Schizophrenia In Elderly Adults: How To Manage Symptoms And Promote Well-Being

Facing a schizophrenia diagnosis later in life can be disorienting. You may feel overwhelmed or scared. Understanding schizophrenia and getting support may bring peace and purpose back into your life. When navigating this life stage, it may be helpful to have a roadmap for schizophrenia later in life. It can help to understand the meaning of this diagnosis and find practical tools to manage symptoms and live life independently. 

Understanding schizophrenia and aging

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) describes schizophrenia as a chronic mental health condition characterized by disruptions in a person's thoughts, perceptions, emotions, and behavior. While it often emerges in young adulthood, schizophrenia can also develop later in life, including into one’s senior years. Late-onset schizophrenia is typically diagnosed after the age of 40, with a peak onset in the mid-50s. Very late-onset schizophrenia can occur after the age of 60.

This condition can pose unique challenges when it appears in an older population. Symptoms can be complex, and sometimes, they might be confused with signs of other health conditions affecting aging adults, such as dementia. Getting a clear diagnosis may help individuals receive the proper support. 

Schizophrenia symptoms

Symptoms of schizophrenia fall into three categories:

• Positive symptoms: These symptoms are added experiences that wouldn't otherwise be there, such as hallucinations (hearing, seeing, or sensing sensory stimuli that are not real) and delusions (strongly held beliefs that aren't in line with reality).
• Negative symptoms: These symptoms represent a loss or decrease in typical abilities, affecting energy levels, motivation, the ability to express emotions, and interest in social activities.
• Cognitive impairment: These symptoms impact thinking, including difficulty concentrating, attention, memory, and decision-making. Cognitive decline is something to watch for, particularly in older adults with schizophrenia.

Managing schizophrenia in later life

Managing schizophrenia in the golden years requires careful consideration and a supportive team. Effective strategies often include:

Antipsychotic medication

Antipsychotic medications form the foundation of schizophrenia treatment, often reducing symptoms like hallucinations and delusions. The best medication for schizophrenia may depend on your unique needs and how your body reacts. Atypical antipsychotic medications are often prescribed for elderly patients with schizophrenia. Atypical antipsychotics act on both dopamine and serotonin receptors, with fewer side effects than typical antipsychotics.

Consult a medical doctor before starting, changing, or stopping a medication for any condition. The information in this article is not a replacement for medical advice or diagnosis. 

Therapy

Various forms of therapy may offer coping skills and support. Cognitive-behavioral therapy (CBT) helps clients identify and challenge unhelpful thought patterns. Family therapy provides support and education for loved ones. Social skills training fosters the ability to re-engage in social settings comfortably.

Support groups

Connecting with others in similar situations through support groups can create a sense of community and decrease isolation. Support groups provide a safe space for sharing experiences, offering encouragement, and learning from one another.

There's hope for living a fulfilling life with schizophrenia. Medication, therapy, and building a support system are often helpful tools for managing psychotic symptoms.

How to promote well-being

Feeling healthy may not only involve keeping symptoms in check. Below are steps individuals can take in later life to promote well-being and self-love. 

Healthy lifestyle habits

Prioritizing physical well-being impacts mental and emotional health. Nourishing foods, regular exercise approved by a doctor, and quality sleep can improve well-being. However, older persons with schizophrenia might benefit from support in managing health conditions like chronic obstructive pulmonary disease, which can complicate treatment.

Stress management

Stress can exacerbate schizophrenia symptoms. Relaxation techniques like deep breathing, yoga, or meditation may calm the mind and body.

Meaningful activities

Finding hobbies and pastimes that bring joy and a sense of fulfillment can make a difference. Volunteering, joining a club, or taking a class are ways to spark meaning and connection.

Living a positive and happy life with schizophrenia may not be about perfection. Eating nourishing foods, managing stress, and finding activities you love are tools that support a more fulfilling life, even with challenges.

Challenges of aging with schizophrenia

The journey with schizophrenia amidst the natural shifts that come with age has its complexities. While younger patients may experience more intense and frequent symptoms, age-related changes in the brain can still impact older individuals with schizophrenia.

Changes in memory and thinking are often a part of aging, especially when also living with schizophrenia. Older adults may find it more difficult to manage medications or appointments. A supportive care team can help you navigate these changes, including the following. 

