Growing older can bring many challenges for the emotions.  It’s not only physical hardships which can make people feel low.  When spouses, friends or relatives die there is a huge emotional impact.  Being forced to move away from a familiar community can also be distressing, even if it’s only a small distance.  Without the activity of employment days can seem tedious and unfulfilling, whilst the knock-on effect of physical ailments can force elderly parents to give up driving and make it difficult to get out and about in general.

So it’s very easy to dismiss elderly parents feeling down as ‘what you’d expect’.  However, we need to think more carefully about whether they may actually be suffering from depression, which is a clinical condition requiring treatment.

Depression is not a natural part of the ageing process but is very common in the elderly.  It’s not a problem to be taken lightly because it can have a severe effect on people’s lives, but properly treated it can be resolved.  Consequently it’s important to assess the situation carefully and decide whether your elderly parent is experiencing an understandable reaction to distressing circumstances or is suffering from a depressive disorder.

Spotting Signs of Depression in the Elderly

Feeling grief at the passing of a loved one is entirely normal and the frustrations of health complaints can be expected to make people feel low.  However, such reactions tend to ease over time whereas depression casts a long-terms shadow over sufferers.

You should consider whether any of the following symptoms are experienced by your elderly parents:

• Anxiety or constant worrying
• Loss of pleasure in activities/withdrawal from social life
• Difficulty sleeping
• Loss of energy/apathy
• Weight loss
• Headaches and dizziness
• Decline in concentration/memory
• Crying
• Pessimism/hopelessness
• Taking less care over the home or personal appearance

It’s important not to take the presence of one or even several of these symptoms as any kind of conclusive evidence, but they are indicators that you should seek professional medical advice from your parent’s GP.

Whilst you should never assume people in happy, active environments are immune from depression it is nonetheless true that those in the following situations are at greater risk:

• Lacking support in life
• Isolated
• With declining health
• With a history of depression or substance abuse

Hidden Depression

Sometimes the symptoms of depression can be entirely physical.  There may be none of the signs listed above but your elderly parent will visit the doctor complaining of pain in the joints, back or abdomen.  Indeed, a whole range of low-level physical complaints can be linked to depression, which can magnify the sense of pain and create a number of physical problems which have no obvious cause.

This is more likely if the person had no problems with depression before retirement age.  So remain alert to the possibility that unexplained physical ailments may point to underlying depression.

Depression and Dementia

Some of the symptoms of depression are similar to those created by dementia.  Problems with attention, memory and interest are shared by both conditions and clearly dementia is one area that people tend to focus on more heavily in the elderly.

It is obviously important to seek advice from a medical professional but if you are concerned there are differences to note.

With dementia the onset of symptoms is generally very slow, over many months and indeed years.  So slow that it is often difficult to notice.  With depression the signs will appear much more rapidly and will usually be accompanied by some of the other symptoms noted above.  It’s also more likely the sufferer will notice these symptoms themselves.

Specific tests conducted by specialists can make a firm diagnosis and if these problems with brain function are related to depression they will generally not be severe and will clear up with treatment.

Treating Depression in the Elderly

Like any disease, depression can vary from mild to severe, which will affect the way in which it is treated.  GPs are certainly very reluctant to prescribe medications, which can prove to be addictive, so in milder cases they will always look for alternative treatment.

The difficulty can often be persuading your elderly parent to accept either the problem or the need to treat it.  A common response is, “It’s no wonder I’m depressed with my life!  You can’t change that so what’s the point?  What do I have to look forward to?”

In addition, your parents are from a generation where any thought of ‘mental illness’ was seen as a stigma and something to be ashamed of.  Consequently, seeking treatment or the idea of seeing a psychotherapist fills them with horror.

You need to be patient and take some time to get them used to the idea, explaining how common depression is in the elderly and that seeking help isn’t a sign of weakness, it’s a way of making things better.  You may have to be insistent since one of the problems with depression is that it sets up mental barriers against doing many things – even for pleasure!

Non-Medication Treatment for Depression

There are many options here and it’s important to note these things are also preventative, so even if your elderly parent isn’t currently suffering from depression you can act in the following ways to help avoid the problem in future.

• Get Active!  The more involved elderly people are in social activities the less likely they are to experience depression.  Explore social groups, voluntary organisations and community activities your parent could become involved with.
• Get Mobile!  One of the causes of inactivity is the decline in physical ability.  Sort out everything which could increase your parent’s mobility, from personal aids to transport schemes for senior citizens in their area.  In addition, see if there is an exercise programme for the elderly in the local community centre.  If not, buy a book or DVD which provides exercise routines for the elderly.  Nobilis liaises closely with Extend a charity who provide gentle exercise to music for older people and for anyone of any age with a disability.  Contact Nobilis for further information on an Extend class in your area. 
• Eat Well!  A healthy, balanced diet with regular meals is important in keeping depression at bay.
• Keep Alert for Symptoms. If everyone is aware of potential signs of depression then that helps spot the problem in its early stages, making it easier to deal with.
• Psychotherapy.  This route may be offered by your parent’s GP.  With professional psychotherapy the causes of depression can be established and a way forward charted.

In some cases your parent’s GP may prescribe medication.  This will probably be at a low dosage in the early stages and possibly only on a temporary basis.  You should not expect any overnight change with medication since antidepressant drugs generally take several weeks to have an effect.  You should also read the accompanying leaflet very carefully to alert yourself to any side-effects, which are common with these medicines.  If your parent experiences any of these side-effects it’s important to ensure their doctor reviews the situation.

Nobilis – Experienced with the Elderly

Nobilis provides in-home care services for the elderly in the Hampshire area.  We know the problems old age can bring and the worries it creates amongst families.

That’s why we have created this information centre to help you understand the problems your parents are going through as well as to find ways forward.  But this help isn’t confined to our website.  Whether you are interested in our home care services or not, we’re happy to share our experience and help you with any advice we can.

If you have questions about the wellbeing of your elderly parents give us a call on 0845 8620647.