Depression in the Elderly

When Is Feeling a Little Blue Normal for the Elderly?

Feeling a little blue from time to time – sure that’s part of living. Too often, however, it’s more than just a little blue – it’s depression. It’s a serious issue among the elderly

Many believe that depression is a normal part of aging and a natural reaction to loss of functional ability, loss of friends, living with chronic diseases – normal parts of aging. That mis-belief leads to a significant under-diagnosis and under-treatment of depression among the elderly.

It’s a combination of not recognizing the signs and symptoms, a lack of knowledge that it can be medically treated and, unfortunately, a reluctance to address the issue. Late life depression affects about 6 million Americans age 65 and older. Only 10% receive treatment.

Consequences: There are significant consequences of untreated depression among the elderly.

• Depression increases the risk of cardiac diseases. Depression doubles an elderly person’s risk of cardiac disease and increases their risk of death from the illness.
• Depression increases the risk of suicide. The suicide rate among people ages 80-84 is twice that of the overall population. The highest rate is among white men. Many of those who commit suicide reached out for help, but most are more likely to seek treatment for other physical ailments than to seek treatment for depression.

Symptoms in Elderly Persons are Different than for younger people

But, getting a senior to admit to depression can be a challenge: “I’m fine.” Some clues that someone may be experiencing some level of depression include:

• Persistent and vague symptoms
• Help-seeking
• Moving in a more slow manner
• Demanding behavior

Unlike normal sadness, depression doesn’t go away by itself and may last for months. A physical exam by a physician can help determine if depressive symptoms are being caused by another medical illness. A medication review may identify the issue that can be corrected by a simple change in medications.

Good News: it’s treatable. There are three major categories of treatment for depression;

• Medication: Medication is effective for a majority of people with depression. It may take some time to identify the correct medication, both from the perspective of effectiveness and from the perspective of side effects. Adherence to the medication regimen is vital and can be a challenge.
• Electro-convulsive Therapy (ECT) (also known as shock therapy) may be useful in cases of more severe depression. It can be life-saving.
• Psycho-social Therapy is another leg of potential treatment plans. This might be as “simple” as connecting or re-connecting with social networks such as churches and seniors groups.

Tips for Being Involved with a Loved One

1. Don’t Dismiss Symptoms: Not eating, being withdrawn, losing weight, complaints are not normal
2. Talk about how they feel. You can’t make many of life’s changes go away, but you can ask them how they
3. Look for subtle signs: As noted above, depression and anxiety are difficult to admit. Pay attention to clues in behaviors: wringing hands, being unusually agitated or “antsy”
4. Don’t impose your terminology: Instead of insisting that your loved one is depressed, talk with them about improving particular challenges like not sleeping well or being anxious
5. Recognize that depression is an illness. This is a disease that needs to be treated, not a failing on their part of pull themselves out of their funk.
6. Don’t take over a person’s life: Part of getting better is feeling competent. Help them accomplish tasks by breaking them into do-able pieces instead of doing it for them.
7. Try to participate in their medical care. With their permission, it’s good for you to be involved in providing information to the physician and knowing treatment plans.

Interim HealthCare stands ready to help treat patients with depression. This can include:

• The standard of care at Interim HealthCare includes screening for depression with interventions as appropriate.
• Supportive personal care services through our personal care division. Our proprietary HomeLife Enrichment program can be part of the treatment plan, as well as respite for caregivers.

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