The 11th International

Conference on Public Health

UNS Tower, Surakarta, Indonesia

May 29-30, 2024

Theme:

"Improving Mental Health of the Elderly"

Background:

The world's population is aging fast. In 2020, 1 billion people in the world were aged 60 years or over. That figure will rise to 1.4 billion by 2030, representing one in six people globally. By 2050, the number of people aged 60 years and over will have doubled to reach 2.1 billion (WHO, 2024). Society is living much longer thanks to improved living conditions and health care. Being able to reach old age is something blessing in many ways. However, there are several issues and challenges facing the elderly, which we all need to pay more attention to (SmithLife Home Care, 2020; Reid, 2024).

One of these issues is mental health. Around 14% of adults aged 60 and over live with a mental disorder. According to the Global Health Estimates (GHE) 2019, these conditions account for 10.6% of the total disability (in disability-adjusted life years, DALYs) among older adults. The most common mental health conditions for older adults are depression and anxiety. GHE 2019 shows that globally, around a quarter of deaths from suicide (27.2%) are among people aged 60 or over (WHO, 2023).

Mental health conditions among older people are often under-recognized and under­treated, and the stigma surrounding these conditions can make people reluctant to seek help (WHO, 2023).

At older ages, mental health is shaped not only by physical and social environments but also by the cumulative impacts of earlier life experiences and specific stressors related to aging. Exposure to adversity, significant loss in intrinsic capacity, and a decline in functional ability can all result in psychological distress (WHO, 2023).

Older adults are more likely to experience adverse events such as bereavement, a drop in income, or a reduced sense of purpose with retirement. Despite their many contributions to society, many older adults are subject to ageism, which can seriously affect people's mental health (WHO, 2023).

There are several other challenging issues facing the older population, including (1) Ageism and a lost sense of purpose; (2) Financial insecurity; (3) Frailty and difficulty with everyday tasks and mobility; (4) Finding the right care provision; (5) Access to healthcare services; (6) End of life pre­pa­rations (SmithLife Home Care, 2020; Reid, 2024)

       1. Ageism and a Lost Sense of Purpose

One of the main challenges facing older people is prejudice or discrimination on the grounds of a person's age, so-called "ageism". It can occur both in the workplace and in personal life. Most cultures tend to glorify youth, so older adults are more often the victims of age-based discrimination and negativity. There are lots of outdated stereotypes about the elderly, which can lead to their isolation and marginalization in many communities (SmithLife Home Care, 2020; Reid, 2024).

Ageism is often considered more acceptable by society than racism and sexism. However, that does not mean that society should turn a blind eye and accept unfair treatment. Awareness of ageism should be promoted. Many steps can be taken to address the problem and challenge of ageism. In principle, society should help create a more open-minded culture so that stereotypes hold less sway and discrimination is less prevalent. People can avoid describing older people and aging as problems (Reid, 2024)

Several ways are recommended to reduce ageism (Nelson, 2019; Reid, 2024). First, society needs to be educated about the myths of aging. Aging needs to be reframed as a time of positive activity, continued growth, and optimism for the future. Stereotypes should be defied. Resisting age-related stereotypes can have a positive effect on mental health, reducing the risk of mental health issues like anxiety and suicidal ideation. With that in mind, it is suggested that older people maintain a sense of independence in as many areas as they can (Nelson, 2019; Reid, 2024).

Second, society needs to foster continued and positive family relations and social support. Such relationships act as a buffer against negative self-views and negative physical and psychological outcomes in older adults. Research has demonstrated that inter­gene­ra­tion­al contact greatly reduces the chances of children developing ageist attitudes. Inter­ge­ne­ra­tional connections can reduce the risk of ageism because face-to-face interactions help people see beyond stereotypes. It is suggested that older people spend more time with children and grandchildren, younger coworkers, or younger people in the local com­mu­nity (Nelson, 2019; Reid, 2024).

Social connection is particularly important to reduce risk factors such as social isolation and loneliness. At this stage of life, meaningful social activities can significantly improve positive mental health, life satisfaction, and quality of life; they can also reduce depressive symptoms. Example interventions include befriending initiatives, community and support groups, social skills training, creative arts groups, leisure and education services, and volunteering programs (WHO, 2023)

Third, psychologists and healthcare workers need to be trained and educated about ageism and the myths of aging. It is vital that age prejudice and stereotypes about aging not take root in those who work with the elderly, as they have obvious direct negative effects on how those professionals treat (or don't treat) and interact with older adults (Nelson, 2019; Reid, 2024).

