Is It Depression, Or Just The Blues?

There are many factors that can cause depression. Moving from an independent setting to managed care is a big step, and despite the best efforts of staff and family members, the change of circumstance can bring on a strong case of the blues. Seniors are also more prone to experience the loss of close friends or family members (due to age and illness), deal with chronic pain, and be faced with some loss of independence and mobility. A period of adjustment is to be expected, but if those blues stick around, depression could be to blame. Depression differs from sadness in that it is persistent, long-lasting, and can be far more than just a state of mind.

There are many clues that a person may be suffering from depression. Some of the most obvious are a loss of interest in activities, lethargy, and a general disinterest in things going on around the person. Depressions symptoms are long-lasting and strong enough to interfere w/ daily life. Take a moment and get to Know the signs: http://www.caring.com/articles/depression-signs

How is depression different from general sadness or grief? It's more serious. Don't assume a depressed person can or will snap out of it. As a friend or caregiver, it's up to you to intervene and be proactive. Depression can affect a person's immunity, stress body systems, and cause physical pain. Unfortunately, depression is still misunderstood by many people, and carries a strong negative stigma. People are taught to hide their feelings and mask symptoms, so it can be hard to address the issue before it becomes severe and interferes with a person's daily functioning.

As a caregiver, you might need to go above and beyond to help a resident cope with depression. It's not so simple as telling someone to cheer up and smile. In fact, that can be one of the most frustrating and insulting things you can say. What can you do? If possible, involve the resident's family or friends. A depressed person is often too down to ask for help or realize how far his or her condition has progressed. Support from friends and family can help a person pull out of the crippling sadness and start to participate in social activities again. If a person in your care makes any mention of suicide, seek help from your facility's social worker, or the resident's doctor, immediately. Even without the risk of suicide, it is essential that family members, a social worker, or a doctor be alerted to the resident's condition.

Treatment options

In many cases, simply getting the depressed person out of isolation and into social activities can make a big difference. The change of scenery from a residential room to a facility's common areas (or outdoors, if possible) can pull a person out of dwelling on sadness. Group therapy and support can make a difference. Cognitive or "talk" therapy is a common first step in addressing depression. In Cognitive Behavioral Therapy (CBT), the depressed person is taught how to break the cycle of negative thoughts and learns coping skills. Sometimes it's enough to talk with a family member or trusted friend, but it might be beneficial to bring in a professional counselor. Your facility's Social Service Designee should be able to arrange for counseling or therapy, if it's needed.

If a resident has a religious affiliation, it could help to bring in members of that person's faith to visit or pray with them, or make it possible for the resident to attend religious services with others of the same faith. Fellowship is a strong way to combat the loneliness and isolation that can lead to depression.

Some medications can cause or exacerbate depression, so get in touch with the resident's doctor, or the person overseeing his or her care, and ask them to review medications for possible negative interactions or side effects. Hormonal issues could also be to blame, so bring up that possible cause when speaking with the doctor.

No matter what the causes, it's important to take depression seriously, and learn to spot the signs before they get out of control. Even though a person's reasons for being sad might sound silly or petty to you, please remember that they are significant to the depressed person and should be respected. Try not to judge, and do what you can to be a good listener and get the resident the help he or she needs.

5 Simple Steps To Help A Lonely Resident

As we move into the holiday season, and the days grow shorter and grayer, many residents may find themselves feeling a bit down an lonely. Here are five simple things you can do to brighten a resident's day and keep the loneliness at bay.

1. Take the resident on an outing.
Something as simple as a trip to a coffee shop, going to see a matinee movie, or taking a short drive in the country can do so much to lift a person's mood. Ask questions and encourage your guest to share stories from his or her life. Be a good listener and you can really make someone's day. If a resident is not able to leave the facility, bring the outing to him or her. Get a take-out treat from a favorite local restaurant, or have a meal wrapped take-out style from your facility's cafeteria. Pick up a red and white checked tablecloth at the discount store to add a festive, picnic element. Brightly colored plates, cups, or utensils add a nice touch, too.

2. Be a friend.
As caregivers, we do the best we can for each of our residents, but some days a resident needs you to go above and beyond. There are those awful days when pain is worse than usual, or they're just feeling blue. Maybe personal issues are getting them down. See if you can free up a few moments in your schedule and sit down and visit with the resident. Let them know that, sure, you have other things you could be doing, but you choose to spend time with them. It could be as simple as chatting about the weather, or as involved as being a sounding board for whatever is worrying or bothering the resident. Think about a time when you were lonely, and how nice it would have been if someone had come along and said "I'm here for you." Schedule a regular visiting time, or give the resident a specific time when you'll be back to visit again. The lonely times go a lot faster if you've got something to look forward to.

