The transition from middle age to older adulthood can be challenging. Although many seniors continue to live active lives, bodies undergo many changes that make it a little more difficult to live independently. Brains also undergo changes that can affect the ability to recall names, faces and other important information. Mental health disorders can make this transition even more complicated, as these disorders tend to affect coping skills and the ability to relate to other people positively.
According to the Centers for Disease Control and Prevention, up to 20% of Americans age 55 and older have at least one mental health concern. A mental health condition may interfere with a senior’s ability to care for themselves, putting their safety at risk. For example, someone with impaired coping skills may not be able to respond appropriately to a fire or other emergency situation.
Mental health symptoms may also prevent older adults from remembering to take their medications or make it more difficult to maintain positive relationships with family members and friends. Seniors with mental health conditions may even isolate themselves from loved ones, leading to poor health outcomes. For older adults who can’t live alone due to their mental health concerns, assisted living is a viable option.
This guide provides an overview of the most common mental health conditions affecting seniors, along with information about the types of senior living that may be helpful. You’ll also find a list of the mental health resources available in each state.
Common Mental Health Conditions That Impact Seniors
Anxiety Disorders
As you get older, it’s natural to worry about things like paying for medical care and maintaining your independence. For people with anxiety disorders, that natural worry turns into something more pervasive. As a result, people with anxiety disorders worry excessively about ordinary things, and the levels of anxiety rise enough to cause impairments and affect day to day life.
According to the National Council on Aging, about 4% of older adults have some type of anxiety disorder. Anyone can develop an anxiety disorder, but these risk factors are especially relevant to seniors:
- Loss of independence
- Reduced mobility
- Chronic health issues
- Medication side effects
- Financial difficulties
If you have an older loved one with anxiety, you can help by listening to their concerns and providing reassurance. Older adults may also benefit from attending support groups, meeting with a spiritual advisor or participating in yoga or other relaxing activities. If your loved one doesn’t drive, consider offering rides to your local church, meeting hall or fitness center as needed.
Bipolar Disorder
Bipolar disorder causes changes in energy, mood, concentration and activity levels. These changes may make it more difficult for an older adult to manage their personal affairs or to maintain employment. Although it becomes less common with age, bipolar disorder still affects about 0.5% to 1.0% of seniors.
For older adults, life stressors and substance misuse are two of the most relevant risk factors for this condition. Divorce, unemployment, the death of a close family member and the development of a new disability are examples of stressors that can affect a senior’s mental health.
When you communicate with an older adult who has bipolar disorder, it’s important to be patient. A kind word can go a long way toward letting your loved one know that you care. It takes time to find the right combination of medications and other treatments, so don’t expect their symptoms to improve overnight. If you feel yourself getting frustrated, search for respite care in your area or ask other family members to pitch in while you take a short break from caregiving.
Depression
Everyone feels a little blue from time to time, but depression is characterized by persistent feelings of sadness. People with depression may also lose interest in spending time with loved ones or doing their usual activities as well as experience changes in sleep and appetite. This condition affects approximately 1% to 5% of seniors living in community settings.
One of the biggest risk factors for depression in older adults is the presence of other health conditions. Diabetes, cancer and other chronic diseases sometimes make it difficult to perform activities of daily living, resulting in a loss of independence. Older adults may also feel lonely or isolated from others, further increasing the risk of depression.
To help a loved one with depression, encourage them to seek treatment for their symptoms. Let them know that depression is a medical condition, not a personal weakness. It’s also helpful to offer rides to medical appointments or attend family therapy sessions with your loved one.
Eating Disorders
Eating disorders affect the relationship people have with food, causing them to develop unusual eating behaviors. These disorders, including anorexia nervosa and bulimia nervosa, also cause people to experience strong emotions related to food and weight.
Eating disorders haven’t been studied extensively in older adults, which makes it difficult to determine how common they are among members of the senior population. Depression, anxiety disorders and a history of trauma are some of the key risk factors for eating disorders.
If your loved one has signs of an eating disorder, try not to criticize their dietary habits or attempt to dictate what they eat. Build their self-esteem by letting them know how much you love them. If they acknowledge that their behavior is concerning, do whatever you can to help them access treatment, whether that’s offering transportation to a doctor’s office or helping with the cost of medical care.
