Contrary to popular belief, depression is not part of the normal aging process. It is natural to feel grief in the face of major life changes, such as leaving a home of many years or losing a loved one. Sadness and anguish, natural responses to major life changes, are normal, temporary reactions to the inevitable losses and hardships of life. However, depression is a medical disorder that continues for prolonged periods. Depression requires professional treatment to reduce the intensity and duration of the condition.
Deteriorating health, a sense of isolation and hopelessness, and difficulty adjusting to new life circumstances often combine to create untenable living situations for the elderly. Suicide in our elderly population far exceeds the general population as a whole.
Fortunately, the treatment prognosis for depression is good. Once diagnosed, 80 percent of clinically depressed individuals can be effectively treated. Medication is effective for a majority of people with depression and the elderly respond the same way. (Adams et al, 2007). Medications can be combined with supportive psychotherapy or cognitive behavioral therapy to improve effectiveness. Psychosocial treatment plays an essential role in the care of older patients who lack social support or lack coping skills to deal with their life situations.
Below are suggestions for activities that caregivers can organize or encourage for an elderly patient with depression:
- Utilize music as a distraction from worries and an assist for relaxation; try it as a sleep aid before bedtime
- Organize interactions with pets as a relief from loneliness; ask friends or neighbors to visit with their pets regularly
- As a focus for new growth, assist the patient with nurturing a seedling
- Select readings as a stimulant for conversations about feelings
- Encourage reminiscence and sharing of recollections for posterity to increase feelings of self-worth
Caregiver skills that are important to nurturing elderly patients with depression include:
- Be patient
- Acknowledge the sadness
- Resist giving advice but hone your listening skills
- Do not pass judgment
- Promote realistic expectations
Deteriorating health and advancing age present problems for the patient and their loved ones. Issues associated with depression can lead to family conflicts, even more isolation, financial strain, abuse of drugs or alcohol, and thoughts of suicide. Depression, left untreated, prevents elderly loved ones from enjoying life as they have in the past.
A strong support system is often helpful to both the caregiver and the senior person's well-being. Find sources of help for caregiver tasks. Contact family, friends, neighbors, church/synagogue, workplace, Area Agency on Aging or other organizations. Keep looking!
Family physicians can have a significant impact on the health and well-being of the elderly and their caregivers. Family physicians can educate caregivers on behavioral management techniques and coping strategies. By providing the holistic approach to care for patients and caregivers, family physicians can help prepare families for the many phases of this challenging role and allow the patients to feel safe with their dignity left intact.
Estee Bienstock RN is the Executive Director of ALLPOINT Home Health. She grew up in Los Angeles, and graduated from the LAC/USC Nursing School in 1976. After years of working in area hospitals, Estee recognized a need for better post-acute in-home care. She then founded Enhanced Health Care in 1989 and quickly set the standard for quality home care. In 2001, Estee formed ALLPOINT Home Health, with the goal of maintaining her unrivaled level of ethics and high standards of customer care. Her philosophy is that each client should be cared for the way she would care for her own family member. Since its inception, ALLPOINT Home Health has been leading the way in helping seniors and disabled adults safely retain their independence in the home.
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