Skip to main content Accessibility help
×
Hostname: page-component-8448b6f56d-wq2xx Total loading time: 0 Render date: 2024-04-24T18:14:57.574Z Has data issue: false hasContentIssue false

Chapter 10 - Anxiety in Older Adults across Care Settings

Published online by Cambridge University Press:  08 March 2021

Gerard J. Byrne
Affiliation:
University of Queensland
Nancy A. Pachana
Affiliation:
University of Queensland
Get access

Summary

The presentation of anxiety in older adults can differ across treatment and care settings. Therefore, providers must be mindful of these differences in order to adjust assessment and identify appropriate interventions to address the impact of anxiety on the patient and, in many cases, their overall health. This chapter aims to provide a brief description of anxiety across settings for older adults. The chapter will address anxiety in subacute treatment settings, home-based care, long-term care, and palliative/hospice care environments. It is important to remember that in these settings anxiety is often a secondary issue that accompanies acute, chronic, and terminal disease processes. Therefore, in addition to assessment and intervention, the impact of anxiety on the disease and treatment processes is also discussed in relation to overall health and treatment outcomes.

Type
Chapter
Information
Anxiety in Older People
Clinical and Research Perspectives
, pp. 157 - 172
Publisher: Cambridge University Press
Print publication year: 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th ed. Washington, DC: American Psychiatric Association.Google Scholar
Andersen, B. L., DeRubeis, R. J., Berman, B. S., et al. (2014). Screening, assessment, and care of anxiety and depressive symptoms in adults with cancer: an American Society of Clinical Oncology guideline adaptation. Journal of Clinical Oncology, 32, 16051619.CrossRefGoogle Scholar
Applebaum, R. A., Straker, J. K. and Geron, S. M. (2000). Assessing Satisfaction in Health and Long-Term Care. New York: Springer.Google Scholar
Åström, M. (1996). Generalized anxiety disorder in stroke patients a 3-year longitudinal study. Stroke, 27(2), 270275.Google Scholar
Ayers, C. R., Saxena, S., Golshan, S. and Wetherell, J. L. (2010). Age at onset and clinical features of late life compulsive hoarding. International Journal of Geriatric Psychiatry, 25, 142149.Google Scholar
Ayers, C. R., Wetherell, J. L., Golshan, S. and Saxena, S. (2011). Cognitive–behavioral therapy for geriatric compulsive hoarding. Behaviour Research and Therapy, 49, 689694.Google Scholar
Ballard, C., Boyle, A., Bowler, C. and Linedesay, J. (1996). Anxiety disorders in dementia sufferers. International Journal of Geriatric Psychiatry, 11, 987990.3.0.CO;2-V>CrossRefGoogle Scholar
Beck, R. A., Arizmendi, A., Purnell, C., Fultz, B. A. and Callahan, C. M. (2009). House calls for seniors: Building and sustaining a model of care for homebound seniors. Journal of the American Geriatrics Society, 57(6), 11031109.Google Scholar
Block, S. D. (2006). Psychological issues in end-of-life care. Journal of Palliative Medicine, 9, 751772.Google Scholar
Boddice, G., Pachana, N. A. and Byrne, G. J. (2008). The clinical utility of the geriatric anxiety inventory in older adults with cognitive impairment. Nursing Older People, 20(8), 3639.Google Scholar
Breitbart, W. (2002). Spirituality and meaning in supportive care: spirituality- and meaning-centered group psychotherapy interventions in advanced cancer. Support Care Cancer, 10, 272280.Google Scholar
Breitbart, W., Chochinov, H. M. and Passik, S. (2005). Psychiatric symptoms in palliative medicine. In Doyle, D, Hanks, G. W. C., Cherny, N. I., and Calman, K, eds., Oxford Textbook of Palliative Medicine, 3rd ed. New York: Oxford University Press, p. 747.Google Scholar
Brenes, G. A., Guralink, J. M., Williamson, J. D., et al. (2005). The influence of anxiety on the progression of disability. Journal of the American Geriatrics Society, 53, 3439.Google Scholar
