Family Science Specialist Jane Strommen PhD Extension Gerontology Specialist Divya Saxena MS Extension Associate Lesson Objectives Understand key issues relating to depression anxiety and suicide in later life ID: 931753
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Slide1
Sean Brotherson,
Ph.D.
Extension Family Science SpecialistJane Strommen, Ph.D.Extension Gerontology SpecialistDivya Saxena, M.S.Extension Associate
Slide2Lesson Objectives
Understand key issues relating to depression,
anxiety and suicide in later lifeLearn about signs of depression and related mental health concerns in later life
Explore specific strategies for managing
depression or related issues in later life
Gain knowledge of specific resources to
deal
with depression and related concerns in
later life
Educate the community about geriatric mental health
Understanding Depression in Later Life 2
Slide3True or False?
Depression only develops when someone has had a major traumatic experience in life, such as the death of a spouse or a heart attack
. Understanding Depression in Later Life 3
Slide4Answer -
False
MythDepression occurs only when people experience major trauma in life.RealityDepression is a commonly occurring mental health condition that may arise due to a variety of factors, including genetic influences, body changes, life
stress, personal losses or other influences.
Understanding Depression in Later Life 4
Slide5True or False?
Individuals dealing with depression usually can overcome it if they just work to cheer themselves up or pull themselves up by their bootstraps.
Understanding Depression in Later Life 5
Slide6Answer -
False
Myth
Depression can be overcome simply by telling yourself to feel better or pulling yourself up alone
.
Reality
Depression is a complex medical and mental health condition that typically improves with a variety of approaches, which may include therapeutic support, social support, exercise, diet, rest and medication
.
Understanding Depression in Later Life 6
Slide7True or False?
Seeking assistance from a doctor or mental health professional for depression is a sign of inability to handle your problems or personal weakness.
Understanding Depression in Later Life 7
Slide8Answer -
False
MythIndividuals dealing with depression are emotionally weak or unstable and seeking help is a sign of weakness.
Reality
Depression is a condition that anyone can experience. Seeking assistance from competent professionals often is necessary and signals wisdom, understanding and strength
.
Understanding Depression in Later Life 8
Slide9Can cause problems with thoughts, feelings and behavior
Causes physical difficulty, emotional fatigue and mental anxiety
Can be treated effectively when diagnosedIs everyone’s responsibility
Depression in Later Life
Understanding Depression in Later Life 9
Slide10Who is at risk for depression?
Aging community members who:
Live aloneAre economically disadvantagedHave no relatives or friends nearbyHave experienced recent losses (job, pets, friends, family members, moves, etc.)
Have been ill or have a progressive or chronic illness
Have personal experience or a family history of anxiety or depression
Have undergone significant challenges with family stress, economic stress or other concerns
Slide11What is depression?
Definition:
A mental health condition characterized by an inability to concentrate; insomnia; loss of appetite; physical tiredness or fatigue; feelings of extreme sadness, guilt, helplessness and hopelessness; and thoughts of despair, discouragement and death. Also called clinical depression. Prevalence: 3.8 percent of people over age 55 residing independently in the community suffer from major depression in any given year. (www.surgeongeneral.gov)
Understanding Depression in Later Life 11
Slide12Symptoms of Depression
Difficulty falling asleep
Sleep more than usualFeel tired all the timeFeel less energetic than usual
Feel nervous or unable
to sit still
Experience an increase
or decrease in appetite or weight
Feel sad or blue most of the day nearly every day
Have trouble making decisions
Think about suicide
Have problems concentrating
Irritability
Lack motivation
Lose his or her temper more easily than usual
Lose interest in things that he or she used to enjoy
Understanding Depression in Later Life 12
Slide13Risk Factors for Depression
Family history of:
Recurrent depression Bipolar disorder Mental health issues
Alcohol abuse or dependence
(www.positiveaging.org)
Social isolation
Personal history of:
Chronic medical illnesses
Chronic pain
Loss of physical functioning
Prior depressive episodes
Reliving bad past experiences
Recent significant loss
Multiple recent stressors
Understanding Depression in Later Life 13
Slide14Anxiety
Often Goes Along With Depression
Understanding Depression in Later Life 14
Slide15Anxiety
Definition:
Anxiety issues represent a mental health condition involving the presence of anxiety so intense or frequently present that it causes difficulty or distress for the individual. Prevalence: 11.4 percent of the population over age 55 suffers from an anxiety disorder in any given year.(U.S. Department of Health and Human Services)Understanding Depression in Later Life 15
Slide16Racing heartbeat, chest discomfort
Shortness of breath or the feeling of being smothered
Numbness or tingling of hands, mouth or feet Dry mouth, sensation of a lump in the throat, choking sensation, clammy hands, sweatingExcess or undue
worry or fear
Fatigue
Disturbed sleep
Jumpiness, jitteriness, trembling
Muscle aches, tension
Dizziness, lightheadedness
Gastrointestinal upset
Symptoms of Anxiety
Understanding Depression in Later Life 16
Slide17Family
history of:
Alcohol abuse Anxiety disorders Mood disordersOther factors: Female gender
Exposure to traumatic event (
www.positiveaging.
org)
Risk Factors for Anxiety
Personal history of:
Depression
Anxiety disorder
Chronic medical illness
Loss of significant person during childhood
Cognitive impairment
Alcohol abuse/dependence
Social isolation
Understanding Depression in Later Life 17
Slide18Grief
, Loss and
Depression
www.youtube.com/watch?v=_
thfjbAtTT8
Understanding Depression in Later Life 18
Slide19Older
Adults Experience Many Losses
Living situation
Relationship
Identity/status
Health
Finances
Independence
Mobility
Understanding Depression in Later Life 19
Slide20Stages of Grief
Denial, numbness, shock
BargainingAngerDepression
Acceptance
Grief vs. Depression
Loss of appetite
Loss of interest in everyday tasks
Loss of sleep or sleeping too much
Physical complaints
Sadness, tearful
Anxiety
Anger, irritability
Understanding Depression in Later Life 20
Slide21Is it grief or depression?
