Recognizing Depression in Assisted Living

Depression is a major concern for anyone in an assisted living facility. Too often, the symptoms of depression are dismissed as part of the aging process, misdiagnosed as cognitive decline, or thought of as a character flaw or weakness instead of the serious medical condition it really is. Most assisted living facilities focus on the more immediately obvious physical issues and neglect their residents’ mental health. One study found that assisted living staff couldn’t be relied on to detect the symptoms of depression, so it is absolutely vital that both you and your loved ones all know the signs and symptoms, and don’t hesitate to seek help when needed.

According to one source, depression ranks among the top five most common chronic conditions among assisted living residents. Not only does depression decrease the afflicted person’s quality of life, it increases the risk of other chronic medical problems, cognitive decline, and social withdrawal. Residents suffering from depression are also more likely to be moved to nursing homes. Depression can even lead to death when it exacerbates another illness, or it becomes severe enough on its own to drive someone to suicide.

Signs and Symptoms of Depression

The most common symptoms of depression include:

• Feeling tired, helpless, hopeless, worthless, or guilty
• Feeling “empty” or “numb”
• Persistent feelings of restlessness or anxiousness
• Losing interest in things that were once enjoyable
• Trouble working, eating, sleeping, and generally functioning
• Lethargy
• Insomnia, oversleeping, or waking up too early
• Difficulty concentrating, remembering, or making decisions
• Aches, pains, headaches, cramps, and/or digestive problems without a clear cause, that don’t ease with treatment

Depression is not grief. Grief is a natural reaction to change and loss; a healthy person can mourn and move on. Depression, by contrast, is persistent and if left untreated, it can last from months, to years, to a lifetime.

In assisted living, depression has correlations with the length of residence, the amount of help needed with daily living activities such as eating and bathing, lower participation in organized activities, and more time spent in bed.

If your loved one is suffering from depression, you should also know the warning signs of a possible suicidal attempt. These include talking about wanting to die, mood swings, a preoccupation with death or violence, risky or self-destructive behavior, and giving away belongings or getting affairs in order when there is no other logical reason.

How to Help a Loved One with Depression

First, be sure to know the symptoms and watch for them. Most assisted living facilities, especially smaller ones, won’t be keeping a very good eye out, so it falls to you.

If you’re concerned that a loved one might be depressed, reach out to them. Tell them your concerns, explain why you’re worried, and offer your support. You may also recommend they seek help from a medical doctor or mental health provider, or even help them prepare a list of questions for visiting a doctor.

It is absolutely critical that your loved one understands that depression is a serious medical condition. It is not a natural part of aging, it is not always tied to dementia, it is not a character weakness, it is not something to be ashamed of, and it is very difficult to recover from without professional help.

After the initial conversation, continued support is vital. Talk to your loved one often. If they come to you for emotional support, hold back your advice and opinions unless they are specifically asked for, and focus entirely on listening. Make plans with your loved one, and go do something they used to enjoy. Don’t overexert yourself caring for a depressed relative; your own self-care is just as important, since you can’t effectively help anyone if you’re burnt out or worn down. Above all else, be patient. Depression is a long-term illness, and it takes a long time to recover.

If you see any signs of suicidal behavior, tell your loved one about what you’ve noticed, and ask them if they’ve been considering suicide. If they say they have, ask if they have a plan. Considering suicide is a very severe symptom of depression, but it is something that can be treated with time, patience, and the right medical care, so be sure to bring it up with their medical professional. Having an actual plan to commit suicide could mean that an attempt is imminent; that’s the time to call 911, and make sure your loved one is safe and being watched until emergency services arrive.

Depression is a very serious illness, and it should be treated as such. The life of someone you love may depend on it.

References:

• Watson, Lea C., Sheryl Zimmerman, Lauren W. Cohen, and Rosalie Dominik. “Practical depression screening in residential care/assisted living: five methods compared with gold standard diagnoses.” The American Journal of Geriatric Psychiatry 17, no. 7 (2009): 556-564. Retrieved from https://www.sciencedirect.com/science/article/pii/S1064748112607660
• Allen, Josh. “Depression in assisted living.” Geriatric Nursing 36, no. 1 (2015): 78-80. Retrived from https://www.gnjournal.com/article/S0197-4572(14)00410-8/abstract