The Professional Geriatric Care Manager’s Blog

Depression in the Senior Years

I attended a conference this week entitled “The Golden Years? Medical, Legal, Ethical Challenges Facing Seniors and their Caregivers.” One of the topics of the program was “Depression in the Senior Years.” The speaker started off with saying depression is a medical disease, just like diabetes, heart disease and cancer; one in five people will develop depression in their senior years.

Depression is characterized as an all-encompassing low mood, accompanied by low self-esteem, and by the loss of interest and pleasure in normally enjoyable activities. The causes of depression can include psychological, hereditary, or biological factors. Certain medications can cause depression. The abuse of alcohol and drugs can cause depression. In the elderly, depression can often coexist with physical disorders, such as stroke, cardiovascular diseases, Parkinson’s disease, and chronic obstructive pulmonary disease.

Symptoms of depression in the elderly include headache, pain, fatigue, insomnia, and digestive problems. There exists a low rate of detection of depression in the elderly by primary care physicians, and depressed older adults have the highest risk of suicide in our society.  Once depression is diagnosed there are varying treatment plans. Depression can be successfully treated with antidepressant medication, psychotherapy, electroconvulsive therapy, or a combination of therapies.

As geriatric care managers, we observe for symptoms of depression. We know that changes in an older person’s behavior or mood should not be ignored. Many of our clients suffer from dementia, or have a history of other physical disorders such as stroke. The risk of major depression has been shown to increase with neurological conditions such as stroke and Parkinson’s disease. If we suspect depression, we will bring it to the attention of the client’s primary care physician, who can prescribe a course of treatment after a medical examination. The primary care physician may also refer the client to a neurologist or psychiatrist for further evaluation. Additional testing is also performed to eliminate causes of the symptoms. Blood tests, such as thyroid tests, to rule out a metabolic disturbance; and a full blood count with ESR, to rule out a systemic infection are drawn. Cognitive testing and brain imaging are done to help distinguish depression from dementia. A CT scan of the brain eliminates any evidence of physical problems, such as brain tumors. As care managers, we arrange for any testing ordered and accompany the client to the scheduled test. At weekly visits we can continually assess the patient. We set up weekly pill boxes to make sure clients are compliant with their medications, particularly if medications have been prescribed for depression. We engage clients in activities, such as working with a senior fitness trainer, sessions with a psychotherapist, or our therapy dog Romeo. The goal is to eliminate feelings of hopelessness and emptiness a client may be experiencing, to aid in the diagnosis and treatment of depression in the elderly, and not just view it as a natural consequence of aging.

Distinctive Care Geriatric Care Management serves Bergen, Passaic, Rockland and Orange County with nurses licensed in New Jersey and New York. We help families dealing with various issues related to their elderly loved ones and would be happy to discuss any concerns you may have related to long term care. Please contact us in our Ridgewood Office at 201-587-5283 to schedule a consultation.