Regular online conversations show potential for helping prevent cognitive decline in socially isolated older adults, according to results from an NIA-funded study published in The Gerontologist.

Social isolation is a risk factor for cognitive decline and dementia. The Internet-based Conversational Clinical Trial (I-CONECT) was led by a team of scientists at Oregon Health & Science University. I-CONECT linked socially isolated older adults with trained conversationalists for regular, 30-minute video chats to stimulate brain function and cognition.

I-CONECT conversations are not just random discussions. Team members are trained to guide participants through conversations specially designed to stimulate brain regions associated with memory, executive function, and abstract thought. The study’s 186 participants were divided into experimental and control groups. The experimental group conversed with trained I-CONECT staff four times weekly for six months, then twice per week for another six months. Control group participants received a weekly, 10-minute phone check-in with I-CONECT staff.

Those receiving the conversational intervention scored an average of 1.75 points higher on cognitive tests than the control group. They also showed higher language-based executive function scores. Measures of emotional well-being improved in both groups. Brain magnetic resonance imaging of participants who had received the intervention showed increased connectivity within the dorsal attention network, a region of the brain associated with working and episodic memory, compared to the control group.

While the study showed promise for the value of stimulating conversations to improve cognitive function in older adults, the original size and scale of this stage of I-CONECT was reduced, in part due to the COVID-19 pandemic. These results suggest a positive result, but they are very preliminary and will require much more extensive testing in different populations and settings.

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Medicare covers both inpatient and outpatient mental health care. And Medicare prescription drug plans cover medications used to treat mental health conditions, but be sure to check the formulary to ensure the brands and dosages you take are included.

 Medicare Part B covers outpatient mental health care, including the following services:

• Individual and group therapy
• Substance use disorder treatment
• Tests to make sure you are getting the right care
• Occupational therapy
• Activity therapies, such as art, dance, or music therapy
• Training and education (such as training on how to inject a needed medication or education about your condition)
• Family counseling to help with your treatment
• Laboratory tests
• Prescription drugs that you cannot administer yourself, such as injections that a doctor must give you
• An annual depression screening

 Be sure to ask any provider you see if they take your Medicare insurance before you begin receiving services. If they don’t, you will likely be responsible for the full cost of the care. Psychiatrists are more likely than any other type of physician to opt out of Medicare, meaning Medicare will not cover any of the cost of the care from those doctors. Additionally, not all non-medical providers (like psychologists or clinical social workers) are Medicare-certified. If you need a list of providers near you who accept Medicare, you can go to www.medicare.gov/care-compare. 

 Medicare Part A covers inpatient mental health care that you receive in either a psychiatric hospital (a hospital that only treats mental health patients) or a general hospital. Your provider should determine which hospital setting you need.

If you receive care in a psychiatric hospital, Medicare covers up to 190 days of inpatient care in your lifetime. If you have used your lifetime days but need additional mental health care, Medicare may cover your care at a general hospital.

 Medicare Part D covers most prescription drugs used to treat mental health conditions. You may have Part D coverage through a Medicare Advantage Plan or through a stand-alone Part D plan. All Part D plans must cover at least two drugs from most drug categories and must cover all drugs available in certain categories, including antidepressants and antipsychotic medications.

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Overview

Mental health includes emotional, psychological, and social well-being. It affects how we think, feel, act, make choices, and relate to others. Mental health is more than the absence of a mental illness—it’s essential to your overall health and quality of life. Self-care can play a role in maintaining your mental health and help support your treatment and recovery if you have a mental illness.

About Self-Care

Self-care means taking the time to do things that help you live well and improve both your physical health and mental health. When it comes to your mental health, self-care can help you manage stress, lower your risk of illness, and increase your energy. Even small acts of self-care in your daily life can have a big impact.

Here are some tips to help you get started with self-care:

Get regular exercise. Just 30 minutes of walking every day can help boost your mood and improve your health. Small amounts of exercise add up, so don’t be discouraged if you can’t do 30 minutes at one time.

Eat healthy. Regular meals, and stay hydrated. A balanced diet and plenty of water can improve your energy and focus throughout the day. Also, limit caffeinated beverages such as soft drinks or coffee.

Make sleep a priority. Stick to a schedule, and make sure you’re getting enough sleep. Blue light from devices and screens can make it harder to fall asleep, so reduce blue light exposure from your phone or computer before bedtime.