Brenes, G. A., Pennix, B. W. J. H., Judd, P. H., Rockwell, E., Sewell, D. D. and Wetherell, J. L. (2008). Anxiety, depression, and disability across the lifespan. Aging and Mental Health, 12(1), 158163.CrossRefGoogle ScholarPubMed
Bryant, C., Jackson, H. and Ames, D. (2008). The prevalence of anxiety in older adults: methodological issues and a review of the literature. Journal of Affective Disorders, 109(3), 223250.CrossRefGoogle Scholar
Bryant, C., Mohlman, J., Gum, A., et al. (2013). Anxiety disorders in older adults: Looking to DSM-5 and beyond. American Journal of Geriatric Psychiatry, 21, 872876.Google Scholar
Chochinov, H. M., Kristjanson, L. J., Breitbart, W., et al. (2011). Effect of dignity therapy on distress and end-of-life experience in terminally ill patients: a randomised controlled trial. Lancet Oncology, 12(8), 753762.Google Scholar
Chorpita, B. F. and Barlow, D. H. (1998). The development of anxiety: the role of control in the early environment. Psychological Bulletin, 124(1), 321.Google Scholar
Cohen-Mansfield, J. and Bilig, N. (1986). Agitated behaviors in the elderly: a conceptual review. Journal of the American Geriatric Society, 34(10), 711721.Google Scholar
Cohen-Mansfield, J., Marx, M. S., Freedman, L. S., Murad, H., Regier, N. G., Thein, K. and Dakheel-Ali, M. (2011). The comprehensive process model of engagement. American Journal of Geriatric Psychiatry, 19(10), 859870.Google Scholar
Cook, G. (2006). The risk to enduring relationships following the move to a care home. International Journal of Older People Nursing, 1(3), 182185.Google Scholar
Cummings, S. M. (2002). Predictors of psychological well-being among assisted-living residents. Health and Social Work, 27(4), 293313.Google Scholar
Diefenbach, G. J., Dimauro, J., Frost, R., Steketee, G. and Tolin, D. F. (2013). Characteristics of hoarding in older adults. American Journal of Geriatric Psychiatry, 21(10), 10431047.Google Scholar
Drummet, A. R., Coleman, M. and Cable, S. (2003). Military families under stress: implications for family life education. Family Relations, 52, 279287.Google Scholar
Edes, T., Kinosian, B., Vuckovic, N. H., Nichols, L. O., Becker, M. M. and Hossain, M. (2014). Better access, quality, and cost for clinically complex veterans with home-based, primary care. Journal of the American Geriatrics Society, 62, 19541961.Google Scholar
El-Gabalawy, R., Mackenzie, C. S., Shooshtari, S. and Sareen, J. (2011). Comorbid physical health conditions and anxiety disorders: a population-based exploration of prevalence and health outcomes among older adults. General Hospital Psychiatry, 33, 556564.CrossRefGoogle ScholarPubMed
Fairman, N. and Irwin, S. A. (2013). Palliative care psychiatry: update on an emerging dimension of psychiatric practice. Current Psychiatry Report, 15(7), 374.Google Scholar
Ferretti, L., McCurry, S. M., Logsdon, R., Gibbons, L. and Teri, L. (2001). Anxiety and Alzheimer’s disease. Journal of Geriatric Psychiatry and Neurology, 14(1), 5258.Google Scholar
Gans, J. S. (1987). Facilitating staff/patient interaction in rehabilitation. In Caplan, B, ed., Rehabilitation Psychology Desk Reference. New York: Aspen Publishers, pp. 185218.Google Scholar
Garuti, G., Cilione, C., Dell Orso, D., et al. (2003). Impact of comprehensive pulmonary rehabilitation on anxiety and depression in hospitalized COPD patients. Monaldi Archives for Chest Disease, 59(1), 5661.Google ScholarPubMed
Gerolimatos, L. A., Gregg, J. J. and Edlestein, B. A. (2013). Assessment of anxiety in long-term care: examination of the Geriatric Anxiety Inventory (GAI) and its short form. International Psychogeriatrics, 25(9), 15331542.CrossRefGoogle ScholarPubMed
Gould, C., Segal., D. L., Yochim, B. P., Pachana, N.A., Byrne, G. J. and Beaudreau, S. A. (2014). Measuring anxiety in late life: a psychometric examination of the Geriatric Anxiety Inventory and Geriatric Anxiety Scale. Journal of Anxiety Disorders, 28, 804811.Google Scholar
Greif, E. and Matarazzo, R. G. (1982). Behavioral Approaches to Rehabilitation: Coping with Change, Vol. 3. New York: Springer Publishing Company.Google Scholar
