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Spotting Depression In The Elderly: Points For Caregivers

Often, when we find a sudden change in the elders at home, a sudden loss of quirkiness, joy or a sudden silence, we mistake it for simple mood swings due to their old age or just lethargy. You might be worried, yes, but are mostly clueless about what they are going through. Depression is a very common issue especially among the elderly and most often goes undiagnosed. Elders seldom reveal their state of mind and admit to the symptoms of depression they show for fear of being categorized weak or mentally unstable. Those who do reveal, already have a fixated opinion about the inability to correct this condition.

There are innumerable reasons and causes for the onset of depression among the elderly. Some of the common ones are changes in the family, mental strain and frustration, chronic pain or ailments, loss of a close one or spouse, financial issues, Immobility or difficulty in ambulation, trouble adapting to new lifestyle changes or inability to accept the post-retirement phase of life. Depression is not only due to the circumstances or lifestyle of a person but may also be a sign of an underlying medical condition or an illness. For many elders, depression might just be a side-effect of any long-term medication or suffering from Dementia.

A common condition?
By far, depression is the most common mental condition found and detected among the elderly and also the most overlooked or ignored till it grows severe. The main reason behind this is the fact that the elderly show a wide range of symptoms and no two cases of depression look alike. The chances of these symptoms being ignored as an ailment or characteristics of old age are higher. The symptoms and signs one shows during the onset of depression can be easily confused by medical examiners as an early symptom of Alzheimer's disease or Parkinson's disease, Thyroid disorders, or any other chronic ailments. However, left undiagnosed, depression does a lot of irrevocable harm to the health and mind of the elders suffering from it.

If you have an elderly at home or if you are the prime caregiver of a senior citizen you need to be aware of the common symptoms and signs of depression. Some of the most common ones are elaborated below.

Frequent thoughts about death and doom: This is a very common symptom among the elderly. If the otherwise cheerful elder of your family is indulging in depressing conversation pertaining to death and doom, they require immediate attention and care.

Talks about suicide and worthlessness of life: This might in severe cases also lead to feelings of committing suicide and ending life. Immediate medical supervision and extreme care are required for such people.

Chronic pain/Immobility/bed ridden: Constant and unbearable pain are often the main cause of depression. As one ages, the ability to withstand pain decreases leading to depression.

Loss of appetite or a sudden episode of binge eating: Dietary pattern varies from person to person and may not be a fool-proof method to diagnose depression. However, a sudden loss or increase in appetite should be a definite cause for concern and requires medical attention.

Sudden mood swings and unexplainable guilt: Old age people tend to delve into their past life and blame their choices when they feel low or upset. This is however for a short duration. If you notice something similar in an elderly around you for an extended period of time, they require help.

Sudden and drastic weight loss or gain: This is also a case of concern as it might signalling towards any underlying chronic ailment. Elderly people have an almost constant weight with not much of a variation. Any sudden gain or loss might affect their hormonal level and result in depression. Many times, this gain or loss might have a direct relation with their mental health.

Irritated or frustrated mood, easily agitated: A person suffering from depression gets agitated easily and has a very borderline temperament. Such transient temperament and mood swings need to be monitored and medically diagnosed to eliminate depression.

Inability to remember things and difficulty in concentrating: This is a common symptom of old age and often ignored by many. However, when this is observed in an otherwise healthy elderly, it is a sure warning signal pointing at depression.

Sudden and drastic onset of lethargy and loss of interest in everything: If you notice an elder person suddenly looking weak or demotivated, it is very important to understand the reason behind it. While it may be due to weakness or a health condition, it is very important that you rule out depression as a reason.

Sudden change in the talking pattern: One's mental health can be gauged by the way they converse. Sudden change in the talking pattern is a very definite way of determining their mental condition. If an otherwise normal elder person is observed as talking either very fast or starts steering away from conversations and stays put off and recluse, it is a definite sign of depression.

Difficulty in sleeping: Sleep apnea and other sleeping disorders are a common sign of depression. You can often find such people lying awake throughout the night or waking up frequently due to nightmares. Disturbed sleep or tossing and turning in bed can also be a warning signal for depression.

With the elderly, a caregiver needs to be really empathetic and relatively tolerant. It is very important that they feel valued and important and viewed as not being a burden on anyone. Ensuring that they have someone they can talk to or confide in is very important to understand their mental disturbances. Being aware of all medical conditions the elder person has and the medications prescribed for them is important for a caregiver. A healthy and active lifestyle with family and friends is a fool-proof way to ensure that the elderly are always happy and anxiety-free.

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Dr M Udaya Kumar Maiya

Guest Author An acclaimed oncologist, Dr Udaya Kumar Maiya is the Medical Director at Portea Medical, India's pioneering home healthcare company

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