How Counseling Can Help Illinois Seniors with Anxiety, Grief, & Marriage

Many older adults in our central Illinois community are living with grief, anxiety, depression, and even marital conflict that has gone on for years, possibly decades.

It’s so easy to just keep pushing through, not realizing how much pain you’re experiencing on a day-to-day basis. Mental health can have a significant negative effect on your general health, including increased inflammation, heart conditions, abnormalities in stress hormones, and metabolic changes typically seen in those at risk for diabetes (National Institute of Mental Health).

It’s also common to feel like you’re alone. Alone in your feelings, but also physically alone. There are nearly half a million seniors living alone in Illinois, the majority of which are women (Senior Care). 

Our mission today is to let you know you are not alone, and you do not have to continue living in emotional pain.

Ed Bacon, LCPC, Founder of Decatur Christian Counseling and Executive Director of Northeast Community Fund is here to share more about what it means to get counseling, how therapy can help you, and how Medicare views this vital service.

Need Medicare or retirement planning help? The Sams/Hockaday team specializes in Medicare health insurance as well as retirement planning. Read more about what we do and schedule an appointment with the agent of your choice today!

Counselors, Therapists, & Psychologists – What’s the Difference?

Counselors and therapists are one in the same – those terms are used interchangeably. Psychologists, on the other hand, are different. Ed explains psychologists tend to focus more on assessments and diagnosis, while spending less time on the counseling process.

Counselors like Ed are trained and licensed to counsel people through all of the major disorders listed in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, commonly referred to as the DSM-5.

“I provide counseling for anxiety, depression, PTSD, bipolar, and a number of other common disorders people struggle with,” he says.

There are also specialists who are trained more extensively in certain areas, like sleep disorders. In those cases, Ed will refer his clients if he feels more specialized help is needed. He also will refer to psychiatrists or medical doctors if the counseling needs to be supplemented with antidepressants or medications.

Counselors and therapists are not licensed to prescribe medicine – only doctors can do that.

Overcoming Anxiety, Grief, Marriage Conflicts, & More

Ed sees clients of all ages, and many of them come because of a past traumatic experience. From childhood abuse to rape, he explains many people live with this and haven’t yet processed it.

“People try to bury and forget the experience,” he says. “People go on for years, even decades, being angry and lacking trust in people. Until they talk about it and get help, they have a cynical view of the world that won’t change.”

He explains our minds try to twist the past, and we start to feel guilt and shame that we were somehow responsible. All of that is common and normal, and when you seek help, your mindset can finally shift.

When it comes to the senior population, Ed explains most come to him for help with grief, or dealing with the loss of a loved one.

Another percentage of adults over age 60 come in for help with marital strife. 

“Believe it or not, there are people who get into their 60s and even late 60s that come in for marriage counseling,” he explains. “They realize life is short, and they don't want to spend the last few decades of their life dealing with the same problems with their spouse.”

Those two scenarios are the most common for seniors – marriage counseling and dealing with grief.

We all know 2020 has been a roller coaster of a year, and while many may think marriage counseling requests would rise, Ed says something very different has happened.

“What has changed and has increased a lot is health anxiety,” he says.

Health Anxiety During COVID-19

The global coronavirus pandemic has caused all sorts of problems, and our mental health was certainly not spared.

“A lot of people seek out counseling because they’re afraid of getting sick. Really, it’s the fear of death. It consumes them,” Ed says.

Clients he sees with health anxiety are obsessive over it. He says they can’t go to work, leave the house, sleep, or eat. In essence, they can’t function.

“That’s really what makes a mental health disorder a disorder. It causes you to lose your ability to function and work,” he explains.

Health anxiety also affects everyone around you, especially your spouse. “The spouse gets tired of the obsessions and constant fear,” he says.

To address this with his clients, Ed uses cognitive therapy, which identifies cognitive distortions, false beliefs, and irrational fears. Our faulty thinking could include magnifying, overgeneralizing, and personalizing. 

“We embrace that small percentage of something happening, and we allow it to grow into a belief that it will, in fact, happen,” Ed says. 

Clients with health anxiety believe there is a 100% chance of them dying from the coronavirus.

“For people with real obsessive thinking and anxiety, they don’t look at the facts. They choose to believe that what’s unlikely to happen will happen. That’s called catastrophizing – we assume the worst, which in this case, is death,” he explains.

Through counseling, Ed helps his clients recognize this irrational fear. He points out the facts, including the recovery rate, the death rate, and the precautions we can take to reduce our risks.

Counseling & Therapy: What to Expect

Ed practices choice theory and cognitive behavioral therapy. He also has a background in solution-focused brief therapy.

He says we choose what we think, believe, and do. If we are focused on depressing memories, that’s a choice. If we focus on thoughts like “no one loves me,” “my life is worthless,” or “life is without hope,” that’s also a choice. When you challenge those thoughts, you quickly realize they’re not true.

“In depressive episodes, people choose to think the worst, and these are typically false beliefs,” Ed says.

To fight that, Ed helps his clients choose differently. He also helps his clients see that sometimes, they’re already coping and doing well. He helps them identify what’s working in those moments so they can do more of it.

Over time, you’ll change those thought distortions to the truth: “My mom loves me,” “my kids love me,” and “my friends love me.”

Encourage the Men In Your Life

Women seek out counseling much more often than men do.

Ed says it has a lot to do with our culture: “Men are taught to be tough, to not show emotion, to have a rough exterior, and to be a ‘man’ by not crying and learning how to fix your own problems. That’s not the case for women. They’re encouraged to express emotions, to talk, and to share what’s wrong.”

