Praise for Aging and Mental Health
“Aging and Mental Health is that rare book which is both pleasurable to read and deeply informative. The science of psychiatric diagnosis and treatment is set forth through rich conceptual frameworks of gerontology and psychology, and – new in this edition – critical health service contexts. As a comprehensive and skillfully crafted resource all in one volume, the book is an indispensable gem for students and practitioners alike.”
Jennifer Moye, PhD, VA Boston Healthcare System and Harvard Medical School
“The Third Edition of Aging and Mental Health offers far more than an update. It is a thoughtfully and creatively designed textbook poised to serve as a strong introduction to major clinical disorders, dominant models of therapy, service delivery systems, and ethical issues, together rounding out the universe of mental health and mental illness in older adults. Generous and well‐selected references for each topic are provided.”
Erlene Rosowsky, PsyD, Director of the Center for Mental Health and Aging and Associate Professor of Psychology, William James College
“Kudos to the authors of this updated new edition on Aging and Mental Health. Life span developmental theory, normative biopsychosocial processes, and models of successful aging inform clinical recommendations for mental health professionals who provide services to older adults. This is an excellent volume to read and reference if one desires to employ an evidence‐based state‐of‐the art approach to assess and treat the mental health problems of older adults and to promote integrated care in geriatric settings.”
Victor Molinari, PhD, President of the American Board of Geropsychology and Professor, School of Aging Studies, University of South Florida
“I’ve used Aging and Mental Health as a textbook for my undergraduate class in “Gerontological Counseling” and my graduate class in “Aging and Mental Disorders” for a decade. This book is unique in including reviews of fundamental issues in gerontology (e.g. age‐related changes), major theoretical models of mental health, the most common mental disorders of late life, and contextual issues such as policy, housing, and caregiving issues. The text is full of vivid case studies and practical information. The Third Edition includes valuable updates, such as incorporation of the DSM‐5 and recent research information. The authors bring years of experience in clinical practice, research, and public policy related to mental health to bear on the topic. This is the perfect text for instructors from diverse fields who want to engage their students in understanding mental health and aging, and help them develop a passion for providing excellent care for older adults and their families.”
William E. Haley, PhD, Professor, School of Aging Studies, University of South Florida
The Psychology of Adult Development
General Editor
James E. Birren
Editorial Advisory Board
Stig Berg, Dennis Bromely, Denise Park, Timothy A Salthouse, K Warner Schaie, and Diana Woodruff‐Pak
During this century, life expectancy at birth has increased more for the average person than it did from Roman times to 1900: There are a greater number of old people today and they live longer than ever before. Within universities there is pressure to educate younger students about the scientific facts of adult development and aging as well as to train professionals to serve and aging society. The past 20 years have seen an exponential growth in material published.
This new series of modular texts has been designed to meet the need to integrate, interpret, and make this new knowledge available in an efficient and flexible format for instructors, students, and professionals worldwide. Each book will present a concise, authoritative, integrated and readable summary of research and theory in a clearly defined area. Bridging the gap between introductory texts and research literature, these books will provide balanced coverage and convey the excitement and challenge of new research and developments. The modular format allows the series to be used as a complete sequence in primary courses in other fields.
Published
The Social Psychology of Aging by Michael W. Pratt and Joan E. Norris
The Neuropsychology of Aging by Diana S. Woodruff‐Pak
Aging and Mental Health, Second Edition by Daniel L. Segal, Sara Honn Qualls, and Michael A. Smyer
This edition first published 2018
© 2018 John Wiley & Sons, Inc.
Edition History
WB ‐ Wiley‐Blackwell (2e, 2011)
Blackwell Publishers (1e, 1999)
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The right of Daniel L. Segal, Sara Honn Qualls, and Michael A. Smyer to be identified as the authors of the editorial material in this work has been asserted in accordance with law.
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Library of Congress Cataloging‐in‐Publication Data
Names: Segal, Daniel L., author. | Qualls, Sara Honn, author. | Smyer, Michael A., author.
Title: Aging and mental health / by Daniel L. Segal, University of Colorado at Colorado Springs, Colorado Springs, CO, US 80918, Sara Honn Qualls, University of Colorado at Colorado Springs, Colorado Springs, CO, US 80918, Michael A. Smyer, Bucknell University, Lewisburg, PA, US, 17837.
Description: 3rd edition. | Hoboken, NJ: Wiley, 2018. | Includes bibliographical references and index. |
Identifiers: LCCN 2017034907 (print) | LCCN 2017035874 (ebook) | ISBN 9781119133162 (pdf) | ISBN 9781119133155 (epub) | ISBN 9781119133131 (pbk.)
Subjects: LCSH: Older people–Mental health. | Geriatric psychiatry.
Classification: LCC RC451.4.A5 (ebook) | LCC RC451.4.A5 S66 2018 (print) | DDC 618.97/689–dc23
LC record available at https://lccn.loc.gov/2017034907
Cover image: Courtesy of Michael A. Smyer
Cover design: Wiley
Daniel L. Segal: To the memory of my grandparents (Samuel and Tess Segal, and Norman and Harriet Golub) whom I loved very much and miss dearly
Sara H. Qualls: To my children and the students at UCCS from whom I learn much
Michael A. Smyer: To four generations of the Pipers
What is important in knowledge is not quantity, but quality. It is important to know what knowledge is significant, what is less so, and what is trivial.
