Depression in Older Person
Depression is one of the most common disorders that affect the elderly. If left untreated, it can result in poorer health outcomes and increased mortality rates. This is because the disorder tends to increase the risk of attack by other diseases and disorders and also reduces the person’s ability to undergo successful rehabilitation. Apart from being linked with diseases, depression is also associated with high incidences of suicide among the elderly (Gunn, et al, 2012). The leading risk factors of depression in older persons include stressful life events, being widowed or divorced and a lack of supportive social network (Goldney, Eckert, Hawthorne & Taylor, 2010). With reference to practice implications and innovations, this paper will address both the patient’s and carers’ perspective on depression in older persons.
Depression in Older Person
Depression is a medical condition and falls in the nursing domain. This is more so due to its associated implication on the general body health. Like other disorders, depression is examined by considering elements such as genetics, aetiology, treatment and prevention. However, the phenomenon that is depression remains largely mysterious and more research needs to be done on the same to comprehensively address its myriad deleterious effects. From the patient’s perspective, the very basic knowledge about depressive disorders is still lacking. Many trials have been made and psychotherapy processes advanced but still many older patients do not have the knowledge on how to cope with the challenges associated with depression. Most patients have problems and doubts in whether the treatment methods employed upon them can really work. Other patients fear the negative responses from the surrounding environment and lack the idea on how well to deal with these problems. Another major challenges the patients encounter is where to get the treatment (Hawthorne, Goldne & Taylor, 2008). The practitioners need to understand the perspectives of the patients and the challenges they go through kin trying to overcome depression. The implications of their practice could offer the required remedy to the patients. Apart from concentrating on prescribing the medications for depression only, more focus should be accorded to the psychological component of the treatment as well as the preventive interventions to reduce the incidences and deterioration of a patient’s condition (Jorm, Christensen & Griffiths, 2005).
A deeper understanding is necessary in the nursing practice to understand the deeper intrigues of the disorder from the patient’s perspective. This could help in developing the remedy to the patient in a more comprehensive approach. The older patients suffer more psychologically as they deem themselves helpless and also may tend to perceive themselves as bothers to others. This may explain the reason why the number of suicides among the depressed is higher in older patients than in younger patients. Innovations need to be included in the treatment protocol to ensure that the medical experts understand more of the older depression patient goes through in his/her daily life. Elements that would require consideration in such an analysis could include what it entails to live with depression, the challenges associated with depression, how the patient relates with the relatives or carers and the side effects of the medications among others. With such information the patient treatment process can be accomplished more successfully reducing effectively the burden associated with depressive disorders (Reavley & Jorm, 2011).
The patient plays a major role in the treatment process and as such more focus should be directed to him/her. The biggest challenge is that many patients do not seek treatment and therefore this result in a large economic and disease burden on disorder that is avoidable. From the patient’s perspective, it is evident that several reasons could be behind their apparent lack of seeking medical attention. These include stigma, wrong perception about the workability of the medication, financial reasons or outright ignorance of their condition. Still from the patient’s perspective, it is clear that a major problem is the unavailability of adequate information concerning mainly the nature, causes, symptoms of depression and how to cope with stigma and other problems associated with depression. The therapists should share as much information as possible with the elderly patients to help them in recovery (Walker, Luszcz, Gerstorf & Hoppmann, 2011).
The relatives or carers of a depressed older person go through challenges both emotional and physical. Taking care of the elderly can be a difficult task as it involves many emotional issues. For relatives of an elderly person to detect depression in them, they should look out for signs such as boredom, loneliness, poor coping skills, stress and loneliness, loss of appetite and low self esteem (Buys, Roberto, Miller & Blieszner, 2008). Approaching such a patient requires stating to the patient that what they are suffering from is a medical condition that can be treated because referring to it as a mental health problem could attract an unwelcome reaction. They ought to make it clear that the disorder is beyond the person’s control or determination and therefore the affected person needs to seek professional help. By the relatives encouraging the elderly person to seek treatment could be beneficial. This entails making the person understand that if they fail to seek the medical attention, they could suffer more serious illnesses or even become disabled. Such an approach could induce in the elderly person the desire to seek medical attention (Lee & LoGiudice, 2012).
In the nursing practice dealing with depression among the elderly requires assessment parameters that will inform the care protocol to be followed in treatment. One of the most important assessment parameters is identifying the risk factors that range from social isolation, alcohol and drug abuse, functional disability and medical comorbidity. Innovations in the assessment should be integrated to enable accurate results be found. Using a standardized screening tool helps to gauge the level of depression in the patient which can be used to make comparison with other handled cases and hence give a more informed direction in treatment procedure. This should be followed by documenting of results noting all elements and symptoms displayed by the patients. Noting details such as onset of the symptoms and duration is also vital in assessment (Hunter & Levett-Jones, 2010). Assessment protocol should also encompass a review of the past medical history of the patient and also run physical examinations to determine the current status of the patient. The medical history should involve observations on whether the patient has been previously on medications that could predispose him/her to depressive disorders such as steroids, antipsychotics, benzodiazepines, immunosuppressive drugs and any other cytotoxic agents (Atlantis, Browning, Sims & Kendig, 2010). Another component to analyse is related metabolic processes that may make one susceptible to depression or that which may complicate the treatment regime such as kidney failure and hypoglycaemia. The cognitive functionality of the individual and the functional ability are other important parameters to assess (Hunter, Ward & Camp, 2012).
If assessment confirms a depression case in the elderly patient, a management protocol should be instituted immediately. The nursing practice has a great role to play in ensuring that the patient recovers from the disorder. One major ways is by involving the relatives and or/ care takers to ensure they understand the signs to observe in determining the progress of the patient. This will also keep them prepared so as to counter any suicidal tendencies; a common problem with many elderly depression patients (Sarris, Goncalves, Wahlin & Byrne, 2011). All etiologic agents should also be removed and/or controlled as well as reduction or removal of depressogenic medications that the patient may be taking (Lenore & Theresa, 2008).
The relatives ought to monitor and enhance nutritional and physical demands of the patient if the patient is undergoing home based care. Social support is also necessary to the patient’s recovery. Encouraging autonomy and increased participation is also beneficial for the emotional wellbeing of the patient. The relatives need to emphasize on the information given to the patient by the therapist to aid in quick recovery and resumption to normalcy (Richmond, Law & Kay-Lambkin, 2011).
Depression in older persons is a common incidence due to the myriad challenges they encounter ranging from emotional to physical to social. Since the disorder is treatable, the nursing practice implications on the healing process are instrumental on whether the patient regains normalcy or not. As such, innovations are highly encouraged depending on the status of the patient to help them recover as quickly as possible. The patient’s perspective and that of the care taker also has a great impact in the recovery process and their input should be given adequate consideration.
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