By coming up with innovative ways to involve older people in the community through social events, we can not only help them maintain a sense of identity and self-esteem but also tap into the wealth of knowledge and experience they have, which is so vital for the development of society.

        2. Financial Insecurity

While the population is living longer, and many elderly people are able and more than willing to work past the standard retirement age, the opportunities are not there. Ageism in the workplace may exacerbate financial insecurity in older people (Reid, 2024). There is ample quantitative evidence linking financial challenges to earlier aging and poorer health outcomes. Financial strain is associated with a greater risk of obesity, disability, malnutrition, poorer health, increased depressive symptoms, and earlier mortality (Samuel et al., 2021). Social programs are vital to the economic security of many older citizens (NCOA, 2024).

        3. Frailty and Difficulty with Everyday Tasks and Mobility

Frailty is the most problematic expression of population aging. "Frailty" is a term that is used a lot, but is often misunderstood. It refers to a person's mental and physical resilience, or their ability to bounce back and recover from events like illness and injury (Ageuk, 2024). It is a state of vulnerability to poor resolution of homeostasis following stress (Lancet, 2013).

Frailty is a consequence of cumulative decline in multiple physiological systems over a lifespan. This cumulative decline erodes homeostatic reserve until relatively minor stressor events trigger dispro­por­tionate changes in health status, typically a fall or delirium (Lancet, 2013).

Accordingly, a person's mobility and dexterity will naturally decline as they age, which makes completing everyday tasks more difficult. Frail people can find it difficult to do everyday tasks. This can gradually cause people to care for themselves and prevent them from being social, pursuing interests, or taking part in activities they enjoy (Swiner, 2023).

More support is needed to enable elderly people not only to live independently through products and programs that focus on safety, balance, fitness, and mobility but also to ensure they can continue to thrive as individuals (SmithLife Home Care, 2020).

       4. Finding the Right Care Provision

When complete independence is no longer practical, many elderly people require addi­tion­al care. Sometimes this care can be provided by family members, but this can place a lot of strain on the caregiver in terms of balancing this with work and other family responsibilities. These caregivers need to be given the training, resources, and emotional support necessary to help them deliver the best care for their loved ones and themselves (SmithLife Home Care, 2020).

In some cases, it is more appropriate for a professional caregiver to be employed regularly, e.g., when there are complex medical conditions and/or physical disabi­lities. With a comprehensive elder care service, the elderly person can remain in their own home (SmithLife Home Care, 2020).

Prompt recognition and treatment of mental health conditions (and associated neu­ro­lo­gi­cal and substance use conditions) in older adults is essential. This should follow stan­dards for integrated care for older people, which is community-based and focused on both the long-term care of older adults living with mental health conditions and declines in intrinsic capacity, as well as the education, training, and support of carers. A mix of mental health interventions is usually recommended, alongside other supports to address the health, personal care, and social needs of individuals (WHO, 2023).

        5. Access to Healthcare Services

Healthcare can be complicated and disjointed for elderly people, especially for those strug­gling with long-term conditions. The care requires lots of different medical pro­fess­ion­als and clinics to coordinate the delivery of medication and other types of care (SmithLife Home Care, 2020).

Access to healthcare services for older adults with activity daily living (ADL) limitation was mainly related to the factors of economic status, affordability for daily life, and living regions in enabling dimension. Limitations in health-related insurance policies, the shortage of family doctors, and other factors contributed to unsatisfied healthcare services demand for older adults (Mai et al., 2022).

Strategies focused on health insurance, the healthcare system, barrier-free facilities, and social support were proposed to increase access to healthcare services for participants, which could benefit the health of older adults (Mai et al., 2022).

       6. End of Life Preparations

End-of-life planning is an essential part of the healthcare journey and growing older. Elderly individuals and their families need support when considering the end-of-life options available, financial implications, and how to ensure that the individual's wishes are respected. End-of-life planning is arranging and making decisions about healthcare and personal wishes in advance.