Medication Misuse
Prescription drug misuse is on the rise, making it a serious concern for anyone with an older adult in their lives. Prescription drug misuse is defined as improper use of medication, such as taking a friend’s prescription medication for pain or using higher doses than recommended. This can lead to increased risk of serious interactions between medications.
More research is needed to determine the prevalence of medication misuse in older adults, but the Administration for Community Living reports that it may be anywhere from 1% to 26%. The aging brain may be more susceptible to the effects of drugs, increasing the risk of medication misuse. Other risk factors include chronic pain, reduced mobility, major life transitions and sudden changes in income.
If you’ve noticed signs of medication misuse, be honest about your concerns. Let your loved one know you’re there to help them without passing judgment. Provide information about treatment options and make it clear that you’ll support them through the recovery process. Avoid making threats or punishing your loved one for their medication abuse.
Post-Traumatic Stress Disorder
Post-traumatic stress disorder may develop after a single traumatic event or exposure to chronic trauma. The traumatic event is usually something shocking or scary, such as a natural disaster, a physical assault or a severe auto accident.
Risk Factors for Mental Health Conditions in Seniors
Mental health conditions have a variety of causes. In older adults, these are some of the most common risk factors:
- Limited mobility
- Alzheimer’s disease/dementia
- Loss of independence
- High levels of stress
- Loneliness and isolation
- Chronic illness
- Low self-esteem
Warning Signs of Mental Health Disorders in Seniors
Each mental health condition described above causes its own unique set of symptoms, but you may notice some early warning signs. Be on the lookout for the following:
- Sudden loss of interest in normal activities
- Pain that doesn’t seem to have a physical cause
- Medication or alcohol misuse
- Sudden weight gain or weight loss
- Changes in eating or sleeping habits
- Feelings of helplessness
- Prolonged episodes of depression
- Hostility toward family members
- Thoughts of self-harm
- Unusual levels of anger or worry
Housing Options for Seniors Living With Mental Health Conditions
Many senior living options work well for older adults with mental health conditions. The right setting depends on many factors, including the type and the severity of the condition, the presence of other health conditions and the senior’s level of independence.
Assisted Living for People With Mental Health Conditions
Assisted living is ideal for older adults who don’t need the full-time care provided by nursing homes. In this type of setting, residents typically have their own apartments or rooms, but they share common areas. Assisted living communities offer housekeeping services, meals and assistance with personal care. Each community also has at least one staff member available 24 hours per day, ensuring residents are safe.
For seniors with mental health conditions, assisted living communities offer a safe place to live. Staff members are available to answer questions and refer residents to health care resources. Some communities offer assistance with medication administration, which may help seniors comply with their treatment regimens.
| Pros | Cons |
| 24/7 supervision | Median cost of $4,500 per month in the United States; may cost more in some states |
| Opportunities to socialize with other residents | Doesn’t include full-time medical care |
| Assistance with personal care | Staff members may not be equipped to supervise residents with severe mental health conditions |
| Structured activities to prevent boredom and loneliness | Not covered by Medicare |
Nursing Homes for People With Mental Health Conditions
Nursing homes are designed for people who need around-the-clock medical care. Residents have access to doctors, nurses, physical therapists, occupational therapists and other health professionals, ensuring they receive the correct treatment for any medical or mental health condition. Some nursing homes are set up like hospitals, while others have a more homelike environment.
Seniors with mental health conditions can benefit from the full-time medical care provided in nursing homes, especially if they have multiple health conditions. Staff members are available to administer medications, address new symptoms and consult specialists when needed. Therefore, living in a nursing home can make it easier to manage a mental health condition.
| Pros | Cons |
| Full-time medical care | Not all seniors qualify for the level of care provided by nursing homes |
| Rehabilitation services available to reduce pain and prevent disability | Median cost of $9,034 per month in the United States; may cost more in some states |
| Contact with staff and other residents may prevent loneliness and isolation | Not covered by Medicare |
In-Home Care for People With Mental Health Conditions
For seniors who don’t need residential care, in-home care is a valid option. This type of care gives older adults access to health and personal care services in the comfort of their homes. Personal care aides typically help with meal preparation, grocery shopping and activities of daily living, while home health professionals provide in-home medical care.
