Anxiety

Responding to Older Adults with Substance Use, Mental Health and Gambling Challenges

On this page:

Kinds of anxiety problems
How common are anxiety problems in older adults?
Signs of anxiety problems
Medications for anxiety problems
How to talk with an older adult who has an anxiety problem
When to get help

It's normal and healthy to feel worried or afraid in certain situations. If, for example, you were about to have major surgery, you might expect to feel worried. Or if you were out walking and a snarling dog came running toward you, the fear you felt could help you run to save your life. These feelings can be described as anxiety, but they are not a concern.

But some people feel anxiety often or all the time. It can affect their ability to carry out daily tasks and to take part in social life and relationships. This type of anxiety is a concern.

Anxiety problems may be related to:

stressful or traumatic events
alcohol, medications or caffeine
family history of anxiety disorders
other medical or psychiatric problems.

Kinds of anxiety problems

There are different kinds of anxiety problems. These include:

phobias: when people fear a specific thing, such as heights or spiders
panic disorder: when people have episodes of extreme fear, often with physical symptoms resembling a heart attack
obsessive-compulsive disorder: when people see danger in everyday things, and perform time-consuming rituals to make things seem more safe
generalized anxiety disorder: when people worry excessively over a long period of time
posttraumatic stress disorder: when people relive the fear experienced during a traumatic event, such as an assault or accident.

How common are anxiety problems in older adults?

Anxiety problems are as common in older people as they are in younger people. Research shows that:

Up to one in four adults has an anxiety disorder sometime in their lifetime.
Almost 20 per cent of people over age 65 have had an anxiety disorder in the past six months; the most common form of anxiety is phobia (Blazer et al., 1991).
Anxiety disorders are the most common mental health problems in women; in men, they are second only to substance use disorders (Rector et al., 2005).

Signs of anxiety problems

Anxiety problems can make people so worried and fearful that they behave in ways they know don't make sense. Anxiety may also make them feel physically ill. Signs that an older adult may have an anxiety problem include:

irrational and excessive worry or fear
checking and rechecking for safety
hoarding, collecting
refusing to do routine activities or being overly preoccupied with routine
avoiding social situations
racing heart
shallow breathing, trembling, nausea, sweating
muscle tension, feeling weak and shaky
depression.

Medications for anxiety problems

People with anxiety problems are often prescribed medications called benzodiazepines (e.g., Ativan, Xanax, Halcion and Valium). These medications have a calming and relaxing effect that helps to relieve anxiety. But they can also cause memory loss, confusion and loss of balance, increasing the risk of falls. When taken regularly for a long time, benzodiazepines can be addictive. Long-term regular use of these drugs should be stopped gradually, and only under medical supervision.

How to talk with an older adult who has an anxiety problem

People with anxiety problems often know that they are too fearful, but cannot control it. If you work with older adults who appear to be overly anxious:

Use a calm and reassuring tone of voice.
Acknowledge their fears but don't play along with them (e.g., "I understand that going to the mall upsets you, but can you come out with me for a short walk? You can let me know when you need to come home and I'll bring you back.").
Be supportive without supporting their anxiety (e.g., "I know you like to keep your bathroom spotless, and so I do an extra-special job. If you tell me what more you'd like me to do, I'll try to make time on my next visit.").
Encourage them to engage in social activities (e.g., "Did you know there's a knitting group meeting at the seniors' centre tomorrow? I see you're always working on a project. Would you be interested in going?").

When to get help

Anxiety problems can make it hard, if not impossible, to enjoy life. Fortunately, most anxiety problems can be managed by psychotherapy, medication and relaxation techniques. Let your supervisor know if you think an anxiety problem is interfering with an older person's life. Your supervisor can then try to connect the older adult with someone who is qualified to help with anxiety problems.

In Responding to Older Adults :

1 The Nature of Aging

2 Substance Use, Mental Health and Gambling Challenges in Older Adults

3 Communication Tools and Techniques

Extra resources

Anxiety

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