Older people may have a persistent or recurring mental illness, may have experienced a more recent issue as the result of bereavement, physical illness or injury (Daley et al. 2012), or be suffering from dementia or other degenerative neurological conditions. Social isolation becomes particularly acute as a person ages.

Older people have particular developmental needs, including the need to look back on life and feel a sense of fulfilment, increased interdependence between their personal and close relationships, and changing patterns of worry as people worry less about self, more about others and more about health care (McKay et al. 2012).

For older adults who have experienced a lifetime of mental health issues, the notion of recovery—its underpinning concepts, expectations and practice emphasis—can be alarming or challenging. Many deeply fear admission to an aged care facility, viewing this as 'reinstitutionalisation' (McKay et al. 2012).

Implications for practice

Early engagement is important so that practitioners and services understand a person's values, expectations, preferences and life choices and can act according to their wishes at times when their capacity for decision making is impaired.

Implications for service delivery

  • Older people need support to connect with each other as well as with others in the community. Other priorities include:
    • establishing partnerships among mental health services, general practitioners, community nursing, aged care services, accommodation and residential facilities, disability support, Home and Community Care and other community support services
    • supporting aged care facilities and services to become more responsive and relevant to the needs of people with mental health issues
    • supporting spouses or partners, family members and close friends who may be elderly and frail themselves
    • providing opportunities for recreation, physical activity and fitness
    • responding to the increasing cultural and linguistic diversity of Australia's older population (Daley et al. 2012; McKay et al. 2012).
  • Services should develop tailored recovery-oriented approaches for older people who:
    • have Aboriginal and Torres Strait Islander background
    • are living in boarding houses or unstable housing
    • are living in rural and remote communities
    • are in or are exiting prison.