Old age is often portrayed as a time of rest, reflection, and opportunities to do things that were put off while raising families and pursuing careers. Unfortunately, the aging process is not always so idyllic. Late-life events such as chronic and debilitating medical disorders, loss of friends and loved ones, and the inability to take part in once-cherished activities can take a heavy toll on an aging person’s emotional well-being.
An older adult may also sense a loss of control over his or her life due to failing eyesight, hearing loss, and other physical changes, as well as external pressures such as limited financial resources. These and other issues often give rise to negative emotions such as sadness, anxiety, loneliness, and lowered self-esteem, which in turn lead to social withdrawal and apathy.
Another, more serious outcome is chronic depression, or depression that is recurring and persistent. Chronic depression has both physical and mental consequences that may complicate an older adult’s existing health condition and trigger new concerns.
There is evidence that some natural body changes associated with aging may increase a person’s risk of experiencing depression. Recent studies suggest that lower concentrations of folate in the blood and nervous system may contribute to depression, mental impairment, and dementia. Researchers also suspect that there may be a link between the onset of late-life depression and Alzheimer’s disease.
Regardless of its cause, depression can have alarming physical effects on older people. The mortality rate for elderly men and women suffering from both depression and feelings of loneliness is higher than for those who report satisfaction with their lives. Treatment programs for depressed elderly patients suffering from cardiovascular disease and other major illnesses usually take longer than normal, and are less successful.
In addition, the feelings of hopelessness and isolation that often spur thoughts of suicide are more prevalent among older adults, especially those with disabilities or confined to nursing homes.
A risk to daily living
Depression can also have potentially harmful effects on an older adult’s health in other ways. Depression can lead to eating habits that result in obesity or, conversely, can cause a significant loss of appetite and diminished energy levels, sometimes resulting in a condition known as geriatric anorexia.
Depressed older adults also experience higher rates of insomnia and memory loss. They also have longer than normal reaction times, increasing the hazards associated with cooking, driving, self-medication, and other tasks that require full attention.
What you can do
While aging is an inevitable part of life, depression need not be part of it. Researchers agree that early recognition, diagnosis, and treatment can counteract and prevent depression’s emotional and physical consequences.
Here are some issues to consider in addressing depression in an older adult:
- Be aware of physical limitations. Encourage an older adult to consult with a physician before making dietary changes or undertaking any new activity that may stress his or her stamina.
- Respect individual preferences. Because elderly people tend to be less amenable to lifestyle changes, they may be reluctant to adopt new habits or do things that their peers find highly enjoyable. A psychologist who specializes in aging issues can help tailor an individualized strategy to combat depression.
- Be tactful. An older person with fragile self-esteem may interpret well-intentioned encouragement as further proof of his or her declining condition. Others may resent any attempts at intervention. A psychologist can help friends and family members craft positive approaches for dealing with these and other sensitive issues.
More than parenting a parent
A combination of trends is sparking heightened interest in generational issues. For one thing, people are simply living longer due to advances in medicine and preventive health. It’s more common today, as opposed to 50 years ago, to see people live into their 90s and some who face financial difficulty may have to face moving back in with their children. The problem is compounded by the fact that a number of Baby Boomers have waited until well after age 30 to start their families. Many now bear the cost of caring for elderly parents, while simultaneously emptying their bank accounts to cover their children’s college tuition.
The whole family is affected by an aging relative’s distress over such changes as declining health, a move to a nursing home, or moving in with their children.
The problem is that many people try to resolve these dilemmas without first talking about them to hear the needs of everyone involved. Thus, a family may feel obligated to bring Grandpa into the home after his heart attack, without first asking him if he would prefer assisted living or a retirement community instead.
Studies show that most older people prefer not to reside with their children, but would rather live independently. Families need to discuss candidly the potential problems of creating a multigenerational household, before bringing an elderly loved one into the home.
Avoiding a role reversal
Conflicts typically arise in multigenerational households because the adult children feel they must assume a parental role with their live- in mother or father. Adult children may become sources of emotional, financial and even physical support for their parents, but this is not the same as raising them. They should learn to regard their parents as individuals, not just people who reared them. They should also recognize that their parents are coping with declining faculties, the deaths of old friends and relatives, and other losses in their lives.
What can be done to lower the risk of depression? There are a few steps you can take. Try to prepare for major changes in life, such as retirement or moving from your home of many years. One way to do this is to try and keep friendships over the years. Friends can help ease loneliness if you lose a spouse. You can also develop a hobby. Hobbies may help keep your mind and body active. Stay in touch with family. Let them help you when you feel very sad. If you are faced with a lot to do, try to break it up into smaller jobs.
Regular exercise may also help prevent depression or lift your mood if you are somewhat depressed. Older people who are depressed can gain mental as well as physical benefits from mild forms of exercise like walking outdoors or in shopping malls. Gardening, dancing, and swimming are other good forms of exercise. Pick something you like to do. Begin with 10 to 15 minutes a day, and increase the time as you are able. Being physically fit and eating a balanced diet may help avoid illnesses that can bring on disability or depression.
Remember, with treatment, most people will begin to feel better. Feeling better takes time. But, it can happen.
Copyright American Psychological Association
*Copyright National Institute of Aging