Seniors with mental health conditions can benefit from having someone check in on them regularly, and it may reduce the risk of isolation. A home health professional can also make sure a senior is taking their medications as prescribed or note when they may need to adjust their medications to better control their symptoms.
| Pros | Cons |
| More convenient than seeking care outside the home | May be more expensive than assisted living |
| Less expensive than nursing home care | Some seniors may not be able to remain at home |
| Allows older adults to remain in their communities | Personal care aides and home health workers can’t help with all home maintenance tasks |
What to Look for in an Assisted Living Community for Seniors With Mental
The Benefits of Senior Living for Seniors With Mental Health Disorders
For seniors with mental health conditions who can’t remain in their home, senior living has many potential benefits:
- Living with other people prevents loneliness and isolation, which may prevent a mental health condition from getting worse.
- Residential care gives seniors an enhanced sense of safety.
- Staff members can recognize worsening symptoms and provide assistance as needed.
- Living in a senior living community can reduce the stigma of having a mental health condition.
When Should Someone With a Mental Health Condition Consider Senior Living?
Your loved one may be a good fit for senior living if they meet the following criteria:
- They’re not in an active mental health crisis.
- They can follow instructions regarding medications, therapy and other treatment options.
- Their mental health condition doesn’t cause symptoms that could put other residents in danger.
Not everyone with a mental health condition is a good candidate for senior living, as not all communities have trained staff available to manage mental health symptoms. Some facilities are also less secure than others, making them a poor fit for seniors who need regular monitoring.
State Resources for Mental Health Assistance
| State Agency | Contact Information | Services Provided |
| Alabama Department of Mental Health | (334) 242-3454 | – 24/7 peer support helpline – Mental health education programs – Mental illness community programs – Specialty services for adults |
| Alaska Department of Health Division of Behavioral Health | (907) 269-4804 | – Outpatient mental health services – Acute mental health intervention services – Mental health screenings |
| Arizona Health Care Cost Containment System | (602) 417-4000 | – Treatment for substance use disorders – Psychiatric care – Counseling |
| Arkansas Division of Aging, Adult & Behavioral Health Services | (501) 686-9164 | – Mental health assessment – Counseling – Substance abuse treatment – Mental health medications – Crisis intervention |
| California Department of Health Care Services | (916) 440-7400 | – Peer support services – 24/7 county crisis hotlines – Mental health services through the Medi-Cal program |
| Colorado Behavioral Health Administration | (303) 866-7400 | – Residential treatment for co-occurring substance use and mental health disorders – Mental health services for low-income and uninsured residents – Crisis intervention – Mental health referrals |
| Connecticut Department of Mental Health & Addiction Services | (860) 418-7000 | – Inpatient mental health treatment – Substance use disorder treatment – Mental health referrals |
| Delaware Health and Social Services (Division of Substance Abuse and Mental Health) | (302) 255-9399 | – Crisis intervention services – Court-ordered drug and alcohol treatment – Integrated treatment for mental illness |
| Florida Department of Children and Families | (904) 515-8064 | – Community-based mental health services – Mental health assessments – Crisis support – Inpatient mental health care |
| Georgia Department of Behavioral Health and Developmental Disabilities | (404) 657-2252 | – Crisis intervention – Substance abuse treatment – Community-based mental health services |
| Hawaii Behavioral Health Services Administration | (808) 586-4686 | – Substance abuse prevention programs – Mental health education – Outpatient mental health care – Inpatient mental health care |
| Idaho Department of Health and Welfare | (208) 334-5726 | – Crisis resources – Community-based mental health care |
| Illinois Department of Human Services | (312) 793-1326 | – Case management – Recovery support – Inpatient mental health treatment – Family-based services |
| Indiana Family and Social Services Administration | (317) 232-7860 | – Behavioral health care coordination – Therapy – Addiction counseling – Home-based support services |
| Iowa Department of Human Services | (515) 256-4662 | – Crisis services – Service coordination – Inpatient mental health care |
| Kansas Department for Aging and Disability Services | (785) 291-3359 | – Crisis hotline – Substance use treatment referrals – Community behavioral health clinics – Residential care |
