Holiday Blues – Depression in the Elderly

November 5, 2010
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The holiday season is quickly coming upon us. If you are a caregiver for an elderly loved one, then you may notice a change in your loved one’s mood as the holidays approach. Perhaps during the holidays you are one of many who visit their elderly parents and family who live some distance away. When you visit, you may notice that loved ones are not as physically active as on prior visits, that they show symptoms of fatigue or sadness, or that they have no interest in the holiday or in their surroundings.
According to the National Institutes of Health, of the 35 million Americans age 65 years or older, about 2 million suffer from full-blown depression. Another 5 million suffer from less severe forms of the illness. This represents about 20% of the senior population – a significant proportion.
Depression in the elderly is difficult to diagnose and is frequently untreated. The symptoms may be confused with a medical illness, dementia, or malnutrition due to a poor diet. Many older people will not accept the idea that they have depression and refuse to seek treatment.
What causes depression in the elderly?
It is not the actual holiday that causes depression, but the fact that holidays tend to bring memories of earlier, perhaps happier, times. Additional contributing factors that bring on depression may be the loss of a spouse or close friend, or a move from a home to an assisted living facility, or a change in an older person’s routine.
Depression may also be a sign of a medical problem. Chronic pain or complications of an illness or memory loss can also cause depression. In addition, diet can also be a factor when proper nutrition and vitamins are lacking.
As an example, Selma’s husband died a few months before Christmas. Her family lived close by and would call or drop in often to check on her. Selma seemed a little preoccupied and tired, but this was to be expected as she had been the caregiver for her husband for many years. When the family noticed that her holiday decorations were not out, and that she had abandoned her annual routine of sending Christmas cards, they began questioning her mental and physical well-being.
A trip to her physician confirmed depression, caused by not only the loss of her spouse, but also a vitamin B12 deficiency. There were both mental and physical reasons for her depression.
Symptoms to look for in depression might include:

  • Depressed or irritable mood
  • Feelings of worthlessness or sadness
  • Expressions of helplessness
  • Anxiety
  • Loss of interest in daily activities
  • Loss of appetite
  • Weight loss
  • Fatigue
  • Lack of attending to personal care and hygiene
  • Difficulty concentrating
  • Irresponsible behavior
  • Obsessive thoughts about death
  • Talk about suicide

How do you know if it is depression or dementia?
Depression and dementia share similar symptoms. An article on www.helpguide.org gives some specific differences: In depression there is a rapid mental decline, but memory of time, date and awareness of the environment remains. Motor skills are slow, but normal in depression. Concern with concentration and worry about impaired memory may occur. On the other hand, dementia symptoms reveal a slow mental decline with confusion and loss of recognizing familiar locations. Writing, speaking and motor skills are impaired, and memory loss is not acknowledged as being a problem by the person suffering dementia. Whether it is depression or dementia, prompt treatment is recommended. A physical examination will help determine if there is a medical cause for depression. A geriatric medical practitioner is skilled in diagnosing depression and illnesses in the elderly. If you are the caregiver of an elderly person it may be beneficial for you to seek out a geriatric health care specialist. For more information on senior health services go towww.longtermcarelink.net/about_senior_health_services.htm.
Treating depression in older people.
Once the cause of the depression is identified, a treatment program can be implemented. Treatment may be as simple as relieving loneliness through visitations, outings, and involvement in family activities. In more severe cases antidepressant drugs have been known to improve the quality of life in depressed elderly people. Cognitive therapy sessions with a counselor may also be effective. As a caregiver or family member of a depressed elderly person, make it your responsibility to get involved. The elderly person generally denies any problems or may fear being mentally ill. You can make the difference and remove the Holiday Blues from seniors suffering from depression. The Geriatric Mental Health Foundation offers a “Depression Tool Kit.” To read more about this tool kit, go towww.gmhfonline.org/gmhf/consumer/depression_toolkit.html.
The attorneys at Oast & Hook can assist clients and their families with their estate, financial, insurance, life care, veterans’ benefits and special needs planning issues.

Ask Allie

O&H: Allie, we’ve heard that a Massachusetts town was recently voted “Dog Town USA.” Please tell us about it.
Allie: Sure! Provincetown, Massachusetts, was voted “Dog Town USA” by Dog Fancy magazine. The town beat out 94 other entries in the annual competition, which is based on the number of dog-friendly open spaces and dog parks, events celebrating dogs and their owners, veterinary care, and laws that support pets. Dogs can accompany their families into the bank and post office, and they can sit and eat on the patios of several restaurants. Dogs also work in shops greeting visitors. The local animal shelter sponsors Pet Appreciation Weekend, including a blessing of the dogs, a pet parade, and a pet tea party. Along the town’s main street, water bowls sit outside almost every business for dogs passing by, and the shopkeepers often grab a bag of dog treats from behind the counter to try to lure the dogs (and their families) inside. According to the town’s tourism office, the town’s history with dogs began in 1620 when its first European canines (an English mastiff and English springer spaniel) docked in Provincetown Harbor aboard the Mayflower. The 10th dog-friendliest place in the Dog Fancy competition is our own Virginia Beach, Virginia. That’s a great story. I wonder what city would win the title of “Feline Town USA?” I’ll let our readers think about that one while I take a quick nap. See you next week!


Oast & Hook attorney Sandra L. Smith and life care planner Carey Raleigh recently gave a podcast interview on the topic of life care planning. To listen to this podcast, please visithttp://tinyurl.com/2uuhvml.
Oast & Hook will hold its quarterly Social Workers and Administrators Breakfast on Thursday, November 18th, at the Virginia Beach Central Library, 4100 Virginia Beach Boulevard, Virginia Beach, Virginia 23452. Registration begins at 9:00 a.m., and the presentation begins at 9:30 a.m. Questions will be answered from 10:30 a.m. to 11:00 a.m. The breakfast is designed to be both a networking opportunity and also an educational opportunity for area professionals who work with seniors, the disabled, and their families. Seats are limited, so please register early for this breakfast by phoning Jennie Dell at 757-967-9704.

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