Prevention Issues : Isolation and Depression in the Elderly

depression in elders

Depression is not exactly “preventable”; certain unchangeable factors impact risk, such as past history of the illness or family history. However, there are steps that can be taken to mitigate some of the risk factors that are common in elders. Your early intervention and support can also be critical, as depression often goes untreated in elders.

For most people, well-being increases with age, but there are certain factors that put elders at risk of depression and suicide such as:

  • 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 (loss of identity due to retirement or physical limitations on activities)
  •  Health problems (illness and disability; chronic or severe pain; cognitive decline)
  • Certain medications or combinations
  • Fears (anxiety over financial problems or health issues, worry about “being a burden” or losing independence, fear of having to go to a nursing home)
  • Grief (death of friends, family members, and pets; the loss of a spouse or partner; loss/changes in lifestyle)

What can you do?

  1. Watch for signs and symptoms, especially in someone with a known family or personal history of depression. Monitor carefully if the person has heart disease, macular degeneration, or has had a hip fracture, stroke, or bypass surgery (these are all known to be associated with developing depression).
  2. When coordinating medical care, make sure to give thorough information to providers and keep good records. Ask questions about drug interactions and possible concerns with conditions known to be associated with depression. Keep a list of symptoms or concerns in order to be able to report accurately to providers. Consider medication management services for elders who take many medications or have difficulty remembering the medication routine.
  3. Encourage loved ones/friends to stay active and plan activities. Check out our post on fun activities for seniors and ways to modify activities to accommodate different needs.
  4. Pay attention if your loved one/friend is withdrawing from normal activities or changing patterns significantly. Keep an eye out for early warning signs of depression such as this and changes in sleep patterns, complaints of aches and pains, cognition and behavior changes. If you spot signs, you may want to read our Aging Wisely advocates’ article on approaching someone when you are concerned about possible depression.
  5. Help show the person ways to adapt to changing circumstances and losses. The loss of mobility or driving privileges can be devastating and cause a person to become more isolated and withdrawn. There are many ways for someone to remain active and continue favorite activities even with these changes. However, the person may not even know how to go about them (imagine driving yourself everywhere and suddenly trying to figure out how to use taxis and public transportation or being told to just rely on family/friends for rides).
  6. Encourage discussion about fears and concerns. Share examples (“My friend’s Mom was so worried she would have to go to a nursing home when her health was failing but she was able to get great helpers at home and she is doing so well. They even helped her get to her granddaughter’s wedding this past May.”) and anticipate unspoken concerns. For example, we’ve often found clients so relieved when their son, daughter or financial advisor reviews their financial situation and demonstrates that there is enough money to live comfortably and pay for care. The adult children are often surprised to hear that this is something that worried the parent.
  7. Suggest activities that provide a sense of purpose (volunteer work is a great example). Ask the person for their opinion or help; show that they are valued for their wisdom and life experience.
  8. Try to encourage outlets for healthy grief. WebMD offers a good overview of grief and grieving resources and Seniors for Living has some great tips in their Grief and Bereavement Resource Guide.

We’re here to help! Contact us at 727-447-5845 for ideas, resources and a wide array of helpful senior care services. Our Aging Wisely geriatric care managers can help with geriatric assessments, resources, and guide you through tough conversations and transitions. Our home care team offers customized support to keep elders active, engaged and healthy.