Optometrists provide vision care to individuals, examining their sight, depth perception and ability to focus while also testing for glaucoma and other eye-related conditions. In addition, optometrists can prescribe glasses or contacts and recommend proper eye care.
Due to a population that is both aging and growing, employment for optometrists is expected to grow a whopping 24 percent between 2008 and 2018, according to the Bureau of Labor Statistics 2010-2011 Occupational Outlook Handbook. Job growth will also occur as more health plans include vision insurance and as more optometrists retire.
The average optometrist who works in an office makes more than $96,000 as of 2008, and self-employed optometrists averaged about $175,000 in annual income in 2007, according to the American Optometric Association. At first, optometrists who have their own practice make less than salaried optometrists, but eventually they make more.
Unlike some doctors who work long nights, weekends, and have to be on call every so often, optometrists typically work a fairly standard 8 a.m. to 5 p.m. schedule, Monday through Friday. Likewise, their offices are generally well kept and comfortable, and most optometrists have ample vacation and sick time as well.
Globally, the population is ageing rapidly. Between 2015 and 2050, the proportion of the world’s population over 60 years will nearly double, from 12% to 22%.
Mental health and well-being are as important in older age as at any other time of life.
Mental and neurological disorders among older adults account for 6.6% of the total disability (DALYs) for this age group.
Approximately 15% of adults aged 60 and over suffer from a mental disorder.
Older adults, those aged 60 or above, make important contributions to society as family members, volunteers and as active participants in the workforce. While most have good mental health, many older adults are at risk of developing mental disorders, neurological disorders or substance use problems as well as other health conditions such as diabetes, hearing loss, and osteoarthritis. Furthermore, as people age, they are more likely to experience several conditions at the same time.
The world’s population is ageing rapidly. Between 2015 and 2050, the proportion of the world’s older adults is estimated to almost double from about 12% to 22%. In absolute terms, this is an expected increase from 900 million to 2 billion people over the age of 60. Older people face special physical and mental health challenges which need to be recognized.
Over 20% of adults aged 60 and over suffer from a mental or neurological disorder (excluding headache disorders) and 6.6% of all disability (disability adjusted life years-DALYs) among people over 60 years is attributed to mental and neurological disorders. These disorders in older people account for 17.4% of Years Lived with Disability (YLDs). The most common mental and neurological disorders in this age group are dementia and depression, which affect approximately 5% and 7% of the world’s older population, respectively. Anxiety disorders affect 3.8% of the older population, substance use problems affect almost 1% and around a quarter of deaths from self-harm are among people aged 60 or above. Substance abuse problems among older people are often overlooked or misdiagnosed.
Mental health problems are under-identified by health-care professionals and older people themselves, and the stigma surrounding these conditions makes people reluctant to seek help.
Risk factors for mental health problems among older adults
There may be multiple risk factors for mental health problems at any point in life. Older people may experience life stressors common to all people, but also stressors that are more common in later life, like a significant ongoing loss in capacities and a decline in functional ability. For example, older adults may experience reduced mobility, chronic pain, frailty or other health problems, for which they require some form of long-term care. In addition, older people are more likely to experience events such as bereavement, or a drop in socioeconomic status with retirement. All of these stressors can result in isolation, loneliness or psychological distress in older people, for which they may require long-term care.
Mental health has an impact on physical health and vice versa. For example, older adults with physical health conditions such as heart disease have higher rates of depression than those who are healthy. Additionally, untreated depression in an older person with heart disease can negatively affect its outcome.
Older adults are also vulnerable to elder abuse – including physical, verbal, psychological, financial and sexual abuse; abandonment; neglect; and serious losses of dignity and respect. Current evidence suggests that 1 in 6 older people experience elder abuse. Elder abuse can lead not only to physical injuries, but also to serious, sometimes long-lasting psychological consequences, including depression and anxiety.
Dementia and depression among older people as public health issues
Dementia is a syndrome, usually of a chronic or progressive nature, in which there is deterioration in memory, thinking, behaviour and the ability to perform everyday activities. It mainly affects older people, although it is not a normal part of ageing.
It is estimated that 50 million people worldwide are living with dementia with nearly 60% living in low- and middle-income countries. The total number of people with dementia is projected to increase to 82 million in 2030 and 152 million in 2050.
There are significant social and economic issues in terms of the direct costs of medical, social and informal care associated with dementia. Moreover, physical, emotional and economic pressures can cause great stress to families and carers. Support is needed from the health, social, financial and legal systems for both people with dementia and their carers.
Depression can cause great suffering and leads to impaired functioning in daily life. Unipolar depression occurs in 7% of the general older population and it accounts for 5.7% of YLDs among those over 60 years old. Depression is both underdiagnosed and undertreated in primary care settings. Symptoms are often overlooked and untreated because they co-occur with other problems encountered by older adults.
