Helping Our Older Adults Manage Depression
With the holiday season likely comes an increase of spending time with elderly family members. At Siena on Brendenwood, we feel it is also an excellent opportunity to encourage our family members visiting loved ones at Siena to engage in conversations about their experiences over the past year and their aspirations for the upcoming year and in particular, assess their mental and cognitive health.
Depression or Sadness?
We all get sad at times. Some people believe that depression in older people is “normal.” But, the kind of sadness that is “normal” just may happen more in later life. Friends pass away, spouses get ill and may die, and older people experience more health issues and a decline in vitality and physical abilities. All of these normal events in later life are sure to cause normal sadness and grieving.
But, the kind of depression that is more serious and may need treatment is called “major” or “clinical” depression. Clinical depression is not in response to a real event in our lives, but rather, is thought to be caused by biological imbalances. This type of depression affects the body and the mind. For instance, people who are depressed and experience a heart attack are less likely to recover as well as happier heart attack victims. Depression can also cause real physical pain, loss of appetite and ability to sleep.
Some people who are depressed are also more likely to take up other bad habits like smoking and drinking alcohol and often lose a desire to take good care of themselves.
One of the main ways to tell the difference between a major depression and a normal reaction to a live event is that a life event will cause temporary sadness and a major depression will continue for weeks or months and typically you will see a decline rather than improvement over time.
Dementia or Depression?
Sometimes, it is confusing to people when someone appears to decline. They may question whether it is Alzheimer's Disease or Dementia. With cognitive disorders like dementia, you will see a loss of short-term memory and orientation (like knowing where they are, what date it is, etc.) coupled with a lack of concern about these losses of mental abilities. In depression, there may be trouble concentrating, but they are oriented and can remember what just happened. Also, while motor skills may slow down in someone depressed, they will still be able to function generally whereas a person with dementia may lose the ability to perform certain tasks altogether.
Who is at Risk?
About 6.5 million – or 18% - of seniors will experience a major depression. While major depression is not caused by life events, serious life events sometimes trigger a depressive episode. Research has shown that certain health conditions are associated with later developing a depressive episode: heart attack, stroke, macular degeneration, and hip fracture.
Women generally are twice as likely to develop depression as men. Some believe this could be due to hormonal changes in later life. Also, being a caregiver is associated with higher levels of developing a major depression and women are more likely to be caregivers later in life. Also, women tend to be more responsible for family relationships and are more likely to experience stress related to maintaining these relationships.
About 15% of seniors living in the community develop a major depression while 25% of seniors in nursing home situations are thought to experience depression.
Signs of Depression in Older Adults
Change in eating habits, loss of appetite, weight loss.
Depressed mood, lack of feeling, or loss of interest.
Change in sleep patterns (most of the time this looks like an inability to sleep but can also show up as “over-sleeping.”)
Avoiding people and activities he or she used to find enjoyable.
Sadness.
Slow moving.
Crying.
Irritability.
Vague complaints of pain or annoyances.
Demanding behavior and a new “neediness.”
Confusion, hallucinations, delusions.
Not all seniors will admit to feeling depressed and the symptoms can sometimes be mistaken for other issues like:
Dementia
Alzheimer’s
Arthritis
Getting Help
It is important to see a physician if you think you or a loved one may have a serious depression.
Unfortunately, many seniors do not seek out help for depression. One reason is that seniors often believe it is just a normal part of getting older. Another reason is that symptoms get confused with other medical problems. Yet another set of people will not seek help because of generational taboos and shame related to getting help for emotional issues.
A physician can diagnose and treat depression. The good news is that treatment is easy and effective for most people. Seeing a doctor is a first step. Elderly people who are lonely or isolated often have a more difficult time recovering from depression. Having some social outlets and fun activities can help. Learning new things, trying new activities, and breaking up routines may help combat depression as you undergo treatment.