Physical health

Older adults with schizophrenia may be more prone to physical complications because of the condition or side effects of medication. Regular medical checkups and proactively managing chronic conditions are key to optimal health. Extrapyramidal symptoms can result from certain medications, so your doctor may continually assess your physical health and adjust accordingly.

Cognitive changes

Schizophrenia can bring about subtle cognitive change. Research indicates as many as 70% of schizophrenia patients may develop dementia later on. Brain-stimulating activities like puzzles, reading, or learning a new skill may help individuals maintain cognitive fitness.

Social isolation

Loneliness and isolation can worsen schizophrenia symptoms. Preserving connections with loved ones and contacting community support resources can prevent withdrawal. Managing schizophrenia as you age might benefit from adjustments along the way. However, resilience is often possible with planning and collaboration.

The role of caregivers

Caregiving for someone with late-onset schizophrenia can take dedication. Below are a few ways to navigate this role and provide the best care possible:

• Educating yourself: Learning about schizophrenia, its symptoms, treatments, and how it uniquely affects older adults may help you understand the condition and empower you to be a better advocate and care partner.
• Fostering open communication: Creating a safe space for your loved one to express their feelings and concerns may let them know you are there to listen without judgment.
• Attending appointments: Accompanying your loved one to doctor's visits or therapy sessions may help coordinate care and ensure everyone is on the same page.
• Prioritizing self-care: Caregiving can be emotionally and physically demanding. Support groups, respite care services, or individual therapy can help you maintain your overall well-being.

Being there for others takes strength. However, taking time to refuel can make you an even stronger support.

Navigating complex systems

Living with schizophrenia in later life might involve navigating healthcare systems, insurance, and possibly long-term care options. Below are a few considerations to keep in mind: 

• Being your own advocate (or helping your loved one advocate): You can ask questions, seek second opinions, or challenge decisions if something doesn't seem right. You have a right to quality care.
• Exploring financial assistance: There might be programs to help with medication costs, therapy, or other services. Social workers or case managers can guide you toward these resources.
• Preparing for the future: Having open conversations about long-term care plans may alleviate stress and uncertainty later on, even if difficult.

Navigating complex systems can be overwhelming, but you have a voice. Being proactive, exploring financial help, and planning ahead may put you in a stronger position to manage mental disorders like schizophrenia.

Finding hope and resilience

Living with schizophrenia, whether you're the person diagnosed or a loved one, can mean overcoming real challenges. However, resilience may be a helpful skill. Aspects of resilience might include the following: 

• Celebrating small wins: Acknowledging even the most minor victories — a completed chore, a moment of connection, or sleeping well — may lead to a sense that one lives a meaningful life.
• Embracing community: Leaning on your support system, whether loved ones, support groups, or spiritual communities, may remind you that you're not alone. Some older adults may enjoy joining a music group like a choir, which has been proven to improve mental health. 
• Holding onto your identity: Schizophrenia can be one part of who you are, not the whole story. Nurturing your interests, sense of humor, and other aspects of yourself that bring joy may keep you connected to your identity.

Support options 

Living with schizophrenia in your later years can come with challenges. Finding therapy that fits your lifestyle can be empowering. However, for some individuals, in-person therapy can present challenges, such as a lack of transportation or finding a specialist. Online therapy through a platform like BetterHelp may provide a convenient solution, often at a lower cost.

Online platforms allow clients to attend therapy from home via phone, video, or live chat sessions, allowing them to choose how they receive support. In addition, clients may be able to access additional tools like support groups, journaling prompts, and worksheets, which can be ways to expand on the skills learned in sessions. 

Recent studies point to the potential efficacy of online therapy for those with psychotic disorders like schizophrenia. Studies indicate that internet-based interventions can aid in symptom reduction and help clients overcome treatment gaps. While research related to the elderly population and those with medical comorbidity is limited, online therapy may be beneficial to explore with your healthcare team. 

Takeaway

Aging with schizophrenia poses unique challenges. However, it is often possible to thrive. With support, education, and self-care, living life on your terms may become a reality. Tapping into community support, learning to advocate for your needs, and exploring options like therapy can be ways to get started.