Try a relaxing activity. Explore relaxation or wellness programs or apps, which may incorporate meditation, muscle relaxation, or breathing exercises. Schedule regular times for these and other healthy activities you enjoy such as journaling.

Set goals and priorities. Decide what must get done now and what can wait. Learn to say “no” to new tasks if you start to feel like you’re taking on too much. Try to be mindful of what you have accomplished at the end of the day, not what you have been unable to do.

Practice gratitude. Remind yourself daily of the things you are grateful for. Be specific. Write them down at night, or replay them in your mind.

Focus on positivity. Identify and challenge your negative and unhelpful thoughts.

Stay connected. Reach out to your friends or family members who can provide emotional support and practical help.

Self-care looks different for everyone, and it is important to find what you need and enjoy. It may take trial and error to discover what works best for you. In addition, although self-care is not a cure for mental illnesses, understanding what causes or triggers your mild symptoms and what coping techniques work for you can help manage your mental health.

For other ideas for healthy practices for your mind, body, surroundings, and relationships, see the National Institutes of Health (NIH) Wellness Toolkits.

When to Seek Professional Help

Seek professional help if you are experiencing severe or distressing symptoms that have lasted 2 weeks or more, such as:

• Difficulty sleeping
• Appetite changes that result in unwanted weight changes
• Struggling to get out of bed in the morning because of my mood
• Difficulty concentrating
• Loss of interest in things you usually find enjoyable
• Inability to perform usual daily functions and responsibilities

Don’t wait until your symptoms are overwhelming. Talk about your concerns with your primary care provider, who can refer you to a mental health professional if needed. If you don’t know where to start, read the National Institute of Mental Health (NIMH) Tips for Talking With a Health Care Provider About Your Mental Health. Learn more about how to get help or find a provider on the NIMH’s Help for Mental Illnesses webpage.

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Medicare Part B covers certain doctor’s services, outpatient care, medical supplies, and preventive services.

• One depression screening per year. The screening must be done in a primary care doctor’s office or primary care clinic that can provide follow-up treatment and referrals.
• Individual and group psychotherapy with doctors (or with certain other licensed professionals, as the state where you get the services allows).
• Family counseling, if the main purpose is to help with your treatment.
• Testing to find out if you’re getting the services you need and if your current treatment is helping you.
• Psychiatric evaluation.
• Medication management.
• Certain prescription drugs aren’t usually “self-administered” (drugs you would normally take on your own), like some injections.
• Diagnostic tests.
• Partial hospitalization.
• A one-time “Welcome to Medicare” preventive visit. This visit includes a review of your possible risk factors for depression.
• A yearly “Wellness” visit. Talk to your doctor or other healthcare provider about changes in your mental health since your last visit.

Part B also covers outpatient mental health services for the treatment of substance abuse.

Your costs in Original Medicare

You pay nothing for your yearly depression screening if your doctor or healthcare provider accepts the assignment.

After you meet the Part B deductible, you pay 20% of the Medicare-Approved Amount for visits to your doctor or other healthcare provider to diagnose or treat your condition.

If you get your services in a hospital outpatient clinic or hospital outpatient department, you may have to pay an additional copayment or coinsurance amount to the hospital.

What it is

Mental health services help diagnose and treat people with mental health disorders, like depression and anxiety. These visits are often called counseling or psychotherapy.

Things to know

Part B covers mental health services and visits with these types of health professionals:

• Psychiatrists or other doctors
• Clinical psychologists
• Clinical social workers
• Clinical nurse specialists
• Nurse practitioners
• Physician assistants

Medicare only covers the visits if you get them from a healthcare provider who accepts assignments.

Part B covers outpatient mental health services, including services that are usually provided outside a hospital, in these types of settings:

• A doctor’s or other health care provider’s office
• A hospital outpatient department
• A community mental health center

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Published by: AARP

Maybe you’ve always dreamed of taking up painting or learning to knit. Perhaps you regret never having mastered a second language. The good news is, it’s never too late to learn — despite what that tired adage says about old dogs and new tricks​

Learning a skill is more than fun. It promotes connections and novel ideas and keeps the brain sharp. Research has shown that older learners can pick up knowledge fairly easily, given the right learning environments and support. A 2019 study published in The Journals of Gerontology found that adults age 58 to 86 who took classes 15 hours per week to learn several skills — such as Spanish, drawing, or photography — not only acquired new talents but also improved their cognitive functioning to match that of adults 30 years younger, after just 1.5 months. ​

So don’t be afraid to try pottery, even if you’ve always been more math-oriented. Or expand your knowledge of the cosmos with an online astronomy class, even if your last science class was decades ago. You can acquire many new skills for free or at very little cost by tapping into resources within your community.

