There are many challenges for adult children caring for aging parents and grandparents. Among these are the threats of depression which hits more elder persons than you might think. In fact, as many as 70% of institutionalized elderly experience significant depression, and the incidence in community settings is approximately 18% in the over 65 population (as opposed to 8% in the general population). Some estimates of frail elderly living in independent settings have found a 30% or higher incidence. Depression is a medical condition that affects not only quality of life, but also the way in which people take care of themselves. It is a condition that is usually easily resolved with new treatments like therapy, antidepressants or a change in living accommodations, but untreated in the elderly, it can have terrible consequences.
Loss is painful—whether an elder is dealing with a loss of independence, mobility, health, a long-time career, or someone they love. Grieving over these losses is normal, even if the feelings of sadness last for weeks or months. Losing all hope and joy, however, is not normal. It’s depression.
According to the National Institutes of Health, of the 35 million Americans age 65 or older, about 2 million suffer from full-blown depression. Another 5 million suffer from less severe forms of the illness.
Causes of Depression
Many seniors face significant life changes and stressors that put them at risk for depression. Those at the highest risk include older adults with a personal or family history of depression, failing health, substance abuse problems, or inadequate social or emotional support.
Causes and risk factors that contribute include:
- Loneliness and isolation – Living alone; a dwindling social circle due to deaths or relocation; decreased mobility due to illness or loss of driving privileges.
- Reduced sense of purpose – Feelings of purposelessness or loss of identity due to retirement or physical limitations on activities.
- Health problems – Illness and disability; chronic or severe pain; cognitive decline; damage to body image due to surgery or disease.
- Medications – Many prescription medications can trigger or exacerbate depression.
- Fears – Fear of death or dying; anxiety over financial problems or health issues.
- Recent bereavement – The death of friends, family members, and pets; the loss of a spouse or partner.
Signs and Symptoms
- Sadness
- Fatigue
- Abandoning or losing interest in hobbies or other pleasurable pastimes
- Social withdrawal and isolation (reluctance to be with friends, engage in activities, or leave home)
- Weight loss; loss of appetite
- Sleep disturbances (difficulty falling asleep or staying asleep, oversleeping, or daytime sleepiness)
- Loss of self-worth (worries about being a burden, feelings of worthlessness, self-loathing)
- Increased use of alcohol or other drugs
- Fixation on death; suicidal thoughts or attempts
Older adults don’t always fit the typical picture of depression. Many depressed seniors don’t claim to feel sad at all. They may complain, instead, of low motivation, a lack of energy, or physical problems. In fact, physical complaints, such as arthritis pain or headaches that have gotten worse, are often the predominant symptom of depression in the elderly. Older adults with depression are also more likely to show symptoms of anxiety or irritability. They may constantly wring their hands, pace around the room, or fret obsessively about money, their health, or the state of the world.
Older adults who deny feeling sad or depressed may still have major depression. Here are the clues to look for:
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Adapted from American Academy of Family Physicians
Other tips for helping a depressed parent or grandparent:
- Invite them out. Depression is less likely when people’s bodies and minds remain active. Suggest activities to do together that your loved one used to enjoy: walks, an art class, a trip to the museum or the movies—anything that provides mental or physical stimulation.
Schedule regular social activities. Group outings, visits from friends and family members, or trips to the local senior or community center can help combat isolation and
