Depression in the elderly.

1. Depression in the Elderly
Katie Brandner

2. Depression is
not a normal
symptom
of aging.
Image Credit: http://inhomecareidaho.com/wp-
content/uploads/IMG_0301-300x200.jpg

3. OT practitioners are in a unique position to
Treat,
Identify,
and
Prevent
Depression in an elderly client

4. WHAT IS DEPRESSION?
Depression is defined as “clinically significant distress or
impairment in social, occupational, or other important areas of
function.
Major depression is characterized by
• A change in mood or sleeping or eating habits
• Low energy or fatigue
• Reduced concentration
• Feelings of worthlessness or excessive guilt
• Thoughts of death or suicide
(American Psychiatric Association, 2013)

5. Image credit: http://www.topnews.in/files/chronic-
condition.jpg
According to the CDC, older adults are
more at risk of experiencing depression
because
• 80% of older adults have at least one
chronic health condition.
• 50% have two or more chronic health
conditions
Depression is more common in people who
have
• Other illnesses
• Limited function

6. How many older adults have
depression?
• 1%-5% of older people
living in a community
• 13.5% of older people who
require home health
• 11.5% of hospital patients
Image Credit: http://stmaryathenstn.org/wp-
content/uploads/2011/11/nursing-home-300x256.jpg
(CDC, 2015)

7. • OT plays a big part in home health and
hospitals
• Often depression in the elderly client
is unrecognized and untreated
• Knowing how to identify depression is
an important tool

8. How do you identify depression in an
elderly client?
• Feeling sad or "empty"
• Feeling hopeless
• Irritable
• Anxious
• Guilty
• Loss of interest in favorite
activities
• Feeling very tired
According to the National Institute of Mental Health, many of
the usual symptoms of depression may be seen in an elderly
client with depression. These symptoms can be:
• Not being able to concentrate or
remember details
• Not being able to sleep or
sleeping too much
• Overeating or not wanting to eat
at all
• Thoughts of suicide
• Suicide attempts
• Aches or pains, headaches, cramps,
or digestive problems

9. Often symptoms of
depression in the elderly
are mistaken for an
illness or for "normal
signs of aging”. These
symptoms can include:
• Fatigue
• Appetite loss
• Trouble sleeping
(National Library of
Medicine, 2015) Image Credit:
http://myhomecareblog.com/files//2013/09/bigstock-Sick-older-
woman-trying-to-eat-34022006-300x200.jpg

10. There are many ways in which the
OT practitioner, the healthcare team, and
the client can work together to help the
client treat and manage their depression.

11. How is depression treated?
Depression is a treatable condition.
Ways to treat it are:
• Medication
• Psychotherapy
• Electroconvulsive therapy
(National Library of Medicine) Image Credit:
http://www.gracepointwellness.org/images/
root/carrietherapysession2.jpg
Image Credit:
http://g.psychcentral.com/news/u/2008/1
2/depressionmedicationparkinsons.jpg

12. Before treatment begins the doctor must
rule out other factors that may be causing
the symptoms like:
• Medications
• Illness
Depression is not cured overnight.

13. While in treatment it’s important to
implement depression management strategies
such as:
• Getting regular exercise
• Learning good sleep habits
• Avoiding drugs and alcohol
• Talking about your feelings with someone
you trust
• Surrounding yourself with positive people
• Doing fun and meaningful activities
• Taking your prescribed medications
correctly
Image Credit: http://www.leanerliving.com/wp-
content/uploads/2012/06/elderly-barbell.jpg

14. How do you treat depression from an OT
perspective?
First understand that depression changes how the client
behaves and chooses their occupations.
As an OT practitioner
• If you see symptoms of depression, let their doctor
know or encourage them to see their doctor to be
evaluated.
• While being treated for depression, help your client
manage their depression by working on meaningful
occupations and pleasurable activities.

15. Common reasons to choose the activities
they continue are:
• Deeply established habits and
commitments
• Gratifying activities
• Friends and family initiated tasks
• Volitional need to keep doing activities
• Distraction from their depression
• As way to hide their depression from
friends and family
(Leibold, M. L., Holm, M. B., Raina, K.
D., Reynolds, C. F., III., & Rogers, J.
C., 2014)
Image Credit:
http://static2.stuff.co.nz/1269548446/63
5/3510635.jpg

16. How is depression prevented?
There is no surefire way to prevent depression.
Some strategies help. These include:
• Stress management
• Reaching out to family and friends
• Getting treatment for depression as soon as symptoms
present
• Getting long term treatment for depression to prevent a
reoccurrence of depression
(Mayo Clinic)

17. • The elderly population is vulnerable
to depression
• As an OT practitioner you need to be
on the lookout for symptoms
• The earlier that depression is
treated and managed, the better!

18. Common triggering events for symptoms of depression in the
elderly:
• A move from home, such as to a retirement facility
• Chronic illness or pain
• Children moving away
• Spouse or close friends passing away
• Loss of independence
Depression can also be related to a physical illness, such as:
• Thyroid disorders
• Parkinson’s disease
• Heart disease
• Cancer
• Stroke
• Dementia
(National Library of Medicine)

19. What do you do if you see signs of
depression?
As an OT practitioner if you see signs
of depression you should tell your
client to visit their doctor for an
evaluation.
You should also start implementing
depression management strategies such
as:
• Having the client choose meaningful
activities and occupations
• Have the client choose occupations
that are pleasurable and rewarding
http://about.lsnc.net/files/2013/03/Grandmother_holding_her_gran
dd.jpg

20. Key concepts
• As OT practitioners it is important for us to
identify, treat, and prevent depression in our
elderly clients.
• Depression is not a normal sign of aging
• If the OT practitioner, the healthcare team, and
the client work together, depression can be
identified, treated, and possibly even prevented
in an elderly client

21. References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders
(5th ed.). Arlington, VA: Author.
Depression is Not a Normal Part of Growing Older. (CENTER FOR DISEASE CONTROL) (2015, March 5).
Retrieved May 17, 2015, from http://www.cdc.gov/aging/mentalhealth/depression.htm
Depression - older adults: MedlinePlus Medical Encyclopedia. (n.d.). (NATIONAL LIBRARY OF
MEDICINE) Retrieved May 17, 2015, from
http://www.nlm.nih.gov/medlineplus/ency/article/001521.htm
Depression (major depressive disorder). (n.d.). (MAYO CLINIC)Retrieved May 18, 2015, from
http://www.mayoclinic.org/diseases-conditions/depression/basics/prevention/con-20032977
Depression Measurement Instruments. (2013). In (The encyclopedia of elder care): The
comprehensive resource on geriatric health and social care. New York, NY: Springer Publishing
Company. Retrieved from
http://ezproxy.greenriver.edu:2048/login?qurl=http%3A%2F%2Fsearch.credoreference.com.ezproxy.gr
eenriver.edu%2Fcontent%2Fentry%2Fspenelderc%2Fdepression_measurement_instruments%2F0
Leibold, M. L., Holm, M. B., Raina, K. D., Reynolds, Charles F., I.,II, & Rogers, J. C. (2014).
Activities and adaptation in late-life depression: A qualitative study. The American Journal of
Occupational Therapy, 68(5), 570-7. Retrieved from
http://ezproxy.greenriver.edu:2048/login?url=http://search.proquest.com/docview/1563107686?acco
untid=1558
Older Adults and Depression. (n.d.). (NATIONAL INSTITUTE OF MENTAL HEALTH)Retrieved May 18,
2015, from http://www.nimh.nih.gov/health/publications/older-adults-and-
depression/index.shtml#pub4

22. Any Questions?