 1925-1945

Prefer privacy “Don’t Air Your Dirty Laundry”

Minimal to no sharing of inner thoughts

Duty and one’s word was their bond

Respect for social order, do things “the right way”

Respect authority

Senior Social Identity

Coping with Change

Moving from one’s established home

Loss of possessions (down-sizing)

Death of a spouse

Community living, loss of privacy

Making new friends

Changes in health and mobility

Death of longtime friends

Coping with challenging personalities

Realities of aging (realization of end of life)

Research Study

Convenience Sample

6 retirement communities N= 243

(3 Washington State, 3 North Carolina)

1 Executive (high-end community)

3 Moderate (moderate income)

2 Low Income/high Medicaid population

Should Retirement Communities

Focus on Residents’ Emotional

Health?

Yes 83.8%

No 7.2%

Not Sure 8.9%

Yes 80.7%

Not Sure 10.3%

No 9.0%

Should Residents Have Access to

Counseling On-Site

Likely/Very Likely 83.6%

Unlikely/Very Unlikely 10.8%

Neither 5.6%

Resident’s Preference to Stay on Campus for Counseling

Is the Staff Interested in My Mood (Emotional Health)?

High Interest 35.2%

Average Interest 30.9%

Neither High or Low 18.0%

Low Interest 8.2%

No Interest 7.7%

33.9%

Are You Concerned About

Another Resident’s Mood?

Yes 64.5%

No 26.1%

Not Sure 9.4%

Would You Tell the Staff

About Another Resident’s Mood?

Unlikely/Very Unlikely 48.3%

Likely/Very Likely 43.6%

Neither 8.1%

How Often Do You Feel

Sadness/Depression?

Often to Very Often 29.2%

Occasionally 31.8%

Total 61.1%

Rarely 27.0%

Never 11.9%

Would You Report Your

Change of Mood to Staff?

Unlikely/Very Unlikely 68.5%

Likely/Very Likely 27.3%

Neither 4.2%

How Do You Handle a Change in Your Mood?

Work it out by myself 76.9%

Talk to friend 11.5%

Tell staff right away 9.4%

Tell staff last resort 2.1%

Does Money Make a Difference?

Comparison of

Executive and Low Income Communities

Low Income/Medicaid

Yes 59.5%

No 28.6%

Not Sure 11.9%

Are You Concerned About Another

Resident’s Mood?

Executive Community(CCRC)

Yes 67.3%

No 27.6%

Not Sure 5.5%

Low Income/Medicaid

Unlikely/Very Unlikely 52.4%

Likely/Very Unlikely 35.7%

Neither 11.9%

Would You Report a Change in Another

Resident’s Mood to Staff?

Unlikely/Very Unlikely 46.5%

Likely/Very Likely 41.0%

Neither 12.5%

Executive Community(CCRC)

Low Income/Medicaid

Why Do You Think Seniors Do Not Want to Report

Changes in Mood

Privacy/A Private Matter 57.4%

Loss of Independence 19.1%

Fear of Assisted Living 19.1%

Executive Community(CCRC)

Privacy/A Private Matter 61.0%

Loss of Independence 19.5%

Fear of Assisted Living 14.6%

Would You Report Your Change in Mood to Staff?

Low Income/Medicaid

Unlikely/Very Unlikely 81.0 %

Likely/Very Likely 16.7%

Undecided 2.3%

Unlikely/Very Unlikely 75.0%

Likely/Very Likely 19.6%

Undecided 5.4%

Executive Community (CCRC)

How Do You Handle a Change in Your Mood?

Executive Community

Work it out by self 76.4%

Talk to Friend 5.5%

Talk to Family 16.4%

Talk to Staff 1.8%

Low income/Medicaid

Work it out by self 88.1%

Talk to Friend 4.8%

Talk to Family 7.1%

Talk to Staff 0.0%

Staff Survey

Do Residents Need Mental Health Counseling?

Yes 76.5%

No 7.4%

Not Sure 16.2%

Staff Report

N= 68

Staff Report

Why seniors do not report changes in their mood.

1. “Residents do not see their behavior as a problem”

2. “Don’t want to be labeled as “crazy”

3. “Afraid they will have to move”

4. “It’s no one else’s business”

How Often Staff Reports Changes

in Resident’s Mood

Less than 1 per month 36.8%

Never reported 23.5%

Combined 60.3%

N= 68

Research Highlights

1. Residents want communities to also focus on emotional support

Seniors prefer those services on campus

2. Staff shows a strong interest in resident mental health/emotional status

Yet, residents are unlikely to share changes in mood

3. Residents are concerned about other residents emotional health

Yet, nearly half are unlikely to report it

4. Staff (75%) maintains residents need mental health support

Yet, residents want to work it out by themselves

5. Lack of staff report in residents mood.

Combined with lack of self-report by residents;

leads to high underreporting

4. Research results revealed Sadness/Depression rates

Yet, residents are unlikely to report their change

in mood to staff.

Bridging Senior Need with Service

Building Trust Adhering to Privacy

The data revealed seniors are unlikely to report changes in mood to

staff; preferring to work things out by themselves

Residents are not going to report changes if they are fearful of

unwanted intervention.

Ways to Encourage Self-Report

Encourage a resident to disclose a smaller related issue

“foot in the door technique” e.g., not sleeping well

Help residents disclose “Let’s go talk to the nurse together”

Remind a resident of their right to privacy. “Would you like the

director to visit with you privately about this matter?

May I check-in with you in a few days?

What do you feel comfortable sharing with me?

Required reporting: Danger to self and or others

Consider Horizontal Leadership

Establish a Referral Process

Service CEO/Director

Create an open referral service. For example: Servers

or maintenance staff can voice a concern about a

resident just as easily as nursing staff.

Pecking orders are inherent in most all organizations

Failure to Listen/Automatic Responses

“How Are You Today”?

Most often response is “fine”. We have a cultural tendency to

quickly engage and move on. Do we take the time to hear the answer?

Ask-Wait-Give a Personal Reply

Is that a new sweater?

Wait for a response

The color really brings out your eyes, it is also my favorite color.

American culture tends to be uncomfortable with silence

Silently holding a seniors hand speaks volumes

Seniors tend to be more thoughtful in their responses- wait.

What are your thoughts today?

“A penny for your thoughts”?

“Isn’t the quiet peaceful”?

“Can you hear the birds singing?

American culture tends to be uncomfortable with emotional pain.

“I was sorry to hear of your wife’s passing, you have been in my thoughts”

Learning to be Comfortable with Silence

Selecting Services

Referrals to social agencies and one’s physician maybe necessary

for significant mental health problems.

However, most problems are adjustment, mild depression,

anxiety, people problems, or worries that can be handled on-site

Be sure the person seeing a resident for emotional issues is a

qualified (potential liability problem).

If possible, the resident should be part of the process.

Be sensitive. Most seniors do not want to be dropped off by the community

van in front of a mental health clinic with peers looking on.

If possible, help a resident find counseling support that will come to them.

Thank You for Attending

Contact information:

Dr. Melinda Spohn, LMHC Executive Director

www. SeniorRetirementProject.org

srproject@live.com

509.638.9044