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These fact sheets are brought to you through a joint partnership with the National Council on Aging. A person who may be thinking about suicide likely does not want to die, but is in search of some way to make pain or suffering go away. Suicidal thoughts in older adults may be linked to several important risk factors and warning signs. It is crucial that friends and family of older adults identify signs of suicidal thoughts and take appropriate follow- up actions to prevent them from acting on these thoughts.
Passive suicidal thoughts include thoughts of being “better off dead.” They are not necessarily associated with increased risk for suicide, but are a sign of significant distress and should be addressed immediately. In contrast, active suicidal thoughts include thoughts of taking action toward hurting or killing oneself.
If someone you know has a suicide plan with intent to act, you should not leave them alone—make sure to stay with them until emergency services are in place. If you or someone you know is experiencing passive or active suicidal thoughts, or has described a plan with intent to act, it is essential that you intervene and get help from a mental health professional immediately.
Medicare Part A (hospital insurance) helps cover mental health care if you’re a hospital inpatient.
Medicare Part B (medical insurance) helps cover mental health services that you would get from a doctor as well as services that you generally would get outside of a hospital, like visits with a psychiatrist, clinical psychologist or clinical social worker, and lab tests ordered by your doctor. Medicare Part D (prescription drug coverage) helps cover drugs you may need to treat a mental health condition. The Older Persons Mental Health Service is a component of the Cairns and Hinterland Mental Health and ATOD Service and operates within the Cairns and Hinterland Hospital and Health Service.
Our team is comprised of experienced Mental Health Clinicians and a Consultant Psychiatrist. The Cairns and Hinterland Mental Health and ATOD Service provide comprehensive mental health services across Cairns and Hinterland Hospital and Health Service. One of the keys to effective grantmaking is to partner with innovative leaders at the very top of their fields. The Institute of Medicine (IOM) is swinging for the fences with the release of a new report, Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis. Ezra Klein, a prominent Washington Post blogger whose work I generally respect and enjoy, recently put up a post (Feds spend $7 on elderly for every $1 on kids) on federal spending on young versus older Americans.
The Urban Institute report had very little invidious comparison between kids and older adults, but Klein has highlighted what little there was and added new factoids of his own.
Ten years ago this month, the initial results of a $10 million depression treatment project funded by the Hartford Foundation (with co-funding from the California HealthCare, Hogg, and Robert Johnson Foundations) were published in the Journal of the American Medical Association. In what remains the largest multi-site randomized trial of its kind, the project—called IMPACT—showed that it is possible to double the benefits of the usual treatment of older adults for depression in primary care practices. So how much progress has our nation made in providing better mental health care for older adults, a decade later?
During my first year of graduate school at Columbia University, I worked at a home care agency as a medical social worker, making home visits to elderly clients with a wide range of acute health and long-term chronic illness needs. That experience opened my eyes to the direct impact of a model of care that lacks patient-centered goals.
While the poll was a new experience for us, writing about the sorry state of care for older adults isn’t. Supporting the results of our poll was “The Good, the Bad, and the Ugly,” in which I discussed how far we need to go to improve care for older adults. Recently, you heard from the creative team—our writer, photographers, and videographers—for our award-winning 2011 annual report focused on mental health and older adults.
Today, we are delighted to give you the opportunity to “slow down and listen,” just as Don did, through the first of our collection of 2011 annual report videos. The first video features Elizabeth, an inspiring older adult who overcame years of depression triggered by the murder of her daughter and subsequent death of her husband. As our dedicated 2012 Hartford Foundation annual report blog series followers know, our August 7 blog featured the creative team behind our award-winning annual report. Writing this year’s annual report had personal significance for me that I could not have anticipated when I began the project. We are always proud of how our innovative and entrepreneurial grantees parlay work started with Foundation support into additional resources to improve the health of older adults (for example, in the CMMI Innovation Challenge program).