Depression
Typically, depressive symptoms will not resolve without some kind of intervention
.
Grief
Intense feelings generally begin to lessen three to six months after the loss.
Timelines are very individual and depend on many factors.
Integrating loss into normal life can take one to two years
.
Understanding Depression in Later Life 21
Slide22Suicide
Research consistently has shown a strong link between suicide and depression
.
Understanding Depression in Later Life 22
Slide23Suicide and
Older Men
White
men 85 and older are more likely to commit suicide than Americans in any other age group, taking their lives at twice the rate of the 15- to 24-year-old group
.
Suicidal behavior in older men can be a reaction to a perceived loss of social status.
Suicide may be linked to loss of impulse control.
Understanding Depression in Later Life 23
Slide24Suicide
and the Older Adult
Watch for These Signs
Withdrawal
from activities they ordinarily enjoy
Negative thoughts, including frequent talk about death
Strong feelings of guilt
Decline in hygiene or
appearance
Stockpiling medication
Understanding Depression in Later Life 24
Slide25At risk for suicide?
Call for help
:FirstLink has a 24-hour Suicide Lifeline,
1-800-273-TALK (8255), which is connected
to
a national network of crisis services. Call
specialists help those who are having thoughts of suicide
or have
a concern about someone.
Seek help:
Go to
the nearest
emergency room for evaluation
Go to
:
www.suicidepreventionlifeline.org
Understanding Depression in Later Life 25
Slide26Depression:
What should I look for?Physical AppearanceDirty clothing, skin or hairBody odor, unshaven, hair uncombed
Little attention to clothing worn,
appearanceSignificant weight loss or weight gain
Fatigue or exhaustion from lack of sleep, despair, etc.
www.nursing.uiowa.edu/hartford/nurse/Gatekeeper1.pdf
Understanding Depression in Later Life 26
Slide27Emotional State
Anxious, nervous, fidgety
Lack of trust, suspiciousness, blamingAngry, hostile, irritableRapid mood changesStatements such as “no one cares” or “I’m all alone”
Sense of discouragement, lack of hope, helplessness
www.nursing.uiowa.edu/hartford/nurse/Gatekeeper1.pdf
Understanding Depression in Later Life 27
Depression:
What
should I look for?
Slide28Personality Change
The person’s usual character or personality may seem different than in earlier
years:Decreased social contacts, isolation from othersSloppy appearance, lack of care for surroundingsLack of eye contact, limited social engagementPreoccupation with health concerns, losses, life challenges or sadness
Lack of interest in hobbies, friends
or things the person formerly enjoyedDifficulty making
decisions
Understanding Depression in Later Life 28
www.nursing.uiowa.edu/hartford/nurse/Gatekeeper1.pdf
Depression:
What
should I look for?
Slide29Living Conditions
Walks not shoveled, lawn not mowed
Neglect of pets, farm animals or family membersLittle or no foodOld newspapers, mail or dirty dishes lying around; limited care of surroundings
Calendar on wrong
month; little attention to time
Shades drawn, garden/flowers neglected;
signs of isolationwww.nursing.uiowa.edu/hartford/nurse/Gatekeeper1.pdf
Understanding Depression in Later Life 29
Depression:
What
should I look for?
Slide30Key Help Factors in Managing Depression
Seek effective medical care or sources of support and treatment
Identify and increase support from family and community membersHave a regular support checkup (weekly, etc.) Understanding Depression in Later Life 30
Slide31Key Help Factors in Managing Depression
Focus on healthy living practices
Increase personal skills in stress managementExplore cultural and religious beliefs that encourage hope, optimism and personal support efforts
Understanding Depression in Later Life 31
Slide32Seeking Treatment and Support for Depression
Focus on getting help and getting better, not on being embarrassed due to depression or anxiety.
Start with your personal doctor.Begin by seeking an opportunity for a medical screening,
T
alk to a trusted counselor, pastor or friend.
Understanding Depression in Later Life 32
Slide33Barriers to Diagnosis and Treatment
Age-related changes
Illness
Attitudes of others
Denial
Health complaints
Alcohol or drug use
Stigma
Understanding Depression in Later Life 33
Slide34What can I do to help?
Avoid
talking to the person if he/she is upset.
Be gentle and kind.
Avoid a confrontational style.
Avoid using labels.
Use
age- and
ability-appropriate
language.
Understanding Depression in Later Life 34
Slide35Be
consistent and patient in your expression of concern.
Be direct in your approach
.
Exhibit a nonjudgmental attitude.
Give
specific examples of behaviors that concern you.
Use
statements such as
“
I am concerned about
you
.”
What can I do to help?
Understanding Depression in Later Life 35
Slide36What can I do to help?
Be
prepared with referral information.
Don’t be discouraged if the person is not ready to accept your assistance.
Don’t worry if you
don’t
say things
perfectly
.
Encourage the
person to
get proper
professional
assistance
from
a primary-care
doctor.
Understanding Depression in Later Life 36
Slide37Where to get help?
Visit your
doctor.
Seek counseling with a mental health professional.
Call 2-1-1 for
confidential
listening
and support,
in addition
to
information and
referral. Call
specialists
are
trained in crisis
intervention
, including
suicide
intervention
.
Understanding Depression in Later Life 37