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Practical Insights for Busy Caregivers

Stay alert to signs of depression


January 23, 2017, by Pat Morden, Caregiver Exchange

Your elderly mother is waking up very early in the morning and seems more tired than usual. She no longer reads or attends her gentle exercise class. Sometimes she seems a little confused. She has lost interest in meals.

There are many reasons why an older adult might exhibit these signs. One that may not occur to you right away is depression. Depression is very common in the elderly, occurring in 1 in 4 older adults living in the community, says Janine Clift, a geriatric emergency nurse at London Health Science Centre. Nearly half of those living in long-term care settings have symptoms of depression, and the elderly have the highest suicide risk of any age group.

Why is depression so common? Says Clift: “Older adults experience many losses -- loss of role, function, partner, and more. That’s why it’s so important that they have a purpose in life and are engaged with something that gives them pleasure.”

Clift says depression can be difficult to diagnosis in older adults, especially as many of the signs mimic or overlap features of dementia. She suggests watching for the following:

  • Sleep disturbance, especially early morning awakening and frequent awakening
  • Loss of interest in previously enjoyed activities
  • Feelings of guilt or excessive preoccupation with regrets about the past
  • Low energy, excessive fatigue not connected to other medical problems
  • Difficulty concentrating
  • Appetite loss, weight loss, constipation
  • Slowing down or agitation
  • Thoughts of suicide (“I’d just like to go to sleep and not wake up.”)
If five or more of these signs are present for at least two weeks, Clift says you should immediately seek medical attention for the person you are caring for. The doctor will do tests to rule out any other illnesses or conditions, and assess for depression. If depression is diagnosed, treatment could include medication, education, music and art therapy, diet changes, light therapy, counselling and exercise.

It’s important that caregivers realize they aren’t responsible for and can’t “cure” depression in the person they’re caring for, no matter how much they want to. “You can’t fix everything,” says Clift. “You don’t know what people may have encountered throughout their lives. The important thing is to look after yourself, so that you can be there for them.”