Ready to nurture your inner scholar without breaking the bank? Here’s how: ​

1. Enroll in a lifelong learning program​

Many colleges and universities offer free, noncredit courses and workshops as part of their lifelong learning programs for students 50 and older. Some even offer older adults free or low-cost access to credit-earning academic classwork, so you can work toward a degree if you wish. The University of Kentucky’s (UK) Donovan Scholarship, for example, covers regular course tuition and fees for Kentucky residents 65 or older.​

Jeffrey Jones, 73, a retired math and technology resource teacher from Lexington, Kentucky, used the Donovan Scholarship benefit to study his first love: music theory and composition. Jones has completed several chamber orchestra compositions, one of which was performed professionally. “I started taking these classes because I wanted to learn to write music. I wanted to train my ear, and that was going to be enough for me,” Jones says. “I had no idea that there might be an outlet for other people to actually hear my work.”​

2. Volunteer as a museum docent​

Have an interest in history or archaeology? How about art or hands-on science? Consider teaching others as a docent at a museum, zoo, or historic site. Len Maynard, 59, joined as a volunteer docent with the San José Museum of Art during COVID-19 when she lived nearby. “Being a docent is the best of both worlds because it gives you an opportunity to deepen your learning and meet new people — and you’re also helping other people learn,” says Maynard, who remains active as an online tour guide and docent cochair for the museum, despite her recent move to Montana. ​

Worried you might not be qualified? Most institutions offer docents thorough training. Maynard spent a year in training, deepening her already strong understanding of art and art history. Yet the course was accessible enough that even class members who had no art background came away feeling confident about leading tours, she says. ​

3. Become a citizen scientist​

Increase your understanding of animal science, nature, or history by answering the call for citizen science volunteers. Help count birds in the Audubon Society’s annual Great Backyard Bird Count. Monitor water quality in a lake or stream. Participate in archaeology digs at historic sites. Find projects in your area seeking volunteers at Citizenscience.gov/catalog. ​

4. Discover your green thumb​

Have your relationships with plants always ended in failure? Make this the year you conquer your gardening fears. Sign up for a low-cost flower maintenance workshop at an area arboretum or garden club, or learn planting skills through a nearby master gardener program.​

5. Tap into art lessons with your parks department​

When you think of parks and recreation, you may envision playgrounds or city tennis courts. But many also offer extensive schedules of free and low-cost art classes — from painting and photography to instrumental music, dance, and more. Nandita Godbole, 51, has taken affordable pottery classes offered by her parks and recreation department in Roswell, Georgia, for the past year. In the process, the professional cookbook author gained an exciting skill — as well as a chance for self-care. “I signed up for pottery as a way to learn something new and not get stagnant, but the studio became this therapeutic place for me,” Godbole says. “You’re forced to disconnect from your phone and focus on what your hands are doing. Through pottery, I’ve found creativity and peace. It’s been a wonderful way to make time for myself.”​

6. Learn home skills with cooperative extensions​

Want to learn how to quilt or improve your cooking? Maybe you’re curious about raising chickens or making your own soaps and sugar scrubs. Check out your local Cooperative Extension System (CES) office. Supported by the U.S. Department of Agriculture and operated through the U.S. land grant university system, CES offices regularly lead affordable online and in-person workshops covering home and garden skills for all learning levels.​

7. Explore free online courses ​

Want to learn something without even leaving home? Consider enrolling in a free online class offered by course-sharing sites such as Coursera, edX, or Academic Earth. Most classes are self-paced, so you can take your time while pursuing topics such as the science of well-being, introduction to philosophy, or basic calculus. ​

8. Lean into library offerings​

The next time you browse at your public library, take a moment to scan its bulletin board or website for upcoming classes and workshops. Many branches frequently offer free, online, and in-person lectures on everything from backyard beekeeping and genealogical research to knitting, creative writing, digital moviemaking, and more. At Florida’s Miami-Dade Public Library System, patrons can enroll in free, 10-week online classes to learn Spanish, as well as U.S. citizenship classes or GED test prep. “Our adult learners appreciate the convenience of the classes and the community that develops within them,” says Nora Morales, the library’s tutoring program coordinator. “Our participants love that they’re learning new skills — and that they get to do it inside a supportive network of other adult learners.”​

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