depression in the elderly
TRANSCRIPT
Depression in the Elderly
Katie Brandner
Depression is not a normal symptomof aging.
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OT practitioners are in a unique position to
Treat,Identify,
andPrevent
Depression in an elderly client
WHAT IS DEPRESSION?Depression is defined as “clinically significant distress or impairment in social, occupational, or other important areas of function.
Major depression is characterized by
• A change in mood or sleeping or eating habits
• Low energy or fatigue
• Reduced concentration
• Feelings of worthlessness or excessive guilt
• Thoughts of death or suicide
(American Psychiatric Association, 2013)
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According to the CDC, older adults are more at risk of experiencing depression because • 80% of older adults have at least one chronic health condition.
• 50% have two or more chronic health conditions
Depression is more common in people who have• Other illnesses• Limited function
How many older adults have depression?
• 1%-5% of older people living in a community
• 13.5% of older people who require home health
• 11.5% of hospital patients
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(CDC, 2015)
•OT plays a big part in home health and hospitals•Often depression in the elderly client is unrecognized and untreated•Knowing how to identify depression is an important tool
How do you identify depression in an elderly client?
• Feeling sad or "empty"
• Feeling hopeless
• Irritable
• Anxious
• Guilty
• Loss of interest in favorite activities
• Feeling very tired
According to the National Institute of Mental Health, many of the usual symptoms of depression may be seen in an elderly client with depression. These symptoms can be:
• Not being able to concentrate or remember details
• Not being able to sleep or sleeping too much
• Overeating or not wanting to eat at all
• Thoughts of suicide• Suicide attempts• Aches or pains, headaches, cramps, or digestive problems
Often symptoms of depression in the elderly are mistaken for an illness or for "normal signs of aging”. These symptoms can include:• Fatigue• Appetite loss• Trouble sleeping(National Library of Medicine, 2015)
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There are many ways in which the OT practitioner, the healthcare team, and the client can work together to help the client treat and manage their depression.
How is depression treated?
Depression is a treatable condition.
Ways to treat it are:
• Medication
• Psychotherapy
• Electroconvulsive therapy
(National Library of Medicine)Image Credit: http://www.gracepointwellness.org/images/root/carrietherapysession2.jpg
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Before treatment begins the doctor must rule out other factors that may be causing the symptoms like:• Medications• Illness
Depression is not cured overnight.
While in treatment it’s important to implement depression management strategies such as:• Getting regular exercise• Learning good sleep habits• Avoiding drugs and alcohol• Talking about your feelings with someone you trust
• Surrounding yourself with positive people
• Doing fun and meaningful activities• Taking your prescribed medications correctly
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How do you treat depression from an OT perspective?
First understand that depression changes how the client behaves and chooses their occupations.
As an OT practitioner• If you see symptoms of depression, let their doctor know or encourage them to see their doctor to be evaluated.
• While being treated for depression, help your client manage their depression by working on meaningful occupations and pleasurable activities.
Common reasons to choose the activities they continue are: • Deeply established habits and commitments
• Gratifying activities• Friends and family initiated tasks
• Volitional need to keep doing activities
• Distraction from their depression• As way to hide their depression from friends and family
(Leibold, M. L., Holm, M. B., Raina, K. D., Reynolds, C. F., III., & Rogers, J. C., 2014)
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How is depression prevented?There is no surefire way to prevent depression.
Some strategies help. These include:• Stress management• Reaching out to family and friends• Getting treatment for depression as soon as symptoms present
• Getting long term treatment for depression to prevent a reoccurrence of depression
(Mayo Clinic)
• The elderly population is vulnerable to depression
• As an OT practitioner you need to be on the lookout for symptoms
• The earlier that depression is treated and managed, the better!
Common triggering events for symptoms of depression in the elderly:• A move from home, such as to a retirement facility• Chronic illness or pain• Children moving away• Spouse or close friends passing away• Loss of independenceDepression can also be related to a physical illness, such as:• Thyroid disorders• Parkinson’s disease• Heart disease• Cancer• Stroke• Dementia(National Library of Medicine)
What do you do if you see signs of depression?
As an OT practitioner if you see signs of depression you should tell your client to visit their doctor for an evaluation.
You should also start implementing depression management strategies such as:• Having the client choose meaningful activities and occupations
• Have the client choose occupations that are pleasurable and rewarding
http://about.lsnc.net/files/2013/03/Grandmother_holding_her_grandd.jpg
Key concepts• As OT practitioners it is important for us to identify, treat, and prevent depression in our elderly clients.
• Depression is not a normal sign of aging• If the OT practitioner, the healthcare team, and the client work together, depression can be identified, treated, and possibly even prevented in an elderly client
ReferencesAmerican Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.Depression is Not a Normal Part of Growing Older. (CENTER FOR DISEASE CONTROL) (2015, March 5). Retrieved May 17, 2015, from http://www.cdc.gov/aging/mentalhealth/depression.htmDepression - older adults: MedlinePlus Medical Encyclopedia. (n.d.). (NATIONAL LIBRARY OF MEDICINE) Retrieved May 17, 2015, from http://www.nlm.nih.gov/medlineplus/ency/article/001521.htmDepression (major depressive disorder). (n.d.). (MAYO CLINIC)Retrieved May 18, 2015, from http://www.mayoclinic.org/diseases-conditions/depression/basics/prevention/con-20032977Depression Measurement Instruments. (2013). In (The encyclopedia of elder care): The comprehensive resource on geriatric health and social care. New York, NY: Springer Publishing Company. Retrieved from http://ezproxy.greenriver.edu:2048/login?qurl=http%3A%2F%2Fsearch.credoreference.com.ezproxy.greenriver.edu%2Fcontent%2Fentry%2Fspenelderc%2Fdepression_measurement_instruments%2F0Leibold, M. L., Holm, M. B., Raina, K. D., Reynolds, Charles F., I.,II, & Rogers, J. C. (2014). Activities and adaptation in late-life depression: A qualitative study. The American Journal of Occupational Therapy, 68(5), 570-7. Retrieved from http://ezproxy.greenriver.edu:2048/login?url=http://search.proquest.com/docview/1563107686?accountid=1558Older Adults and Depression. (n.d.). (NATIONAL INSTITUTE OF MENTAL HEALTH)Retrieved May 18, 2015, from http://www.nimh.nih.gov/health/publications/older-adults-and-depression/index.shtml#pub4
Any Questions?