Doris: Not a Normal Part of Aging

Doris* pulled her boney knees up close to her chest and sat motionless for hours on the floor in the corner of the dark bedroom. Her fl oral housecoat was twisted loosely around her frail, thin frame. Her heart raced. She had difficulty breathing. Traumatic memories of 52 years of physical and verbal abuse by her now deceased husband filled her head. She felt sick and hadn’t eaten or taken her blood pressure medicine for three days. She was alone, frightened and couldn’t move. For months, she had been afraid of leaving the house, but now even leaving her bedroom was not an option. Soon, her son, who she depended on for nearly everything, would be taking his family on a Caribbean cruise. There would be no one to protect her or rescue her. Doris feared she might die – alone.

The sound of the doorbell broke the dull silence barely rousing Doris from a sleepless fog. That’s when, Kathryn found her 78-yearold mother-in-law conscious but unresponsive in the bedroom of her silent house. Kathryn dialed 9-1-1. Paramedics promptly transported Doris to the hospital. After being rehydrated, Doris became more alert but doctors couldn’t identify any physical reasons for her condition. So after just one day, she was released. At that point, the county crisis center referred Doris to Volunteers of America-Minnesota’s Senior Mental Health Services. The program offers age-specific diagnostic and treatment options that address the specialized mental health service needs of older adults. It’s one of the only local mental health programs for seniors that will meet with clients in the comfort of their own homes. Theresa, a Volunteers of America licensed mental health therapist with experience in treating older persons, visited Doris at home. Theresa reminded Doris of her physician’s findings to reassure her that she was physically healthy. She also reminded Doris that her doctor had instructed her to resume her blood pressure medication so that her physical problems would not further complicate her recovery from the serious but equally treatable mental health symptoms. Then Theresa conducted a comprehensive, diagnostic assessment, and mental health screening. The results revealed that Doris was suffering from a combination of mental health issues which were preventing her from living her life fully including panic disorder with agoraphobia (an unnatural fear of open spaces), generalized anxiety, and post-traumatic stress disorder. Doris was comforted to know that the testing performed by Theresa did not show indications of dementia. This was a relief to Doris because she had been fearful she might have Alzheimer’s disease and that it would jeopardize her ability to function independently. Additionally, Doris was relieved to learn that her anxiety, sense of hopelessness, and other issues were not a normal part of the aging process. Yet, she was hesitant about receiving mental health services because of her generation’s stigma of mental illness. So, Theresa took extra time to educate Doris. She offered her hope and explained that she could get better with a combination of medication and therapy. With Theresa’s skilled encouragement, Doris accepted home-based mental health therapy and the assistance of a geriatric psychiatrist who is a member of the Senior Mental Health Services’ multi-disciplinary team. Doris was relieved to learn that her anxiety, sense of hopelessness, and other issues were not a normal part of the aging process.

Next, Theresa collaborated with Doris’ primary doctor, her psychiatrist, and her family to develop a holistic treatment plan tailored to meet Doris’ individual needs. Weekly therapy sessions were part of the plan and included individual talk therapy and family therapy. Gradually, Doris became comfortable, confident and trusting of Theresa and the VOA-MN support. Doris’ progress came one step at a time. She started by eating three meals each day and taking her medication regularly. With Theresa’s guidance, Doris practiced relaxation techniques and positive self-talk. She was progressively able to reduce her bad memories, fears and phobias. Over time, Doris started to feel like herself again. Each day, she pushed herself to reengage in the community and reconnect with people and activities that she enjoyed, including baking, playing the piano at church, and exercising with friends at a local senior center.

Today, after nearly a year of hard work, Doris meets with her therapist Theresa once every three weeks. While she realizes there is a chance of relapse, Doris can identify the triggers and warning signs, and has developed effective coping skills to prevent that. More importantly, she feels good, is active, and has resumed her role as mother, grandmother and great-grandmother. Although Doris’ family will be leaving for the British Isles in a few weeks, she’s no longer worried about being alone.

*We have changed the subject’s name and certain details to protect privacy and confidentiality. The individual in the accompanying photo is a model.

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