Older people with depressive symptoms have poorer functioning compared to those with chronic medical conditions such as lung disease, hypertension or diabetes. Depression also increases the perception of poor health, the utilization of health care services and costs.
Treatment and care strategies to address mental health needs of older people
It is important to prepare health providers and societies to meet the specific needs of older populations, including:
training for health professionals in providing care for older people;
preventing and managing age-associated chronic diseases including mental, neurological and substance use disorders;
designing sustainable policies on long-term and palliative care; and
developing age-friendly services and settings.
The mental health of older adults can be improved through promoting Active and Healthy Ageing. Mental health-specific health promotion for older adults involves creating living conditions and environments that support wellbeing and allow people to lead a healthy life. Promoting mental health depends largely on strategies to ensure that older people have the necessary resources to meet their needs, such as:
providing security and freedom;
adequate housing through supportive housing policy;
social support for older people and their caregivers;
health and social programmes targeted at vulnerable groups such as those who live alone and rural populations or who suffer from a chronic or relapsing mental or physical illness;
programmes to prevent and deal with elder abuse; and
community development programmes.
Prompt recognition and treatment of mental, neurological and substance use disorders in older adults is essential. Both psychosocial interventions and medicines are recommended.
There is no medication currently available to cure dementia but much can be done to support and improve the lives of people with dementia and their caregivers and families, such as:
early diagnosis, in order to promote early and optimal management;
optimizing physical and mental health, functional ability and well-being;
identifying and treating accompanying physical illness;
detecting and managing challenging behaviour; and
providing information and long-term support to carers.
Mental health care in the community
Good general health and social care is important for promoting older people’s health, preventing disease and managing chronic illnesses. Training all health providers in working with issues and disorders related to ageing is therefore important. Effective, community-level primary mental health care for older people is crucial. It is equally important to focus on the long-term care of older adults suffering from mental disorders, as well as to provide caregivers with education, training and support.…
Mental illness is a general term for a group of illnesses that may include symptoms that can affect a person’s thinking, perceptions, mood or behaviour. Mental illness can make it difficult for someone to cope with work, relationships and other demands. The relationship between stress and mental illness is complex, but it is known that stress can worsen an episode of mental illness. Most people can manage their mental illness with medication, counselling or both.This page lists some of the more common mental health issues and mental illnesses.
Anxiety disorders is a group of mental health disorders that includes generalised anxiety disorders, social phobias, specific phobias (for example, agoraphobia and claustrophobia), panic disorders, obsessive compulsive disorder (OCD) and post-traumatic stress disorder. Untreated, anxiety disorders can lead to significant impairment on people’s daily lives.
Common behaviour disorders in children include oppositional defiant disorder (ODD), conduct disorder (CD) and attention deficit hyperactivity disorder (ADHD). Treatment for these mental health disorders can include therapy, education and medication.
Bipolar affective disorder is a type of mood disorder, previously referred to as ‘manic depression’. A person with bipolar disorder experiences episodes of mania (elation) and depression. The person may or may not experience psychotic symptoms. The exact cause is unknown, but a genetic predisposition has been clearly established. Environmental stressors can also trigger episodes of this mental illness.
Depression is a mood disorder characterised by lowering of mood, loss of interest and enjoyment, and reduced energy. It is not just feeling sad. There are different types and symptoms of depression. There are varying levels of severity and symptoms related to depression. Symptoms of depression can lead to increased risk of suicidal thoughts or behaviours.
Dissociation is a mental process where a person disconnects from their thoughts, feelings, memories or sense of identity. Dissociative disorders include dissociative amnesia, dissociative fugue, depersonalisation disorder and dissociative identity disorder.
Obsessive compulsive disorder (OCD) is an anxiety disorder. Obsessions are recurrent thoughts, images or impulses that are intrusive and unwanted. Compulsions are time-consuming and distressing repetitive rituals. Ttreatments include cognitive behaviour therapy (CBT), and medications
Paranoia is the irrational and persistent feeling that people are ‘out to get you’. Paranoia may be a symptom of conditions including paranoid personality disorder, delusional (paranoid) disorder and schizophrenia. Treatment for paranoiainclude medications and psychological support.
Post-traumatic stress disorder (PTSD) is a mental health condition that can develop as a response to people who have experienced any traumatic event. This can be a car or other serious accident, physical or sexual assault, war-related events or torture, or natural disasters such as bushfires or floods.
People affected by psychosis can experience delusions, hallucinations and confused thinking.. Psychosis can occur in a number of mental illnesses, including drug-induced psychosis, schizophrenia and mood disorders. Medication and psychological support can relieve, or even eliminate, psychotic symptoms.
Schizophrenia is a complex psychotic disorder characterised by disruptions to thinking and emotions, and a distorted perception of reality. Symptoms of schizophrenia vary widely but may include hallucinations, delusions, thought disorder, social withdrawal, lack of motivation and impaired thinking and memory. People with schizophrenia have a high risk of suicide. Schizophrenia is not a split personality.