By creating a plan, the elderly can ensure that their final wishes are respected and that they receive the end-of-life care they want and deserve. It can also help loved ones understand the elderly's desires and guide them during difficult and emotional times. Additionally, end-of-life planning can help alleviate any financial and legal burdens for the family members (SmithLife Home Care, 2020; Nurse Next Door, 2024).

Promotion and Prevention Strategy

Mental health promotion and prevention strategies for older adults should focus on supporting healthy aging. That means creating physical and social environments that support well-being and enable people to do what is important to them, despite losses in capacity (WHO, 2023).

Key mental health promotion and prevention strategies for healthy aging include (WHO, 2023):

1. Measures to reduce financial insecurity and income inequality
2. Programs to ensure safe and accessible housing, public buildings, and transport
3. Social support for older adults and their carers
4. Support for healthy behaviors, especially eating a balanced diet, being physically active, refraining from tobacco, and reducing alcohol use
5. Health and social programs targeted at vulnerable groups such as those who live alone or in remote areas and those living with a chronic health condition.

Name of the Conference:

 The 11th International Conference on Public Health

Theme:

"Improving Mental Health of the Elderly"

Aim: 

This conference aims to discuss issues and challenges facing the elderly and to find innovative ways to address these issues with a special focus on mental health.

Venue and Dates:

UNS Tower, Surakarta, Indonesia, May 29-30, 2024

Participants:

Participants of the conference include allied health sciences students, psychology stu­dents, nutrition students, academicians, researchers, older people, caregivers, health practitioners, public health profess­ion­als, social workers, and health planners.

Invited Speakers:

1. Prof. Helen Herrman (Australia)
2. Dr. Reuben Jacob (Australia)
3. Dr. Joel Rey Ugsang Acob (Philippines)
4. Prof. Dr. Budi Anna Keliat (Indonesia)
5. Dr. Intje Picauly, MSi (Indonesia)
6. Dr. I Dewa Gede Basudewa, SpKJ (Indonesia)
7. Dr. Hanung Prasetya (Indonesia)

Programs:

Day 1 (May 29, 2024): Symposium

Day 2 (May 30, 2024): (1) Symposium; (2) Oral presentation

Organizing Institution:

Master's Program in Public Health

Graduate School, Universitas Sebelas Maret

Jl. Ir. Sutami 36A, Surakarta 57126,

Central Java, Indonesia.

Website: https://theicph.com/index.php/icph

Reference:

Lancet (2013). Frailty in older people. Lancet. 2; 381 (9868): 752–762. doi:10.1016/­S01­40­-6736(12)62167-9. doi: 10.3389/fpubh.2022.921980

Mai S, Cai J, Li L (2022). Factors associated with access to healthcare services for older adults with limited activities of daily living. Front Public Health. 10: 921980. doi: 10.33­89/fpubh.2022.921980

NCOA (2024). Get the facts on economic security for seniors. https://www.ncoa.org/­article/get-the-facts-on-economic-security-for-seniors. Accessed in May 2024.

Nelson TD (2019). Reducing ageism: which interventions work? Am J Public Health. 109(8): 1066–1067.

Reid S (2024). Ageism and age discrimination https://www.helpguide.org/­articles/­aging-issues­/­ageism-and-age-discrimination.htm. Accessed in May 2024.

Samuel LJ, Wright R, Granbom M, Taylor JL, Hupp C, Lavigne L, Szanton SL (2021). Community-dwelling older adults who are low-income and disabled weathering financial challenges. Geriatr Nurs. 42(4): 901–907. doi:10.1016/j.gerinurse.2021.04.025.

SmithLife Home Care (2024). What are the biggest challenges and problems for elderly people in our society?https://www.smithlifehomecare.com/blog/what-are-the-biggest-challenges-for-elderly-people-in-our-society./ Accessed in May 2024.

SwinerCN (2023). What to know about frailty in older adults. https://www.­webmd.­com/healthy-aging/what-to-know-about-frailty-in-older-adults. Accessed in May 2024.

WHO (2023). The mental health of older adults. https://www.who.int/news-room/fact-sheets­­/­­­detail/mental-health-of-older-adults. Accessed in May 2024.