Starting last year, we have been preparing an application to the Corporation for National & Community Service (CNCS) as part of its Social Innovation Fund competition. We are part of a cohort of just four new awardees for 2012 who will be intermediaries between the Social Innovation Fund and subgrantees implementing innovative models.
Our campus is alive with public debates, forums, lectures, music, theatre, film, art and festivals.

Research & innovationANU research priorities address the challenges facing Australia and the world.
GivingYour donation will make a real difference to our community of researchers and students. Current studentsANU has a huge variety of support services, programs and activities to enhance your student experience. Researchers at The Australian National University (ANU) are looking for older people with chronic mental illness, and family or friends who support them, to take part in a study to work out if more support services are needed in the Canberra region. PhD student Sharon Leigh-Hazell wants to speak to people from across the ACT and surrounding areas for her study into services and support for people aged over 60 who have had a mental illness for more than five years. Ms Leigh-Hazell has a lived experience as an advocate and support person for her mother who had a long-term mental illness.
A recent study found that around one in four older people had experienced mental illness sometime in their life. Ms Leigh-Hazell said there has been limited research into care for older people with chronic mental illness, and particularly the link between physical and mental health services and support for older people and carers. Thinking about your mental illness or caring for someone with a mental illness can be upsetting.
Mental Health America collaborates with the National Council on Aging (NCOA) My Medicare Matters campaign in support of our joint goal of assisting older adults to access mental health resources through Medicare. Have you experienced increasing social isolation in recent years, the death of loved ones, or feelings of hopelessness?
Suicide attempts are more likely to end in death for older adults than younger adults, especially when attempted by men.
An example of an active suicidal thought would be answering yes to the question “In the last two weeks, have you had any thoughts of hurting or killing yourself?” These thoughts require immediate clinical assessment and intervention by a mental health professional. A timely and appropriate intervention can prevent suicide, and addressing issues sooner rather than later often results in better treatment outcomes. Part B may also pay for partial hospitalization services if you need intensive coordinated outpatient care. Use the Medicare QuickCheck® to get a personalized report on the best options for your situation. People are living longer, and older people are forming a larger part of the global population. Friends and family members die, physical fitness declines, and neurocognitive disorders like dementia increase. Pachana is Professor of Clinical Psychology and co-director of the Ageing Mind Initiative at The University of Queensland, Brisbane, Australia. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. Hartford Foundation’s dedicated staff is constantly monitoring the dynamic health care landscape to identify powerful opportunities for large-scale change that will result in better care and better lives for all older adults.
Hartford Foundation, the notion of improving health outcomes while decreasing costs appeared implausible. Our aide, Abdulai (last name withheld), served as my family’s lifeline, the person my grandfather could rely on for personalized and direct care, the person my mother could trust in clarifying medications and complicated procedures.
His post was a reanalysis and interpretation of a recent Urban Institute report on spending on kids, funded by the Annie E.
Klein means to be advocating for increased spending on children so as to help create the future we all want to have in our country. And it demonstrated what changes are needed in the process of depression care to ensure that more patients get better.
After conducting many home visits with frail elderly clients, I began to notice the lack of coordination of care by the various parties involved. It also illustrated the effects of a fragmented and extremely ineffective health care system for the aging adults in our nation. Hartford Foundation as an intern for the summer of 2012, I was curious about how a foundation could address the needs of the increasing numbers of older adults. Our annual report discussed the lack of quality mental health care for older adults, recently illustrated by the callous dismissal of annual report writer Lynne Christensen’s mother’s post-surgical depression as “to be expected.” Our April poll, “How Does It Feel?
To help you better understand this important and frustrating issue, we’ve gathered a collection of Health AGEnda posts that address some of the problems—and solutions—we’ve identified. Although there are some good programs improving geriatrics training for physicians, not all of them are producing robust results.
Elizabeth, together with her Depression Care Manager Rita Haverkamp, RN, MNS, CNS, participated in Project IMPACT—a successful, Hartford-funded model to assess and treat depression in a primary care setting.