Gum, A. M., Petkus, A., McDougal, S. J., Present, M., King-Kallimanis, B. and Schonfield, L. (2009). Behavioral health needs and problem recognition by older adults receiving home-based aging services. International Journal of Geriatric Psychiatry, 24, 400408.Google Scholar
Harris-Kojetin, L., Sengupta, M., Park-Lee, E. and Valverde, R. (2013). Long-term care services in the United States: 2013 overview. National Center for Health Statistics: Vital Health Statistics, 3(37), 1107.Google Scholar
Hartke, R. (1991). Introduction. In Hartke, R, ed., Psychological Aspects of Geriatric Rehabilitation. New York: Aspen Publishers, pp. 18.Google Scholar
Hartke, R. (1991). The older adult’s adjustment to the rehabilitation setting. In Hartke, R, ed., Psychological Aspects of Geriatric Rehabilitation. New York: Aspen Publishers, pp. 7396.Google Scholar
Hawes, C., Phillips, C. D. and Rose, M. (1999). A national study of assisted living for the frail elderly: final summary report. U.S. Department of Health and Human Services Office of Disability, Aging, and Long-Term Care Policy Office of the Assistance Secretary for Planning and Evaluation. http://aspe.hhs.gov/daltcp/reports/finales.pdfGoogle Scholar
Hess, L. S. (2012). Anxiety in Older Adults with Dementia Residing in Long-term Care Facilities. Doctoral dissertation, University of Louisville.Google Scholar
HHS (2003). The future supply of long-term care workers in relation to the aging baby boom generation: report to Congress. Washington, DC: HHS. Retrieved from http://aspe.hhs.gov/daltcp/reports/ltcwork.pdfGoogle Scholar
Hicken, B. L. and Plowhead, A. (2010). A model for home-based psychology from the Veterans Health Administration. Professional Psychology: Research and Practice, 41, 340346.CrossRefGoogle Scholar
Irwin, S. A. (2012). Palliative care, geriatric psychiatry, and you. American Journal of Geriatric Psychiatry, 20(4), 281283.Google Scholar
Irwin, S. A. and Hirst, J. M. (2015). Overview of anxiety in palliative care. In S. D. Block, ed., UptoDate. www.uptodate.com/contents/overview-of-anxiety-in-palliative-care/abstract/37Google Scholar
Irwin, S. A., Montross, L. P. and Chochinov, H. M. (2012). What treatments are effective for anxiety in patients with serious illness? In Morrison, R. S., and Goldstein, N, eds., Evidence-Based Practice of Palliative Medicine. Philadelphia, PA: Elsevier Saunders, pp. 191197.Google Scholar
Jungers, C. M. (2010). Leaving home: an examination of late-life relocation among older adults. Journal of Counseling and Development, 88, 416423.Google Scholar
Kales, H. C., Gitlin, L. N. and Lyketsos, C. G. (2014). Management of neuropsychiatric symptoms of dementia in clinical settings: recommendations from a multidisciplinary expert panel. Journal of the American Geriatric Society, 62, 762769.Google Scholar
Kangas, M., Henry, J.L. and Bryant, R. A. (2002). Posttraumatic stress disorder following cancer. A conceptual and empirical review. Clinical Psychological Review, 22, 499524.Google Scholar
Keister, K. J. (2006). Predictors of self-assessed health, anxiety, and depressive symptoms in nursing home residents at week 1 post-relocation. Journal of Aging and Health, 18(5), 722742.Google Scholar
Kessler, R. C., DuPont, R. L., Berglund, P. and Wittchen, H. U. (1999). Impairment in pure and comorbid generalized anxiety disorder and major depression at 12 months in two national surveys. American Journal of Psychiatry, 156, 19151923.Google Scholar
Kim, H., Stektee, G. and Frost, R. O. (2001). Hoarding by elderly people. Health and Social Work, 26, 176184.Google Scholar
Kolva, E., Rossenfield, B., Pessin, H., Breitbart, W. and Brescia, R. (2011), Anxiety in terminally ill cancer patients. Journal of Pain and Symptom Management, 42(5), 691701.Google Scholar
Le Roux, H., Gatz, M. and Wetherell, J. L. (2005). Age at onset of generalized anxiety disorder in older adults. American Journal of Geriatric Psychiatry, 13, 2330.CrossRefGoogle ScholarPubMed