(Leo Tolstoy)
In this book, we have endeavored to take Tolstoy’s maxim to heart, sorting out the significant from the trivial in the domain of aging and mental health. As we did so, we had two audiences in mind: today’s clinicians and the clinicians of the future. The first group includes clinicians who are already in practice settings but who want to know more about the intricacies of working with older adults. The second group encompasses students in the professions that work with older adults (e.g., psychology, social work, counseling, nursing, psychiatry).
Both groups must face the issues of aging summarized by Michel Philibert, a French philosopher: “Of aging, what can we know? With aging, what must we do?” (Philibert, 1979, p. 384). These are also issues that older adults and their family members must face. In a way, they are variations on the questions that often arise in clinical settings. Consider the following example:
Betty was worried about Alex. His memory seemed to be failing him more often. He would get to the store and forget half of the things she’d sent him there for. He seemed more tired than usual, with less energy for his hobbies at the end of the day or on weekends. He didn’t want to go out with friends to the movies or to dinner. Alex didn’t seem to notice anything different in his behavior. Betty called to ask your advice: “Should I get him tested at the local Alzheimer’s Center?”
How would you answer Betty? What would you need to know? Which portion of her story is significant in forming your answer? Which less so? In answering these questions, you are implicitly answering Philibert’s queries as well. You are implicitly making a differential diagnosis of Alex’s situation: Is this a part of normal aging? Is this a pathological pattern? Is it a combination of the two? (Of aging, what can we know?) You may also be linking your answer to an implicit action plan. Betty certainly is: Diagnose the problem and then decide what kind of treatment is most appropriate. (With aging, what must we do?)
To fully answer Betty’s question requires much more information about aging in general, about patterns of mental health and mental disorder in particular, about Alex’s distinctive history and pattern of functioning, and about the contexts in which she and Alex live and receive services. We designed this book to provide you with frameworks for considering each element.
The book is divided into four parts. Part I is an overview of basic gerontology, the study of the aging process. This background information forms a context for answering the simple question often posed by clients and their relatives: Should I be worried about this pattern of behavior (e.g., Alex’s apparent memory problems)? To answer this deceptively simple question requires that we sort out the influences of physical illness, basic processes of aging, and the intersection of historical and social trends as they affect older adults’ functioning. In Part I, we outline the basic parameters of mental health in later life, providing the foundation upon which later chapters build.
In Part II, we consider basic models of mental disorders. Each model provides a set of assumptions about mental health and the development of mental health problems, their assessment, and their treatment. These assumptions direct the clinician’s attention to specific aspects of older adults and their functioning. For example, assume for the moment that Alex’s memory problems are not organically caused. The behavioral perspective might highlight the context of the older adult’s behavior. Four important models of mental health and mental disorder are outlined in the chapters of Part II. In each chapter, we focus on an important question for older adults and those who work with them: How is this approach relevant to older adults and the problems they encounter in later life?
Part III focuses attention on the most commonly occurring mental health problems and disorders in later life: neurocognitive disorders, major depression, bipolar disorder, serious mental disorders (e.g., schizophrenia), anxiety disorders, post‐traumatic stress disorder, sexual disorders, sleep disorders, substance use, personality disorders, and other common disorders. In each chapter, we outline the prevalence of the disorders, the most appropriate assessment approaches for older adults, and the most effective treatment strategies for older adults. We were fortunate to be able to call upon Stephen J. Bartels and his colleagues for their expertise in the diagnosis and treatment of severe mental disorders (Chapter 10).
Part IV concludes our book with several chapters focusing on the contexts and settings of contemporary geriatric mental health practice. The contexts of housing, health care settings, social service settings, and public policy affect how, where, and why older adults with mental health problems are diagnosed and treated. Families and caregiving are also addressed, as families are the primary providers of care, and caregiving is a challenge facing millions of people who are taking care of older family members and friends who need assistance. This section concludes with an analysis of ethical and legal issues facing practitioners in geropsychology and also discusses the impact of global climate change.
Colleagues and friends in several settings have helped us write this book: in the Department of Psychology, the Aging Center, and the Gerontology Center of the University of Colorado at Colorado Springs, and in the Center for Advanced Study in the Behavioral Sciences at Stanford University. We thank Brian P. Yochim and Mary Dozier for their feedback on specific chapters of the book, and we thank Lacey Edwards for her contributions to Chapter 4. We also thank Michelle Buffie for her expertise in making figures and tables. Early in the development of the first edition we benefited from the guidance and advice of Jim Birren and two anonymous reviewers. The process of revision for the second edition was supported by input and advice from our academic and community services colleagues as well as a new set of anonymous reviewers. We eagerly acknowledge our debt to each, while also admitting that any remaining flaws are ours. We also express our deepest appreciation to our friends and editors at Wiley, including Darren Reed, Monica Rogers, Roshna Mohan, Catherine Joseph, Elisha Benjamin, and Nishantini Amir, and our excellent copy‐editor Katherine Carr, whose patience and diligence ensured that this third edition came to fruition. Finally, we remain grateful to our family members and friends for their ongoing love, encouragement, and support.
Our goal throughout this book is to provide information and a set of frameworks that will be useful in working with older adults and their families. In the end, we hope that you will conclude that there is much to hope for in aging, and much that we can do to foster positive mental health later in life.