Depression in Older Adulthood

Team S.A.DLaTricia Russell

Brianna Wells

Shetera Chaney Jackson

Treshana Davis

“There are wounds that never show on the body that are deeper and more hurtful than anything that bleeds.”

-Laurell K. Hamilton

How does Depression Differ in Older Adults?

Older adults are less likely to indicate that they are feeling depressed

More likely to consult a physician than a mental health professional

Depression more common in those with limited function due to other health conditions

Higher rate of suicide than any other group; twice that of the young population (older men the highest rate)

Unique Symptom: feeling confused or forgetful

Symptoms are often confused with other ailments, and are not recognized

Those with neurodegenerative disorders (ex. Alzheimer’s) run a higher risk

15% of those aged 65+ struggle with depression

Demographics

Biological Factors

Physical changes Genetics Hormones Brain Chemicals – nerve cells Activity Theory

Activity Theory

Expresses the importance of remaining socially and physically active

Positive relationship between activity and life satisfaction

Quality of Life

Individual opinion about well being

Biopsychosocial

Sedentary lifestyle in older adulthood may increase risk for depressive symptoms

Early Mortality

Cognitive Decline

Psychological Factors

Personality, stress and loss are some of the psychological factors that can contribute to depression In older adults

Personality

Association between depression and neuroticism Stress & Loss

Loss of spouse or significant other, loss of role in family or society Suicide and depression in older adults

Disengagement Theory

First theory proposed to describe the social process of aging

According to the disengagement theory as people pull away from society concurrently society pulls itself away from older persons because they no longer fit into its cohesiveness

When society pulls away from the elderly after they have many years of social interaction, this can bring about a feeling of loss which can lead to depression.

Social Factors Social Isolation

Loss of Social Roles

Loss of a Loved one

Retirement

Health Problems

Social isolation leads to increased risk of depressive symptoms, suicidal ideation, and cognitive decline

Loneliness is as a discrepancy between one's desired and achieved levels of social interaction and is subjective and usually temporary

Isolation-lacks a sense of belonging, minimal social contact or fulfilling relationships

Self-Determination Theory

Family Issues Familial issues are important in the progress of depression within older adults.

During periods of financial or psychological hardships specifically, strong family relationships have been reported as being an important source of support (Daig et al., 2009 and Sun et al. 2007). Studies have shown that satisfaction of the outcome of one's life decreases the symptoms of depression. Not only is it important to have strong bonds with family members, but relationships with friends are just as important as well. Reports have shown that as adults tend to age, their social life diminishes due to factors such as; outliving their family and/or friends, damaged relationships, or just time related separation. By the time these adults age and can no longer travel like they once could, they become isolated from people and the world around them. This, in short, causes loneliness which allows depression to progress. Most cases of depression derive from the abandonment older adults face when placed in a personal care home or retirement center away from their loved ones where family members often forget about them; minimal calls and little to no visits. Another factor of depression in late adulthood is the perceived outcome of the person's life; if one feels that he/she has not accomplished much or hardly anything throughout their lifetime then they begin to experience depressive symptoms as well. 

Cultural Issues

“Age is a social construct and the experience of growing old is culturally mitigated”

The older adult should not be expected to socially disengage

Collectivistic versus Individualistic cultures

Ethical Considerations

Social Justice: As social workers, we must realize the social injustices placed upon those suffering from depression in late adulthood and advocate for a change. We cannot continue to sweep this population under the rug as we go on about our lives. It would mean a lot to even volunteer different places just to be the joy of a person's day or to set up programs where others have that option to visit the older adults in nursing homes suffering from depression.

Competence: It is always pertinent to be competent of any group you decide to work with. Understand the issues and limitations (if any) of not just the group as a whole, but most importantly the individual themselves because no two people are alike. Tweak the solution to match that of the person. 

Dignity and worth of the person: Always remind the client that they are in charge of their life. Empower them so that you can then encourage them to make the change for themselves. Let them know that they are capable of defeating their shortcomings. 

Importance of human relationships: When working with persons suffering from depression, one must acknowledge the importance of human relations and the interaction between others. This will allow the client to build some sort of rapport with others which would help to build a support system for them. 

Practice Recommendations

In order to decrease the amount of depression within the late adulthood population it is highly recommended that one correctly diagnose a patient with depression by relying on a combination of data and evidence from a person with clinical experience or someone who may deal directly with the patient who would notice a change in their behavior. It would also be beneficial to request an evaluation of the patient (for accuracy). Most importantly, just make sure the patient's needs are being met; physical, spiritual, emotional, and mental. Become knowledgeable of the person so that you can be able to distinguish "sad" from an ultimate change in character.  

REFLECTIONS

Conclusions

Symptoms of depression harder to recognize in old age; remain knowledgeable

Old age and disengagement is a construct of culture

Older adults should remain physically and socially active to prevent depression

It is not always social isolation that causes depression, but the depression that can lead to isolation

Older adult population has the highest rates of suicide

In future practice, learn to recognize changes in behavior and character to prevent depression