Helping Elderly with Anorexia: Overcoming Resistance to Mental Health Care

What to do when an elderly person with anorexia refuses to see a psychiatrist or a psychosomatic specialist?

Hello, my elder relative has anorexia and often only eats a piece of cracker and a cup of soy milk a day.
However, he is very resistant to seeing a psychiatrist and prefers to believe that his physical discomfort is due to heart or kidney issues.
After hospitalization and evaluation, the doctor informed us that there are no physical problems and recommended that we take him to see a psychosomatic specialist or psychiatrist.
However, even mentioning this causes him to become very angry, and he may not eat for several days, which further weakens his body.
Is there a more gentle clinic name that might be more acceptable to him, such as a department within internal medicine or geriatrics that has mental health professionals?

Wen Hui, 30~39 year old female. Ask Date: 2016/04/05

Dr. Wang Xiumei reply Psychiatry

If the elderly patient refuses psychiatric care, you can first try consulting a family medicine physician.

Reply Date: 2016/04/05

More Info

Helping elderly individuals with anorexia, especially when they resist mental health care, can be a challenging situation. It is essential to approach this issue with sensitivity and understanding, as the elderly may have deeply ingrained beliefs about their health and may resist any suggestion that they need mental health support.
Firstly, it is crucial to recognize that anorexia in the elderly can be a complex issue, often intertwined with physical health problems, mental health conditions, and social factors. In many cases, older adults may not recognize their eating habits as a problem, attributing their lack of appetite to physical ailments such as heart or kidney issues, as your relative has done. This can lead to a cycle of denial and resistance to seeking appropriate care.

One effective strategy is to frame the conversation around their physical health rather than mental health. Since your relative is more open to discussing physical ailments, you might consider emphasizing how proper nutrition is essential for managing their existing health conditions. For instance, you could explain that adequate nutrition can improve their energy levels, support heart health, and enhance overall well-being. This approach may help them see the importance of eating more without feeling threatened by the idea of needing mental health care.

Additionally, you could explore the possibility of consulting with a geriatrician or an internist who has experience in dealing with elderly patients and their unique needs. Many hospitals and clinics have specialists in geriatric medicine who can address both physical and mental health issues. These professionals often have a more holistic approach and can provide a comprehensive assessment of your relative's health, including nutritional needs, without immediately labeling the situation as a mental health issue.

If your relative is still resistant to seeing a mental health professional, consider seeking out a psychologist or psychiatrist who specializes in geriatric care. Some practitioners may offer a more integrated approach, working alongside primary care physicians to address both mental and physical health concerns. This can help your relative feel more comfortable, as they may view the visit as part of their overall health management rather than a specific mental health intervention.

Another option is to involve a trusted family member or friend in the conversation. Sometimes, hearing concerns from someone they trust can make a significant difference in their willingness to seek help. This person can help validate their feelings and encourage them to consider the benefits of professional support.

In terms of practical steps, you might also explore community resources such as meal delivery services or nutritional counseling specifically designed for seniors. These services can provide support in a non-threatening manner, focusing on improving their diet without directly addressing the underlying mental health issues.

Lastly, it is essential to be patient and understanding. Change takes time, especially for older adults who may feel vulnerable or resistant to new ideas. Continue to express your concern and love, and gently encourage them to consider the benefits of a more balanced diet and the possibility of professional support when they are ready.

In summary, addressing anorexia in the elderly requires a compassionate and strategic approach. By focusing on physical health, involving trusted individuals, and exploring integrated care options, you can help your relative overcome their resistance to mental health care while ensuring they receive the support they need for their overall well-being.

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