Depression in the elderly often goes undetected although it is a real and common problem. The elderly have a unique set of circumstances that can precipitate depression. They are more likely to be widowed, they may have to move from their homes, they are losing friends to death or dementia at a faster rate than before and they may have health issues that affect their overall feelings of wellbeing, both physically and mentally. Grieving is normal but when grieving turns to depression, it is time for intervention.
According to helpguide.org, two million Americans over the age of 65 suffer from clinical depression and another five million are showing some early signs. Although not every patient with dementia is depressed, depression may be an indicator of the onset of dementia, particularly Alzheimer’s. Other signs include sudden onset of anxiety, change in mental status, but infection (especially pneumonia) must be ruled out first since it can create a loss in cognition. Social withdrawal and sleep disturbances are an indicator for depression at any age. Unexplained physical symptoms such as generalized pain can also be attributed to depression. The most concerning statistic is that suicide among the elderly is a very common tragic response to depression. The group most at risk is single, elderly men.
Loss of independence is a quick way to trigger depression in most elderly. It is critical to help them maintain as much independence as possible. They may no longer be able to drive, but perhaps they can get on a facility bus and do their own shopping. Encouraging and possibly facilitating social time would help them escape loneliness. I am sure most would agree that sitting alone to dwell on all that is wrong in life is destructive. If there is a supportive family matrix, speak with them about engaging the elderly member. Remind the patient that there is hope and help should they have any of the above feelings.
Depression is treatable with medication and interventions, but must be identified. Do a thorough screening of your patients with every major assessment, but watch and listen for the signs every time you visit.
Sources:
Depression in Older Adults and the Elderly. Helpguide.Org Retrieved from http://www.helpguide.org/mental/depression_elderly.htm
Elderly Depression Symptoms. Living Strong Retrieved from http://www.livestrong.com/article/274632-elderly-depression-symptoms/#ixzz1v30iYw9h
