How does schizophrenia affect seniors? How do caregivers handle it?
When it comes to schizophrenia, there are two generations to study: older adults with schizophrenia: the “old-old” (older than 75) and “young-old” (aged 55 to 74 years). Although most seniors with schizophrenia live long, their life expectancy is shorter than that of unaffected people. The risk of death is at least two times greater in cases with schizophrenia than in the general population, which has grown over the past decades. The mortality rate and deaths caused by suicide and accidents are high. Seniors with schizophrenia also suffer from higher rates of congestive heart failure, chronic obstructive pulmonary disease, and hypothyroidism. This is partly due to lifestyle choices such as poor diet, smoking, lack of physical inactivity, and neuroleptics drug effects.
Our knowledge of the mechanisms bearing the increased morbidity and mortality in elderly patients with schizophrenia is sadly limited, and additional research is required to recognize modifiable clinical and social risk factors. It’s generally noted that positive symptoms of schizophrenia decline in later life, and negative symptoms dominate the case. Yet, findings from various studies invalidated this understanding.
The International Study of Schizophrenia (ISoS) assessed 18 global groups over 15- and 25-year periods and found 77% of cases had no sign of significant negative symptoms during their illness. Similarly, a study of standardized geriatric patients with schizophrenia showed no notable changes in negative symptoms over time. Because of the chronicity of the disease, the patient’s family with schizophrenia has to shoulder the main brunt of the illness. Studies worldwide have evaluated multiple aspects of caregivers’ lives, such as the responsibility, coping, quality of life, social support, expressing emotions, and emotional morbidity. Although the study has recognized caregiving as a negative phenomenon, nowadays, it brings personal gains and satisfaction.
Studies suggest that caregivers of patients with schizophrenia experience caregiving gains; for example, they become more sympathetic towards disabilities, feel a greater sense of inner strength, and experience clarity about their priorities in life.