Caring for an older adult with depression
Depression is the mental health problem older adults are most likely to develop, and their chances of experiencing depression go up as they get older. This article discusses the causes, symptoms, and treatment of depression in older adults. It then describes actions a caregiver can take to supplement the primary treatment.
Depression in older adults
Depression is the mental health problem older adults are most likely to develop, and their chances of experiencing depression go up as they get older.1 Women are twice as likely to develop depression as men.2
Some leading reasons that older adults may develop depression are:
- health or financial problems
- loss of independence
- the death of a loved one
- side effects of medication
When an older adult is depressed, not only are they suffering emotionally, but other conditions or diseases they have may get worse and harder to treat.3
How to identify depression
The most common symptom of depression is persistent sadness. However, many older adults experience depression differently than younger people, leading to a missed or misdiagnosis.4 Thus, caregivers should watch for outward signs of depression. These may include:
- Physical complaints such as worsening headaches or arthritis
- Insomnia (inability to sleep)
- Apathy (lack of interest)
- Loss of feelings (numbed emotions)
- Weight or appetite loss
- Trouble focusing
- Neglect of personal care and hygiene (bathing, brushing teeth, changing clothes)
- Indications that the person feels sad, empty, or hopeless
- Thinking or talking about death and/or suicide
These symptoms may be signs of other medical problems, mental-health conditions, or medication side effects. If the person you are caring for has any of these symptoms, it is very important to ask a medical or mental-health professional for an official diagnosis.
Treatments for depression
Caregivers should know that depression is not a “normal” part of aging: it is an illness that needs to be diagnosed and treated. Eighty percent of depressed older adults can be effectively treated.5 The main types of treatment for depression are psychotherapy and antidepressant medication.
Psychotherapy involves the person talking to a qualified mental-health professional such as a counselor, therapist, psychologist, or psychiatrist. Doing this can help the person work through the reasons for their emotions and learn better ways to cope with them.
Antidepression medications work by rebalancing mood-related chemicals in the brain. They take longer to work in older adults, and may not work as well, because of physical and chemical differences in older brains.6 Since poor sleep is both a cause and a symptom of depression in older adults,7 doctors may prescribe a sleep aid.
Caring for a person diagnosed with depression
Though depression is a medical condition that needs to be treated by medical professionals, caregivers can help. They can optimize the primary treatment by helping the person get enough sleep, stick to their medication and/or therapy schedule, and eat healthily.
In addition, there are important steps caregivers should take to supplement the primary treatment, including helping the person to stay socially active, physically active, and find a sense of purpose; and listening to the person without judgment, blame, or advice.
Help the person stay socially active
Older adults who are isolated or lonely have higher rates of depression. It is important to make sure that the person receiving care has plenty of opportunities to interact with other people. Some of the many ways to do this are to:
- Arrange for regular outings in the neighborhood. Even seeing and interacting with total strangers has a positive effect on mental health. Choose to do morning tea at a local café or bakery instead of at home, even if it’s more of a hassle.
- Enroll the person in adult day care, clubs, and hobby groups. When participation in group activities is built into the person’s schedule, it is easier for them to feel like they are still connected to the outside world.
- Set up virtual visits using technology. If the person has mobility problems or is confined to a bed, help them connect with friends and extended family members through a tablet or laptop.
- Add to the list of visitors who rotate through. Many people beyond a person’s family members and close friends are usually happy to visit, if asked. These include neighbors in an apartment complex, acquaintances who share interests with the person (such as a fellow book-club member), and the caregiver’s own friends.
Help the person stay physically active
Physical exercise has been shown to both prevent and reduce depression in older adults.8 Even gentle exercise, such as walking or gardening, can help. Resistance exercises such as weightlifting and resistance-band exercises reduce depression symptoms no matter how much or little the person does.9 Forms of exercise that are usually done with other people, such as water aerobics or chair yoga sessions, are useful in keeping the person both socially and physically active.
Perhaps the best types of exercise are those that combine body and mind, such as tai chi or qi gong.10These exercises involve meditation, breathing, relaxation, anxiety-reduction, socialization (if done in group classes), and the sense of purpose that comes from trying to learn a new skill.
Help the person find a sense of purpose
Feeling useless and unengaged can be a big part of depression in older adults. Help combat these feelings by incorporating things that make the person feel that they are valued and their lives have meaning. There are countless ways to do this, including to:
- Ask them for their opinion, advice, or help with a minor, completable task.
- Start a “memory-capture” project by asking them for favorite memories and life experiences, recording these, and having them transcribed by a person or software program to create a personal memoir. Guide them to focus on happy memories and those that remind them that they are loved and valued.
- Collaborate with the person in devising “giving back” and “paying forward” actions, such as volunteering, paying for the coffee of the person next in line, or arranging small monthly donations to a charity.
- Help them learn a new skill or achieve small, realistic goals, such as learning key phrases of the language spoken in their favorite foreign country, writing in a diary every day, or getting to the next level in a brain-training tablet game.
Listen to the person without judgment, blame, or advice
It is important for the person receiving care to be able to trust the caregiver with their feelings and thoughts, especially during times of struggle. Though it can be hard to hear about a person’s problems without trying to “fix” the situation, caregivers can help most by listening without interruption, gently asking questions to encourage further detail, and expressing sympathy, caring, and concern.
If listening makes the caregiver feel helpless, they can ease these feelings by simply asking, “What can I do to help?” or “What do you need most from me right now?”
10 things every caregiver should know
Depression in older adults
Depression: Supporting someone who is depressed
Stories from People with New Depression
External supporting content
1 The State of Mental Health and Aging in America, p.2. Centers for Disease Prevention and Control (CDC).
2 Statistics related to mental health disorders. Johns Hopkins Medicine.
3 The State of Mental Health and Aging in America, p.2. Centers for Disease Prevention and Control (CDC).
4 Depression in Older Adults: Signs, Symptoms, Treatment. HelpGuide.
5 The State of Mental Health and Aging in America, pp. 2, 6. Centers for Disease Prevention and Control (CDC).
6 Depression in Older People. WebMD.
7 Depression in Older People. WebMD.
8 Exercise plays an active role in treating depression. McMaster University.
9 Exercise plays an active role in treating depression. McMaster University.
10 Exercise plays an active role in treating depression. McMaster University.