It is the unique function of the caregiver to satisfy the mental and emotional needs of their elderly patient. The health of an older person is a composite of the person's lifestyle, physical health, social support network, coping skills, and cognitive abilities.

As people age, issues they have grappled with their entire lives possibly tried to ignore, such as alcoholism, family dysfunction, abuse, and other stresses, tend to impact their health.

If a dementia process begins, long-buried issues may suddenly take on major significance. Mental health problems in older adults often contribute to decreased self-esteem, diminished quality of life, and impaired social functioning.

Good mental health implies a capacity to manage life stresses to achieve a state of emotional homeostasis. Consider the life crises the older person may face: retirement, with accompanying loss of status and independence; loss of spouse and other loved ones; sensory losses; and possibly, disease, pain, surgery, dependence, and institutionalisation.

Depending on the person's coping mechanism any one of these could precipitate psychological problems. The cumulative effect could overwhelm even an emotionally strong, healthy person.

Many older adults who seek mental health services have an underlying physical illness. Keep in mind that the far-reaching physical changes of aging often have profound psychological effects, and emotional difficulties also may cause physical symptoms.

In order for older adults to overcome all these feelings of frustration, is to talk about them openly. The caregiver must open the lines of communication.

To foster your older patient's cooperation, take a little extra time to help him to see the relevance of your questions, you may need to repeat an explanation several times, give the patient plenty of time to respond to your questions and directions, remain silent to allow him to collect his thoughts and ideas before responding.

Finally, be patient, and remember skillful assessment is essential, because older patients with anxiety tend to have many physical complaints, that can lead to actual physical disorders if left untreated.

Paulette Godfrey is a qualified geriatric caregiver and the matron of Herb Garden Seniors Residence in Southampton.