Depression in the Elderly
This paper explores four published articles that report on results from
research on how the depression affects the elderly community. One article is a study done on the elderly in a nursing home and the other three provides information on mental health and how people can improve on being more understanding and caring towards the elderly.
This study was performed in an elderly house in Pristina-Kosovo by European Psychiatary association. There was 86 people living in the house from ages 65-94. They were checked by a psychiarist for depression with the Beck Scale and geriatric depression scale. (F. Drevinja, S. Haxhibequiri)
Assessments and Measures
Many of the residents had symptoms of depression: refusing food, inactivity, and neglcting their health. Many have never been treated for depression. The researchers had difficulty dealing with the residents over the age of seventy due to health issues, dementia. F. Drevinja, S. Haxhibequiri)
The researchers found that life in the elderly home was quite organized and they weren't under-staffed. They had a psychologist, psychiatrist, social worker, nurse, dentist, physiatrists. Although the home had all of these resources for these people, many of the residents were very depressed. Many residents lost hope for the future and lost their confidence as they got older. The researchers found that 5 people of the eighty six people living there which have psychotic symptomatology, while others, over the age of seventy years old have been in need of treatment with antidepressants. (F. Drevinja, S. Haxhibequiri)
Depression is the most common and serious mood disorder in the world according to the DSM-5. When dealing with depression in older people, it is found that depression without sadness is most common. Depression in the elderly often stems from issues that seem to be harder to deal with. Due to the added stressors in later life, the DSM-5 states that older people are at a higher risk for suicide. (Taylor, 2014)
The DSM-5 outlines the following to make a diagonosis of depression.
The person must be experiencing five or more of the following symptoms for more then two weeks.
Fatigue and loss of energy nearly everyday.
Feelings of hopelessness and worthlessness.
Diminished interest or pleasure in all or almost all activities most of the day, nearly everyday.
Weight loss or weight gain.
If the person in question are feeling an extreme sadness for two weeks or more, it is important to be screened for depression. Once that person gets screened, they can figure out what the next step may be.
There are many options for older adults struggling with depression. Warren Taylor states in his article he states the following examples could help older adults.
Lifestyle changes: The way one lives their life can have an affect on how they act and feel. If someone doesn't take time for themselves. Also, money is a factor in causing stress in a lot of people but more in the elderly. Many other adults have trouble making ends meet since for some people social security and their pension may not be enough. There are bills to be paid and some people just can't afford it. Many people also deal with health issues later in life which can be a factor into them not being able to move around and exercise and work.
Brain Stimulation: Electroconvulsive therapy (ECT) is the most effective treatment for severely depressed patients, including elderly patients. (Taylor, 2014) ECT should be considered if they are sucidical , if they haven't responded to antidepressants, or if they have a sereve health problem. Current ECT protocols are safe but they have side effects such as confusion and anterograde and retrograde amnesia.
Maintenance therapy: Studies have shown that going to treatment after remission has it's benefits. One study involved older adults with recurrent depression who had a short-term remission with nortriptyline and interpersonal therapy over a period of 16 weeks. Participants were randomly assigned to maintenance therapy with nortriptyline or placebo and to monthly maintenance psychotherapy or no psychotherapy. After three years, relapse rates were significantly lower among persons assigned to continued treatment with nortriptyline alone (43%), nortriptyline and interpersonal therapy (20%), or interpersonal therapy alone (64%) than among persons receiving placebo and no interpersonal therapy. (90%) (Taylor, 2014)
Many people who have been independent their whole lives have trouble with coming to terms with getting older. They are often afraid or ashamed to ask for help. They have trouble coming to terms with the new normal and it plays a huge role in their daily lives. Communicating to someone who may be struggling is the first step for them to figure out how to cope with their new reality.