That’s why a disproportionate amount of women are seeing therapists over men. “Everyone needs a confidante – a sounding board. Whether you’re male or female, there’s much to be gained from counseling and nothing to lose,” he says.

When you bottle up your anger of anxious thoughts, Ed says the pressure builds and it leads to a meltdown or panic attack. Seeing a therapist can prevent that from happening.

Ed says men often prefer to see male therapists and vice versa. There are only a small number of male therapists in the Decatur area, so the majority of Ed’s personal clients are actually men.

Counseling for Illinois Seniors: Does Medicare Cover It?

Unfortunately, Medicare doesn’t cover counseling or therapy from a counselor or therapist.

“Seniors generally pay out of pocket if Medicare is their primary,” Ed explains.

Medicare only covers mental health services and visits with the following types of health professionals:

• Psychiatrist or other doctor
• Clinical psychologist, social worker, or nurse specialist
• Nurse practitioner
• Physician assistant

Counselors are not included on that list.

Medicare Part B does pay for one depression screening per year, but the screening must be done in your doctor’s office or a primary care clinic. All other mental health care, such as psychiatric evaluations, medication management, and psychotherapy must be done with a doctor for Medicare to contribute their portion (Medicare.gov).

Ed offers a sliding fee for clients who are paying out of pocket. “It’s based on income,” he explains. That fee ranges from $65-$125 per session.

Does Medicare Pay for Marriage Counseling?

Medicare doesn’t cover marriage counseling from LPCs (Licensed Professional Counselors), LCPCs (Licensed Clinical Professional Counselors like Ed), or MFTs (Marriage and Family Therapists).

Medicare will only help pay for marriage counseling if it’s provided by a psychiatrist, doctor, clinical psychologist, social worker, nurse specialist, nurse practitioner, or physician assistant. In those cases, marriage counseling would fall under the mental health care category, which is covered at 80% under Medicare Part B.

In almost all cases, couples will be seeing an LCPC or MFT for marriage counseling, so for all intents and purposes, Medicare does not cover marriage counseling.

Does Medicare Pay for In-Home Counseling?

The rules on this one are even more complex and few-and-far between.

Medicare will pay for medically prescribed services that help patients cope with the emotional aftermath of an injury or illness. That could include in-home counseling, but Medicare only helps cover it if you’re receiving skilled nursing care.

So again, in almost all cases, Medicare does not cover in-home counseling.

Will Medicare Ever Cover Counseling?

The American Counseling Association (ACA) and its division, the Association for Adult Development and Aging (AADA), are leading advocacy efforts for the inclusion of counselors under Medicare.

As previously mentioned, Medicare only covers counseling services from doctors, psychologists, and clinical social workers. However, access to these covered providers is often a challenge. It’s much more common to have an LPC in your area, but Medicare doesn’t cover their services.

The ACA explains: 

“Unfortunately, Medicare beneficiaries don’t enjoy the same access to outpatient mental health professionals as do those with private health insurance. [...] There are more than 120,000 LPCs nationwide, licensed for independent practice. Licensed professional counselors are master’s-degreed mental health professionals, meeting education, training, experience, examination, and ethical standards on par with those of providers already covered by Medicare.”

If Medicare covered LPCs, it’d open up access to more of our older population. We also know the lack of mental health treatment can lead to chronic medical conditions including diabetes and congestive heart failure. 

The ACA says that expanding access to our nation’s 120,000 licensed professional mental health counselors would save at least $200 million every year in other medical care, which would more than cover the cost of covering LPCs under Medicare.

The ACA says the best thing we can do is call our congressional members who rely on all of us to educate them on pressing issues like this. Read more about communicating with Illinois legislators here.

Art Terrazas, the director of government affairs for ACA says, “With the rapid growth in the older population, we are going to see a serious increase in the need for mental health providers, and Medicare is sidelining 40 percent of the providers at a time when we need them the most.”

Choosing In-Home Counseling & Therapy

Counseling for seniors is most commonly done in an office setting, but getting help from home is easier than ever. Whether it’s the coronavirus, mobility, or just wanting to stay in the comfort of your own home, there are telehealth services that allow you to get therapy remotely.

For example, WellQor, a provider of psychological services for older adults, offers a Telehealth program using video conferencing. WellQor’s proprietary technology platform includes Emotional Vitals™, which help you track your progress through a patient portal.

Another service called BetterHelp is the world’s largest counseling service offered 100% online. Over a million people get counseling through unlimited messages, chat, phone, and video sessions for a flat subscription fee.

If getting to an office was holding you back from getting help, seek out telehealth services like these to get your life back on track.

Conclusion

Counseling can help people of all ages, including seniors. Counseling Today, a publication of the American Counseling Association, explains that millions of seniors are going through life changes, including:

• A second career
• The need to give care or be cared for
• Reduced income
• Personal loss
• Physical illness or pain
• Depression or other mental illness
• Cognitive decline
• Terminal disease
• Facing one’s own mortality
• Confronting ageism

These are all normal and expected transitions that counseling can help you through. While it can be uncomfortable to seek out help later in life, realize that there are counselors and therapists right here in central Illinois eager to help.

It’s time to put some shine back into your golden years!

Ed Bacon, LCPC is the Founder of Decatur Christian Counseling and Executive Director of Northeast Community Fund. Ed holds a Master of Arts degree from Lincoln Christian Seminary in pastoral care and counseling as well as a Master of Science degree from Illinois State University in community counseling. Ed is also a U.S. Army veteran with over 25 years of counseling experience.