For many seniors who lived through the Depression, two world wars and the volatile 20th century, talking about their problems isn’t popular.
These generations don’t blab every little detail on Facebook or tweet spontaneous feelings, hence the Silent Generation and the G.I. Generation.
So when feelings of depression or hopelessness strike after a spouse’s death or social isolation from leaving their home for assisted living, many seniors keep the hurt to themselves. They might not tell anyone, much less their doctor, get a referral to a mental health counselor and then ride the care center shuttle to their appointment. Many suffer silently to avoid the stigma of seeing a counselor.
That’s why Melinda Spohn, a licensed mental health counselor and executive director of the Senior Retirement Project, goes to them in their home or apartment at local care centers. She also counsels family caregivers who are stressed and often filled with guilt and resentment.
“It’s scary,” Spohn said about the misconception that people can self-heal. “Most people just don’t have the tools to do that.”
Seniors need to know depression is treatable, often with only a couple of sessions with a counselor. Yet if depression isn’t addressed it can lead to larger problems, including substance abuse and suicide.
Spohn founded the nonprofit Senior Retirement Project in 2009, an innovative and rare way to bring low-cost mental health services directly to the elderly in the privacy and comfort of their own home. She knows of no other licensed counselors in the area who specialize in home visits and contract directly with assisted living facilities.
To Spohn, she’s filling an important niche.
“She’s been a godsend,” said Melissa Goetz, the assisted living administrator at Riverview Retirement Community. “It seems like anything in the mental health arena is extremely difficult for assisted living facilities to access. (Melinda) has been very much a relief to me and the residents.”
Before Spohn, Riverview had no onsite licensed mental health professional. Often caregivers and paraprofessionals take on these roles, even though they don’t have proper training, Spohn said.
Riverview contracts with Spohn for 10 hours a month where she can visit the campus and talk with seniors, Goetz said. If a resident wants a private, in-home session, Riverview pays for the first two hours. If more visits are warranted, the senior or their family negotiates the price with Spohn.
Because the Senior Retirement Project is nonprofit and doesn’t bill insurance or Medicare the fees are only $38 per hour. Low-income seniors can pay less. Spohn said that her fee is often less than the 40 percent Medicare co-pay for outpatient counseling services.
Because Spohn is a familiar face at Riverview, she can create a rapport and trust with residents making them more likely to confide in her and ask for help.
While creating the Senior Retirement Project, Spohn conducted a research study on six retirement communities, three in Washington state, including Riverview, and three in North Carolina with a variety of income populations.
In her findings, “Don’t Air Your Dirty Laundry: Supporting Resident Mental Health” nearly 84 percent of the residents surveyed said retirement communities should focus on residents’ emotional health and 80 percent said facilities should have a designated mental health professional onsite.
Spohn said these numbers are revealing because even though residents want mental health services available, 68.5 percent of them admit they are “very unlikely or unlikely” to discuss a change in mood with staff.
“They aren’t talking,” she said. “They put on a happy face but they become isolated and withdrawn. They are hurting inside.”
That’s why Spohn said it’s crucial to have someone onsite who gets to know the residents so they are more comfortable talking about their feelings with a professional. She knows residential mental health care can combat the stigma and elderly depression.
Her findings also show that nearly 77 percent of the residents survived would work out problems by themselves if their mood declined. Yet nearly 84 percent said if they did utilize counseling they would prefer to stay on campus.
Nearly 77 percent of the staff at the surveyed communities believed residents need mental health counseling yet 60 percent of the staff said they never report a change in mood or do so for less than one resident per month.
Spohn concluded that there is a high rate of underreporting because of the combined lack of reporting by residents and staff, which ultimately means many seniors are left to suffer silently.
“This is why the in-home piece is so crucial,” Spohn said.