Proximity to friends and family is important, yet they desire independence for as long as safely possible. Housing is mostly single units, homes or small apartment building clusters in urban, suburban, and rural settings. Services addressing the needs of an ever increasing frail dependent group are often inadequate. The frail elderly group has a greatly increased risk of debilitating mental illness. Caretakers of these victims of dementia are themselves a high risk group for depression anxiety and other stress- related disorders.
Alcoholism continues to be a rampant undetected treatable disorder in the elderly.
Anxiety states, phobic behavior, and delirium are common and increase with aging. Despite the increasing number of mentally disturbed elderly, mental health professionals have had limited track record of community outreach , . Psychiatric home care nurses have had the most hands on experience and report success in maintaining the elderly in their communities. The elderly are averse to seek mental health treatment. Stigma of mental illness, being labeled crazy, memories and media representations of state hospitals as snake pits are common barriers.