Intrigued by their stories, we asked our annual report writer, Lynne Christensen, to tell us more about her experience writing about mental health and older adults.

About halfway through the writing process, I learned that my 81-year-old mother needed a heart valve replacement, and the surgery couldn’t wait. Today, I am very proud to announce that in partnership with our long-time grantees at the University of Washington’s Advancing Integrated Mental Health Solutions (AIMS) center, led by Jurgen Unutzer, we have managed the same trick ourselves, resulting in what should ultimately be almost $11 million in new money to improve older adults’ mental health. This competition calls for foundations and non-profit organizations to put forward evidence-based models (like the University of Washington’s IMPACT depression care model) that solve important social problems. Staff at CNCS and our program officer (writing that feels odd!) tell us that the selection process “was highly competitive and sought proposals that would drive impact and transform lives. Older people with mental health issues are also more likely to have other conditions like diabetes and cardiovascular disease but the quality of care for them is poorer. A 2012 Australian Institute of Health and Welfare report found around half of the people in residential aged care had at least one mental disorder, excluding cognitive impairment or dementia.
Ken Laidlaw is Professor of Clinical Psychology and Head of Department of Clinical Psychology at Norwich Medical School, University of East Anglia, UK. I am very pleased to announce that our Trustees last week approved three new grants totaling $6.7 million that leverage these opportunities. Securing strong patient-centered care for a loved one had to come at an extra expense—a large price tag for both the individual, his family, and the institution administering the care.
Casey Foundation, that analyzed spending on children in a post American Recovery and Reinvestment Act and budget reduction world.
For example, in addition to tweeting the inflammatory title of this piece, he also tweets that spending on children will soon be less than interest payments on the debt—another rhetorical comparison intended to show that we need to invest more in kids than we currently do.
Given the extremely large caseload that nurses, social workers, and physical therapists undertook at the home care agency, the tendency was to visit a client as quickly as possible and interact minimally with other health professionals so that one had time to complete all necessary paperwork. I learned that one of the ways the foundation achieves its goal is by building the capacity of health care professionals trained in geriatric care. For example, raising falls screening from a dismal 11 percent to a still-mediocre 34 percent is nowhere near good enough, and I believe there needs to be a greater sense of urgency in solving the problem. Only organizations with a track record of success implementing programs with evidence of effectiveness were eligible. According to the CDC, an estimated 10,189 older Americans (ages 60 and up) died from suicide in 2013. Use the checklist on the next page to determine if you or someone you know may be showing warning signs of suicidal thoughts. Meanwhile, as young people move to cities or abroad, more older adults live alone or without social support. Studies show that older adults enjoy greater life satisfaction and happiness than younger adults. After all, my family recently hired a home health aide to assist and advocate for my grandfather during his stay in the hospital and then during hospice, what is supposed to be one of the most patient-centered forms of care.
In addition, the Hartford Foundation funds efforts to implement models of care focusing specifically on the geriatric population so that older adults receive the appropriate care to maintain quality of life. The poll showed that although the vast majority of older adults are satisfied with their care, that care lags badly behind recommended care for older adults on numerous measures. Notably, the suicides are particularly high among older, white males (32.74 suicides per 100,000 people). Perhaps retirees have more time for hobbies and socialising without the burden of childcare. My family believed that a consistent, if costly, presence and support system would serve him well during employee shifts and other downtime between caregivers. The coordination of funding, management, and direct service will inevitably help bring real change to the health care system and its impact on older adults.
Assuming we do a good job (which we plan to!), we then get another year and another $1 million. In fact, the rate of suicide in the oldest group of white males (ages 85+) is  over four times higher than the nation’s overall rate of suicide.
At the same time, factors like social support, culture, and personal values have a important influence on well-being in older age.
It is my hope that, through collaboration among the varying levels of health care professionals and institutions, we will achieve our goal of improving the health care of older adults. Thus, our $3 million over three years should turn into $6 (thanks to the federal match) and then almost $11 million (thanks to the matching funds for the subgrantees).

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