More mentally ill people expected to reach old age

Society will need to add services for seniors with mental illnesses, because more people with those conditions are surviving into old age, a University of Iowa expert said.

"It's a very difficult social problem, and we'll have to start thinking carefully about how best to meet that need. It's a big question that will become more important over time," said Dr. Susan Schultz, a geriatric psychiatrist who is director of the university's Center on Aging.

Researchers have long known that people with schizophrenia, bipolar disorder or similar conditions tend to die years or decades earlier than others, Schultz said. The premature deaths have been largely attributed to poor physical health, including ailments that went untreated because people with mental illness were less likely to obtain timely medical care.

But health care providers have strengthened their monitoring and care of such patients, and modern psychiatric medications have helped more people with mental illness function and thrive, she said. Those improvements should soon start showing up in lifespan statistics, she said.

Schultz stressed that not all seniors with mental illnesses need to be placed in specialized facilities. Standard nursing homes can handle many such residents, especially if the facilities' staff members are properly trained, she said. It's important that the staff members talk to the patients' previous mental health care providers, so they understand how best to handle the patients' issues, she said.

But Schultz said some patients with deep mental illness probably would benefit from staying in specialized nursing homes that focus on such cases. Schultz predicted there will be a need for more such facilities soon. Iowa now has just three.

Schultz sometimes referred her patients to the geriatric program at the Iowa Mental Health Institute at Clarinda, which closed in June. She said many of those patients would likely need extensive assistance.

"Clearly the type that we see coming from Clarinda, they were there for a reason because they have complex illnesses," she said. But she didn't know enough details about each case to comment on the appropriateness of sending some to standard nursing homes.