3. Help your resident connect with others.
Arthritis and failing eyesight can make it hard for seniors to do things we take for granted, like writing a letter or making a phone call. Help a resident write a letter or email. Is your resident having trouble with a phone or cell phone? Offer to help w/ dialing, or write or type up a list of important phone numbers in large numbers.

4. Small gifts
Bring the resident a small gift like fresh flowers or a small potted plant. A little gesture can both brighten up their room and make their day. But--and this is important--Don't just gift and run. Take a few minutes to visit with the resident. Let them know you were thinking of them and that you genuinely care about them. Then, when they look up and see your gift, they'll remember your visit with a smile, and look forward to the next time you're able to stop by.

5. Make contact
This suggestion takes a little more care and effort than the previous ones. If you can do so without violating HIPPA or your resident's privacy, reach out to others on behalf of the resident, and see if you can arrange for friends or family to visit. Some residents are too proud to ask for help, or too upset or distracted to take the initiative on their own. Ask your facility's SSD to contact the resident's family or friends. Arrange a surprise visit. No family? Drum up a volunteer, pet visit, or something w/ local scouting troop or school. Sometimes it's not so important who is visiting, but that the resident has visitors, period.

Finally, If you have several residents who are dealing with loneliness, try arranging a group activity. A movie night (or ongoing movie club) is a great way to bring people together and get them talking. Invite family members and volunteers, if possible, too. Get the group together and watch a classic movie with an upbeat theme like Singin' in the Rain. Musicals are great because of the lively music and lavish dance scenes! Provide snacks, dim the lights, and let everyone enjoy a movie together. Afterward, lead a discussion about the movie. Encourage everyone to talk about their favorite songs or scenes, or reminisce about other favorite movies and actors from that time period. If the movie had dancing, bring in a volunteer to teach everyone a simple dance based on a song from the movie. Or lead a sing-a-long or karaoke with songs from famous movie musicals.

Sometimes the smallest gestures can have the biggest impact. If you see someone looking down, or who hasn't had visitors in a while, a little attention from you can make a huge difference.

Elder Abuse and Neglect

Every year, tens of thousands of elderly Americans are abused in their own homes, in relatives’ homes, and even in  facilities responsible for their care. You may suspect that an elderly person you know is being harmed physically or emotionally by a neglectful or overwhelmed caregiver or being preyed upon financially. By learning the signs and symptoms of elder abuse and how to act on behalf of an elderly person who is being abused, you’ll not only be helping someone else but strengthening your own defenses against elder abuse in the future.

It’s difficult to take care of a senior when he or she has many different needs, and it’s difficult to be elderly when age brings with it infirmities and dependence. Both the demands of caregiving and the needs of the elder can create situations in which abuse is more likely to occur.

Many nonprofessional caregivers, spouses, adult children, other relatives and friends find taking care of an elder to be satisfying and enriching. But the responsibilities and demands of elder care giving, which escalate as the elder's condition deteriorates, can also be extremely stressful. The stress of elder care can lead to mental and physical health problems that make caregivers burned out, impatient, and unable to keep from lashing out against elders in their care.

Among caregivers, significant risk factors for elder abuse are

• Inability to cope with stress (lack of resilience)
• Depression, which is common among caregivers
• Lack of support from other potential caregivers
• The caregiver's perception that taking care of the elder is burdensome and without psychological reward

Substance abuse

Even caregivers in institutional settings can experience stress at levels that lead to elder abuse. Nursing home staff may be prone to elder abuse if they lack training, have too many responsibilities, are unsuited to care giving, or work under poor conditions.

The elder's condition and history

Several factors concerning elders themselves, while they don't excuse abuse, influence whether they are at greater risk for abuse:

• The intensity of an elderly person's illness or dementia
• Social isolation; i.e., the elder and caregiver are alone together almost all the time
• The elder's role, at an earlier time, as an abusive parent or spouse
• A history of domestic violence in the home

The elder's own tendency toward verbal or physical aggression

In many cases, elder abuse, though real, is unintentional. Caregivers pushed beyond their capabilities or psychological resources may not mean to yell at, strike, or ignore the needs of the elders in their care. (The preceding is an excerpt from helpguide.org.  Click HERE for the full article.)

Below is  presentation with more information on Elder Abuse.