Lee, D., Woo, J. and Mackenzie, A. E. (2002). The cultural context of adjusting to nursing home life: Chinese elders’ perspectives. Gerontologist, 42, 667675.Google Scholar
Lichtenberg, P. A. and MacNeill, S. E. (2003). Streamlining assessments and treatments for geriatric mental health in medical rehabilitation. Rehabilitation Psychology, 48(1), 5660.Google Scholar
Livingston, G., Kelly, L., Lewis-Holmes, E. and Cooper, C. (2014). Non-pharmacological interventions for agitation in dementia: systematic review of randomized controlled trials. British Journal of Psychiatry, 205, 436442.CrossRefGoogle Scholar
Logsdon, R. G., Gibbons, L. E., McCurry, S. M. and Teri, L. (1999). Quality of life in Alzheimer’s disease: patient and caregiver reports. Journal of Mental Health and Aging, 5, 2132.Google Scholar
Mack, J. L., Patterson, M. B. and Tariot, P. N. (1999). Behavior rating scale for dementia: development of test scales and presentation of data for 555 individuals with Alzheimer’s disease. Journal of Geriatric Psychiatry and Neurology, 12(4), 211223.Google Scholar
Martini de Oliveira, A., Radanovic, M. and Cotting Homem de Mello, P., et al. (2015). Non-pharmacological interventions to reduce behavioral and psychological symptoms of dementia: a systematic review. BioMed Research International, 2015, 218980.Google Scholar
Meeks, S., Woodruff-Borden, J. and Depp, C. (2003). Structural differentiation of self-reported depression and anxiety in late life. Journal of Anxiety Disorders, 17, 627646.Google Scholar
Mega, M. S., Cummings, J. L., Fiorello, T. and Gornbein, J. (1996). The spectrum of behavioral changes in Alzheimer’s disease. Neurology, 46(1), 130135.Google Scholar
Mintzer, J. E. and Brawman-Mintzer, O. (1996). Agitation as possible expression of generalized anxiety disorder in demented elderly patients: toward a treatment approach. Journal of Clinical Psychiatry, 57, 5563.Google Scholar
Miovic, M. and Block, S. (2007). Psychiatric disorders in advanced cancer. Cancer, 110(8), 16651676.Google Scholar
Neville, C. and Teri, L. (2011). Anxiety, anxiety symptoms, and associations among older people with dementia in assisted-living facilities. International Journal of Mental Health Nursing, 20(3), 195201.Google Scholar
Ninot, G., Fortes, M., Poulain, M., et al. (2006). Gender difference in coping strategies among patients enrolled in an inpatient rehabilitation program. Heart & Lung, 35(2), 130136.Google Scholar
O’Neil, M., Freeman., M., Christensen, V., Telerant, A., Addleman, A. and Kansagara, D. (2011). Non-pharmacological Interventions for Behavioral Symptoms of Dementia: A Systematic Review of the Evidence. VA-ESP Project #05-225. Washington, DC: US Department of Veterans Affairs.Google Scholar
Porter, R. J., Gallagher, P., Thompson, J. M. and Young, A. H. (2003). Neurocognitive impairment in drug-free patients with major depressive disorder. British Journal of Psychiatry, 182, 214220.Google Scholar
Qiu, W. Q., Dean, M., Liu, T., et al. (2010). Physical and mental health of the homebound elderly: an overlooked population. Journal of the American Geriatrics Society, 58(12), 24232428.CrossRefGoogle ScholarPubMed
Reinardy, J. R. and Kane, R. A. (2003). Anatomy of a choice: deciding on assisted living or nursing home care in Oregon. Journal of Applied Gerontology, 22, 152174.CrossRefGoogle Scholar
Reisberg, B., Franssen, E., Kluger, A., et al. (1990). The clinical course of Alzheimer’s patients. Neurobiology of Aging, 11, 253.Google Scholar
Roth, A. Nelson, C.J., Rosenfeld, B., et al. (2006). Assessing anxiety in men with prostate cancer: further data on the reliability and validity of the Memorial Anxiety Scale for Prostate Cancer (MAX-PC). Psychosomatics, 47, 340347.Google Scholar
Schoevers, R. A., Beekman, A. T. F., Deeg, D. J. H., et al. 2003. The natural history of late-life depression: results from the Amsterdam Study of the Elderly (AMSTEL). Journal of Affective Disorders, 76, 514.CrossRefGoogle ScholarPubMed
