By Marie Bradby

Her mother painted the artwork that hangs on the her office wall. Photos by Melissa Donald

If you want to maintain good mental health for yourself and your elderly loved ones, you might want to heed the advice of psychologist and professor Dr. Suzanne Meeks.

“I sometimes talk about it as a bank account,” Suzanne says.“Keep a balance of positive experiences over negative, because when the bank account gets empty, you can get depressed. Draw on positive activities and experiences when things go bad. People who are resilient keep a big bank account of positive engagements.”

For the past 15 years, Suzanne, chair of the Department of Psychological and Brain Sciences at the University of Louisville, has been researching mental health of the elderly in nursing homes. The residents are more at risk for mental health problems because they have chronic diseases, disabilities, and cognitive impairments, she says. “And, it’s not an environment that’s particularly good for getting un-depressed.”

Suzanne, 57, became interested in geropsychology after her grandmother became chronically ill and after an internship at a state mental hospital.

Suzanne wants to find solutions to the mental health issues plaguing some older adults living in nursing homes. 

“When I was doing my dissertation, my grandmother had a stroke,” Suzanne says. “At 82, she played bridge, played golf, and ran a business. In a short time, she went from very active to a person with a much diminished life.

“As I watched the big change in her, I became interested in those transition points that older people experience.”

Though her grandmother didn’t deal with depression, Suzanne worked with people with severe depression at a state mental hospital. “I looked at how they had coped with severe mental illness their whole lives, but they still had a sense of identity in spite of all their struggles,” she says.

Suzanne has helped develop an intervention program called Be-Activ, which is a collaboration with a mental health provider and nursing home staff, particularly the activities staff. The focus is to develop opportunities for residents to increase their enjoyment in life with things that are meaningful and enjoyable.

A therapist helps a resident build a repertoire of activities as simple as getting coffee each morning, going out to dinner with a relative, singing or listening to music, drawing in coloring books, going outside and sitting in the sun, or looking at magazines.

“We all do these very simple things every day to maintain our balance of emotions — I can have tea any time I want, I can have chocolate in the afternoon, take a walk, call a friend,” Suzanne says. “If you are depressed, it’s hard to have those pleasures. In a nursing home, it’s even harder to have access to those pleasures.”

Aging well, Suzanne says, is about maintaining a positive attitude and designating quality time for yourself. 

Suzanne and her colleagues published a case study about a 63-year-old woman who benefitted from their intervention program. “She was in a nursing home, confined to a wheelchair, had a leg amputated, severe diabetes and severe depression,” Suzanne says. “She was able to come up with many things she would find enjoyable: to watch NASCAR on Saturday afternoons; to draw in coloring books. As we built up her list, she started going out of her room to bingo, trivia and other activities in the facility. In 10 weeks, she was doing 10 to 15 things a week instead of zero. So her depression remitted, and she was coping better in life.”

Suzanne is facing challenges to implement these simple but important activities into nursing care.
“We are in a time of fiscal challenge,” Suzanne continues. “Our model for funding care in nursing homes really limits what we can do. The funding is all related to the medical care that is provided. There is no reimbursement model for enrichment possibilities.”

Here are some things you can do for yourself to age well:

  • Keep a positive balance. To deal with the inevitable negatives in your life, you have to keep up your “stash” of positivity. Create occasions for joy and laughter, and find and savor small pleasures such as 10 minutes with a loved one, a bar of chocolate, your favorite tea in your favorite mug, comfort food (pancakes for dinner), appreciating something of beauty.
    • Exercise, exercise, exercise. Exercise is an evidence-based treatment for depression that keeps your joints working, keeps the extra weight off, protects your heart, and makes you feel good after you do it. Build exercise into your routine and don’t compromise. It should be on the calendar, a time you don’t give away.
    • Eat less and eat right. I see the ravages of chronic diseases like diabetes and heart disease every day in nursing homes. Many of these diseases are influenced by lifestyle patterns that can be changed, and often those changes begin with diet. It’s really hard to change what you eat, so get help if you need it.

    Here are some things for friends or relatives in long-term care:

    • Help them access things that are meaningful, engaging, and fun. If you visit, make an appointment and be predictably on time to give them a chance to anticipate and remember the visit. Bring a little of their favorite food (a milkshake, fresh fruit, some other treat they can’t get where they live). Bring magazines, albums, or books to look at and talk about. Bring favorite music. Take them out in the garden. Bring them a puzzle or something else engaging to do. Bring a story, the newspaper. Sing together. Play a game.
    • Be an advocate. Help them remove barriers for their ideal care or enjoyment.
    • Be a listener. Don’t argue, cajole, or try to make things out to be better than they are. Be empathetic and acknowledge when things are sad, frustrating, infuriating, or feel wrong. You may not be able to change anything, but you can listen and accept their feelings.
    • Focus on what works, what is good, and what they can still do. If they have stress and health changes that their attention is on (such as, ‘Am I going to walk again?’) or chronic pain, they are focused on what hurts and what isn’t working as opposed to what is.
    • Give compliments. Tell jokes. The tiny things matter.
    • For caregivers, take care of yourself. Pay attention to sleep, diet and exercise.