The Experience

Perhaps one of the most unfortunate learnings I've experienced this semester has been the incredibly high rates of depressed residents in long-term care facilities. It was first introduced as one of the 3 D's common in aging, including dementia, delirium, and depression (Balsdon, 2022). Some of the biggest contributions to older adult depression include loss of independence, loss of loved ones, and cognitive and physical changes. Depression is defined as a mental disorder involving feelings of disinterest, sadness, low self-worth, poor concentration, and overall fatigue (Sims, 2022). Vital learning highlighted in the lecture is that depression is not a normal part of the aging process, despite its prevalence in these populations.

Older-adult depression comes in both objective and subjective forms and can be observed as such too. Subjective forms may include feeling thoughts of sadness/hopelessness, and objective forms may include a caretaker noticing that a resident is no longer eating during mealtimes. Depression may lead to suicidal thoughts and/or actions and comes in both active or passive forms of a planned suicide. Examples of active suicide may be planning to overdose on prescribed medications, while passive suicide may include taking part in risky behaviors such as not wearing a seatbelt when in a car (Sims, 2022). Both are equally dangerous and must be addressed as soon as they're recognized.

Regardless of someone's experience and thoughts towards depression, it is vital that it is viewed as seriously as a chronic illness and be treated immediately. As mentioned in lectures, some ways to reduce depression in older populations include maintenance of independence in every area possible (Balsdon, 2022), spirituality, maintenance of positive ADL patterns (ex. sleeping), social activity, exercising, gathering support systems, medications, preventing addiction habits, and more (Sims, 2022). These are all implementable, measurable, and simple ways to help reduce the devastating effects of depression and the risk of suicidal thoughts or desires.

My clinical experience in this realm included caring for a resident with diagnosed depression. She never socialized, showed disinterest in eating, spent the day sleeping, and displayed closed body language while avoiding eye contact during conversations. This resident's lowest moments appeared when her dementia caused difficulty in memory recollection and understanding, which caused her visible frustration and sadness. This goes to show that not only are the 3 D's major risk factors in older populations but also often co-occur in existence.

The most important takeaway regarding older-adult depression is that recognized depression must be addressed every day. For example, the resident I cared for often didn't look socially approachable. However, when I kept trying to prompt conversation, we eventually reached a point where she was laughing with me, patting my back, and showing gratitude for this newfound therapeutic relationship. This showed me that no resident with depression is a lost cause and that every sign of depression in older adults -- from appetite suppression to social withdrawal -- should be seen as a cry for help. Every resident should feel included, welcome, and cared for on a daily basis, and maintenance of mental health check-ins should be constantly practiced in every healthcare setting.