| Kentucky Cabinet for Health and Family Services | (502) 564-4527 | – Crisis hotline – Substance abuse treatment – Behavioral health services |
| Louisiana Department of Health Office of Behavioral Health | (225) 342-1562 | – Peer support services – Crisis intervention – Substance abuse treatment |
| Maine Department of Health and Human Services | (207) 592-4334 | – Crisis services – Residential treatment – Mental health support |
| Maryland Department of Health | (410) 767-6492 | – Residential treatment – Crisis intervention – Case management |
| Massachusetts Department of Mental Health | (617) 626-8097 | – Behavioral health helpline – Suicide prevention program – Peer support networks – Case management |
| Michigan Behavioral Health and Developmental Disabilities Administration | (517) 335-0499 | – Substance abuse prevention and treatment – Community mental health programs |
| Minnesota Department of Human Services | (651) 431-6408 | – Social support – Funding for mental health treatment – Referrals to treatment providers |
| Mississippi Department of Mental Health | (601) 359-1288 | – Crisis services – Substance abuse treatment – Community-based mental health care |
| Missouri Department of Mental Health | (573) 751-9499 | – Crisis intervention – Mental health treatment – Education and preventive services |
| Montana Board of Behavioral Health | (406) 444-9389 | – Crisis intervention – Social supports |
| Nebraska Division of Behavioral Health | (402) 471-7856 | – Crisis services – Mental health education and preventive services -Community-based mental health services |
| Nevada Division of Public and Behavioral Health | (775) 684-2211 | – Inpatient mental health care – Substance abuse treatment – Crisis response |
| New Hampshire Bureau of Mental Health | (603) 271-8378 | – Rapid response crisis system – Substance abuse treatment – Block grants for mental health programs |
| New Jersey Division of Mental Health and Addiction Services | (609) 438-4352 | – Addiction treatment – Family support – Mental health screening |
| New Mexico Human Services Department | (505) 660-2788 | – Substance abuse treatment – Treatment for compulsive gambling – Mental health treatment |
| New York State Office of Mental Health | (518) 474-4403 | – Crisis assistance – Mental health clinics – Supportive housing |
| North Carolina Department of Health and Human Services | (919) 733-7013 | – Substance abuse treatment – Crisis services – Support services – Community-based mental health treatment |
| North Dakota Department of Health and Human Services | (701) 328-8824 | – Peer support – Crisis lifeline – Programs for individuals who’ve recently experienced a first episode of psychosis – Residential mental health treatment |
| Ohio Department of Mental Health and Addiction Services | (614) 466-2337 | – Ohio CareLine – Peer support – Crisis intervention – Mental health treatment |
| Oklahoma Department of Mental Health and Substance Abuse Services | (405) 248-9281 | – Support groups – Substance abuse recovery programs – Outpatient mental health treatment |
| Oregon Health Authority | (503) 449-7643 | – Supportive housing – Behavioral health crisis system – Mental health care |
| Pennsylvania Department of Human Services | (717) 705-8167 | – Crisis support – Peer support services – Community-based mental health treatment |
| Rhode Island Department of Behavioral Healthcare, Developmental Disabilities and Hospitals | (401) 462-2339 | – Crisis support – Referrals to mental health treatment providers |
| South Carolina Department of Mental Health | (803) 898-8319 | – Mobile crisis team – Mental health clinics |
| South Dakota Department of Social Services | (605) 367-5236 | – Mental health helpline – Crisis support – Mental health assessment |
| Tennessee Department of Mental Health and Substance Abuse Services | (615) 253-3049 | – Peer support services – Crisis intervention – Inpatient mental health care |
| Texas Health and Human Services Commission | (512) 838-2054 | – Crisis counseling – Outpatient mental health treatment |
| Utah Department of Health and Human Services | (801) 540-5242 | – Crisis helpline – Mental health screening |
| Vermont Agency of Human Services | (802) 241-0122 | – Clinical assessments – Outpatient mental health treatment – Individual and family therapy |
| Virginia Department of Behavioral Health and Developmental Services | (804) 371-6638 | – Mental health treatment – Treatment for substance abuse |
| Washington Behavioral Health Administration | (360) 725-5252 | – Inpatient mental health care – Funding for community mental health programs |
| West Virginia Department of Health and Human Services | (304) 352-5837 | – Addiction recovery resources – Crisis helpline |
| Wisconsin Department of Health Services | (608) 266-2861 | – Suicide prevention programs – Peer recovery centers |
| Wyoming Department of Health | (307) 777-8763 | – Crisis support – Treatment for problem gambling – Funding for outpatient mental health care |