Helping Seniors with Depression
Advice for families and caregivers
Depression is a significant problem among the elderly. Seniors at highest risk for depression are those dealing with illness, the loss of their support system, anxiety over various issues, and/or a sense that they no longer have a purpose in life. It's estimated that 6 million adults over 65 are depressed, but that only 10 percent of them receive treatment for it.
Q: My parent has been depressed since being diagnosed with diabetes. How can I help?
A: Many diabetics suffer from untreated depression.
- Consider having your parent evaluated for depression, which could interfere with compliance with any doctor's orders and with getting well.
- People who have been newly diagnosed with diabetes have a lot to learn. Encourage your parent to focus on problem-solving and what can be done to improve the situation.
- Suggest that he or she start small and then build on the changes being made.
- Reassure your parent that it will be possible to get control over his or her health, but that it will be an ongoing process and will require practice.
- Support groups could be very helpful during this adjustment period, and beyond.
- Participation in a local hospital's diabetes clinic -- one that educates about the disease and teaches how to monitor glucose levels -- could also be beneficial.
Q: My parent has been depressed since being diagnosed with Parkinson's. How can I help?
A: Depression is a frequent reaction to the diagnosis of Parkinson's. Here are some things you can do:
- Remind your parent that he or she could still have many years of good functioning.
- Also, encourage your parent to exercise, as exercise helps to lift a person's spirits, giving a sense of control over one's body.
- Exercises recommended by a physical or occupational therapist specially trained in Parkinson's disease can help minimize the effect of Parkinson's by keeping muscles limber.
- Even if your parent refuses to exercise, treating the depression may help improve the quality of the rest of his or her life and ultimately enable your parent to more actively participate in disease management.
- Finally, your parent may benefit from joining a support group. To find or create a support group in your area, call The National Parkinson's Foundation at 1-800-327-4545 ext. 7697. Each group decides how often to meet, ranging from once a week to once a month.
Q: My parent has become depressed since having had a stroke. How can I help?
A: Frustration is to be expected. Empathize with the frustration, but calmly refocus on small goals ahead.
Depression is common in stroke patients. It's important to discuss the depression with your parent's doctor and the rehabilitation staff and to treat it so that it won't impede rehabilitation.
Some stroke patients have found that the regular practice of relaxation techniques has helped them manage their frustration and anxiety while going through rehabilitation.
And some, when they are recovered enough to participate, find attending support groups helpful. For more information on support groups for stroke patients, go to: my.americanheart.org or strokeassociation.org.
Q: My visits with my parent who has Alzheimer's are depressing? How can I make them better?
A: Here are some strategies to have a better visit:
- Try to keep the mood upbeat.
- Maintain a friendly, positive tone. Avoid anger or irritation, which can upset the patient.
- Focus on topics of interest to your parent, like lunch or sports or the weather, as he or she may often do better on those subjects. Avoid more abstract topics, like politics.
- Avoid open-ended questions, which can be overwhelming. Instead ask yes or no questions.
- If you find yourself getting frustrated by repetition of a question, calmly redirect the conversation to a different topic.
- If you believe your parent might be depressed -- a common reaction in Alzheimer's patients who are aware of their diminishing abilities and often feel anxious about them -- have your parent evaluated and, if needed, treated for the depression.
- If you are depressed, a normal and understandable reaction to seeing a parent who has become impaired, seek treatment for your depression. Caregivers often feel overwhelmed and need to learn to carve out some time for themselves, as difficult as it may seem.
How can I help my parent cope with hair loss due to chemotherapy?A: If your parent is traumatized by hair loss:
- Empathize, and don't minimize. Even though this symptom is not as debilitating as, say, nausea, it is very public and distressing. Don't rush your parent into thinking about wigs and hats. Let him or her focus as long as needed on the unwished-for change.
- When your parent is ready, help him or her find wigs, hats, eyebrows and/or eyelashes that make your parent feel more comfortable with him- or herself again. Support your parent's search for the right look. The hair loss may reinforce your parent's sense of loss of control due to aging in general, and feeling okay about appearance can help your parent feel more in control. Some websites that may be helpful are: Headcovers Unlimited and breastcancer.org.
- If your parent expresses shame or discomfort for being upset about something as trivial or superficial as appearance, let him or her know that the reaction is totally understandable.
- If your parent is reluctant to be seen in public with this evidence of illness, help him or her come up with a response to use if someone comments on it.
- If your parent is depressed due to the hair loss, find someone to talk to who has experienced the same thing, and see if this helps. Some people, if they can summon the energy to do so, find that exercise improves their sense of well-being, which helps their mood and therefore helps combat depression. If this doesn't help, find a professional to treat your parent's depression.
- Suggest, but don't insist, that your parent join a cancer support group, which many patients find helpful. Some support groups share their experiences and feelings, while others do activities like yoga or guided meditation. Support groups can be found at your local hospital, or online at cancer.org. Find one that fits your parent's personality and preferences.
- Many people find talking with a clergy person to be helpful.