Schulz, R. (1976). Effects of control and predictability on the physical and psychological well-being of the institutionalized aged. Journal of Personality and Social Psychology, 33(5), 563573.Google Scholar
Segal, D. L., June, A., Payne, M., Coolidge, F., L. and Yochim, B. (2010). Development and initial validation of a self-report assessment tool for anxiety among older adults: the Geriatric Anxiety Scale. Journal of Anxiety Disorders, 24, 709–214.Google Scholar
Shankar, K. K. and Orrell, M. W. (2000). Detecting and managing anxiety in people with dementia. Current Opinion in Psychiatry, 13, 5559.Google Scholar
Singh, R., Hunter, J. and Philip, A. (2007). The rapid resolution of depression and anxiety symptoms after lower limb amputation. Clinical Rehabilitation, 21(8), 754759.Google Scholar
Singh, R., Ripley, D., Pentland, B., et al. (2009). Depression and anxiety symptoms after lower limb amputation: the rise and fall. Clinical Rehabilitation, 23(3), 281286.Google Scholar
Stall, N, Nowaczynski, M. and Sinha, S. K. (2013). Back to the future: home-based primary care for older homebound Canadians: part 2: where we are going. Canadian Family Physician, 59, 243245.Google Scholar
Stall, N, Nowaczynski, M. and Sinha, S. K. (2014). Systematic review of outcomes from home-based primary care programs for homebound older adults. Journal of the American Geriatrics Society, 62, 22432251.CrossRefGoogle ScholarPubMed
Starkstein, S. E., Jorge, R., Mizrahi, R., Adrian, J. and Robinson, R. G. (2007). Insight and danger in Alzheimer’s disease. European Journal of Neurology, 14(4), 455-460.Google Scholar
Teachman, B. A. (2006). Aging and negative affect: the rise and fall and rise of anxiety and depression symptoms. Psychology and Aging, 21, 201207.Google Scholar
Teri, L. E., McCurry, S. M., Logsdon, R. G., et al. (1998). Exercise and activity level in Alzheimer’s disease: a potential treatment focus. Journal of Rehabilitation Research and Development, 35(4), 411419.Google Scholar
Tinetti, M. E., Inouye, S. K., Gill, T. M. and Doucette, J. T. (1995). Shared risk factors for falls, incontinence, and functional dependence: unifying the approach to geriatric syndromes. JAMA, 273(17), 13481353.Google Scholar
Tolin, D. F., Robison, J. T., Gaztambide, S. and Blank, K. (2005). Anxiety disorders in older Puerto Rican primary care patients. American Journal of Geriatric Psychiatry, 13, 150156.Google Scholar
US Census Bureau (2010). National population projections: summary. www.census.gov/population/www/cen2010/glance/Google Scholar
Watanabe, Y. (2005). Fear of falling among stroke survivors after discharge from inpatient rehabilitation. International Journal of Rehabilitation Research, 28(2), 149152.Google Scholar
Wetherell, J. L., Sorrell, J. T., Thorp, S. R. and Patterson, T. L. (2005). Psychological interventions for late-life anxiety: a review and early lessons from the CALM study. Journal of Geriatric Psychiatry and Neurology, 18, 7282.Google Scholar
Wetherell, J. L., Thorp, S. R., Patterson, T. L., Golshan, S., Jeste, D. V. and Gatz, M. (2004). Quality of life in geriatric generalized anxiety disorder: a preliminary investigation. Journal of Psychiatric Research, 38, 305312.Google Scholar
Wolitzky-Taylor, K. B., Castriotta, N., Lenze, E. J., Stanley, M. A. and Craske, M. G. (2010). Anxiety disorders in older adults: a comprehensive review. Depression and Anxiety, 27, 190211.Google Scholar
World Health Organization (2015). World report on ageing and health. http://apps.who.int/iris/bitstream/10665/186463/1/9789240694811_eng.pdfGoogle Scholar
Yang, J. A., Garis, J., Jackson, C. and McClure, R. (2009). Providing psychotherapy to older adults in home: benefits, challenges, and decision-making guidelines. Clinical Gerontologist, 32, 333346.CrossRefGoogle Scholar
Yerkes, R. M. and Dodson, J. (1908). The relation of strength of stimulus to rapidity of habit-formation. Journal of Comparative Neurology and Psychology, 18, 459482.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×