2014-07-31 / Relationships

It’s important to recognize depression in our elderly friends and family

Brenda knocked, but there was no answer. She used her key to open the door but, sadly, knew what would await her. Sure enough, her mother, Selma was sitting listlessly in front of the television — lost in her own world — and not paying attention to the show. The room was dark. There was clutter everywhere. It disturbed Brenda to see the disarray, as her mother had always been meticulous about her housekeeping. Brenda kneeled in front of her mother, and kissed her softly. Selma looked up, but didn’t answer. “How are you today, Mom? Did you have a good night?” Selma shook her head, and moaned. “I was in pain all night. I didn’t sleep.” Selma mumbled something inc oherently. Brenda couldn’t make out the words but knew Selma was frightened and despondent. It broke Brenda’s heart. Selma had been such an exuberant and energetic woman her whole life. She had been an accomplished professional, with many interests and an active social life. Nothing in the world, though, had been more important to Selma than her children and grandchildren. To see Selma so withdrawn was very upsetting.

According to reports from the “National Alliance on Mental Illness,” depression affects more than 6.5 million of the 35 million Americans age 65 years and older.

Depression in this age group often goes untreated because many people assume that depression is a normal part of aging, and a natural reaction to the many losses older people face, the lifestyle changes and transitions, and their increasing medical complications and limitations. Oftentimes, these seniors may be confused f dhtf and unable to understand that their distress is due to depression. They may have difficulty explaining the symptoms to family or medical personnel, or refrain from pb reaching out for help because of pride, embarrassment or fear of placing a burden on others. Most elderly depressed people had experienced recurrent episodes of the illness throughout much of their lives. For others, the depression has a first onset in later life.

Concerned family members should be on the lookout for these tell-tale signs of depression, because their loved ones might not explicitly speak of sadness or worry: apathy, lack of energy, irritability, poor hygiene, loss of interest in formerly enjoyed activities and relationships, sleep and appetite changes, and persistent medical complaints. An important concern is that this is a population at increased risk of suicide, so the above symptoms should be taken very seriously.

According to reports from NAMI: “Sadness and grief are normal, temporary reactions to the inevitable losses and hardships of life. Unlike normal sadness, however, clinical depression doesn’t go away by itself and lasts for months. Clinical depression needs professional treatment to reduce duration and intensity of symptoms. Any unresolved depression can affect the body. For example, depression, if left untreated, is a risk for heart disease and can suppress the immune system raising the risk of infection.”

A thorough medical evaluation is recommended because of the complexities of evaluating depression in the elderly. We should be mindful that depression may be a side effect of a prescribed medication, or a complication of a cooccurring medical condition.

Often, symptoms of dementia and chronic medical conditions overlap with symptoms of depression, so professionals must take great care to address the totality of the clinical situation. Common treatments for depression include psychotherapy, antidepressant medications, and in more severe cases, electroconvulsive therapy. It’s not uncommon for an elderly person to become confused by treatment recommendations, or forgetful; consequently compromising the effectiveness of a treatment regime. It takes patience and a commitment to the process to find the best treatment plan because each person will have special medical and psychological needs.

It is important for the elderly person to find a professional they trust and have a rapport with, so they will be more likely to comply with treatment recommendations.

Providing a comprehensive medical and psychological evaluation, although critically important, is often not sufficient to address the complex needs of the elderly. Because so many older people live alone, have minimal supports available to them, or neglect their medical care, it’s important for their loved ones to be diligent in initiating contact, and to make sure they are taking responsible care of their needs.

A further challenge is to help this individual find the means to reach out for more fulfilling social interactions and activities. It’s shortsighted to assume that older folks are not able to find enjoyment in new endeavors. Older people can find tremendous meaning and satisfaction in maintaining connections with existing friendships and family relationships. They may further enjoy reaching out for new friendships at senior centers, church groups or cultural activities within the community.

It’s important we remember that a proud senior may answer “NO” when asked directly if they are feeling depressed. Showing sensitivity and paying close attention may alert us to the advisability of medical intervention.

Understandably, this population may experience undo loss and hardship, but it’s important to remember that depression is very treatable. When properly diagnosed and addressed, the large majority of depressed people will be able to experience significant relief and resume their former level of functioning. ¦

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