Q: My parent has been depressed since beginning chemotherapy. How can I help?
A: Here are some helpful responses:
- Offer emotional support.
- Listen with compassion, without judging.
- If your parent is concerned that his or her remaining quality of life will be poor, validate those concerns, but let your parent know that together you'll make the most of the remaining time, that you'll be there with him or her. This will be especially necessary if your parent has experienced loss of a support system -- perhaps due to death or a move.
- Offer hope.
- Talk with your parent's doctor about the possibility of medication-induced depression.
- Help your parent get professional treatment for the depression.
- If your parent has enough energy, encourage him or her to do some amount of exercise, which helps lift a person's spirits.
- Suggest, but don't insist, that your parent join a cancer support group, which many patients find helpful. Some support groups share their experiences and feelings, while others do activities like yoga or guided meditation. Support groups can be found at your local hospital, or online at cancer.org. Find one that fits your parent's personality and preferences. For those who have neuropathy, there is a specific support group at neuropathy.org.
- Many people find talking with a clergy person to be helpful.
Q: My parent has been depressed since breaking a hip. How can I help?
A: Elders who break their hips can feel that the situation is the beginning of the end and that they will become increasingly frail and incapacitated. Empathize with your parent's feelings. Don't minimize the situation, but remind your parent that it is temporary and that he or she will gradually become more fully mobile. If your parent continues to feel depressed, tell the doctor and make sure the depression gets treated and starts to improve. Also, any exercise that your parent is able to do will help improve his or her mood.
Q: My parent is depressed over her low-fat, low-salt diet since having a heart attack. What can I do?
A: Your parent needs to learn to enjoy eating different kinds of foods, and that may take time. You can search for low-fat recipes on the internet or purchase a low-fat cookbook for your parent. Encourage him or her to try using different fresh spices to add flavor to food to compensate for the lack of salt. Some popular options are cilantro, ginger, or thyme, each of which can make a big difference.
Give your parent time. Depression is a normal response to a heart attack, but if you find that your parent is depressed, hopeless, has low self-esteem, and cries easily after a few months, he or she should seek treatment for the depression. Many post-heart attack patients benefit from support groups. Contact your doctor, hospital or American Heart Association's Mended Hearts program to find one in your area, or email: firstname.lastname@example.org, or call: 1-888-HEART99 (1-888-432-7899). The AHA can arrange for a visit from someone who has experienced heart disease if the patient prefers that.
Q: My parent who has pneumonia worries that she'll never get better. What can I do that will help?
A: Feeling weak and ill can be depressing. Reassure your parent that he or she should get better soon. Make sure your parent is eating enough to get his or her energy back. Nutritious soups -- such as chicken or lentil soup -- which supply fluids, vitamins and protein may be helpful. But if your parent doesn't recover as soon as expected, speak with the doctor about trying another treatment. And talk to the doctor about the fact that your parent seems depressed to see if treatment is recommended.
Q: My parent is very depressed about the changes in his life due to vision loss. How can I help?
A: Your parent will have to mourn the loss of that life and gradually come to terms with his or her new life. You can:
- Encourage your parent to join a support group, where others in the same situation share their feelings about and strategies to cope with vision loss.
- Encourage your parent to participate in vision rehabilitation programs, and then accompany him or her to some. This will enable you to learn what your parent can do independently and enable you to support his or her successes.
- Encourage your parent to get counseling from someone trained to deal with vision issues, either individually or in a group setting.
Q: Going through radiation therapy has left my parent depressed. How can I help?
A: Depression during treatment is quite common, perhaps from the exhaustion that accompanies radiation, from other side effects, or from worries about future quality of life. Here's what you can do:
- Reassure your parent that the side effects will disappear within a few weeks of treatment, but also tell his or her doctor that he is depressed. Treating the depression may help your parent's recovery from the radiation.
- If your parent can summon enough energy to exercise, it could help lift his or her spirits a bit.
- Some people benefit from joining a support group for people dealing with cancer or with their particular form of cancer. Some support groups share their experiences and feelings, while others do activities like yoga or guided meditation. Support groups can be found at your local hospital, or online at cancer.org. Find one that fits your parent's personality and preferences.
- Many people find talking with a clergy person to be helpful.
Q: My parent is depressed about breathing issues. How can I help?
A:Encourage your parent to join a support group for others dealing with the same or similar issues. The American Lung Association runs Better Breathers, support groups for those with chronic lung disease that both educate and offer opportunities to share experiences. To find out more, go to lungusa.org or call 1-800-LUNG-USA. Other groups might be run at your local hospital. If your parent tries this and is still depressed, encourage him or her to get treated for depression, and make sure that the treatment is working. Having difficulty breathing is exhausting, anxiety-provoking and understandably depressing.
Q: How can I find a caregiver for my depressed parent?
A: Care.com is a website that lists people throughout the United States who provide care to seniors, includes photos and descriptions of their experience, and does free background checks for members. You can search by zip code. For specific listings, go to: Care.com.