Felicity Green CMHN Country Liaison Officer

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Felicity Green CMHNCountry Liaison Officer
ROYAL ADELAIDE HOSPITAL Glenside Campus Mental
Health Services For Older PeopleCountry Liaison
Service
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Depression in Older People
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Depression Definition

• A pervasive and persistent change characterised
  by depressed mood and loss of interest or
  pleasure in life.

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How common is Depression?

• Depression is the 4th leading medical cause of
  disability in the Australian community.
  (Australian Institute of Health Welfare,1999)
• By 2020, Harvard University and the World Bank
  predict that depression will be the 2nd major
  cause of disability worldwide. (Murray and Lopez,
  1996)

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Under-diagnosed and Under-treated

• This may be because the symptoms are regarded as
  normal in this age group.
• It may be because this group are reluctant to ask
  for help.
• It may be that physical illness masks the
  picture.

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Under-diagnosed and Under-treated cont.

• It may be because depression in older people does
  not present with the standard picture.
• The result is that many elderly suffer
  needlessly.
• If detected and treated the elderly have the same
  response to treatment and have good prospects of
  recovery.

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What are the Symptoms of Depression?

• Clinical Depression Is Different From Everyday
  Blues
• Sadness
• Loss Of Interest
• Loss Of Energy
• Loss Of Appetite And Weight
• Persistent depressed mood for more than 2 weeks

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What are the Symptoms of Depression cont.

• Sleep Disturbance
• Inner Feeling Of Restlessness
• Avoiding Other People
• Loss Of Confidence Or Self Esteem
• Feelings Of Being Bad, Worthless Or Guilty
• Thoughts Of Death And Suicide

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Contributing Factors

• Recent stressful life events or losses

• Interpersonal difficulties

• Grief about physical disabilities

• Thinking patterns from early life
  experiences

• Past episodes of depression

• Effects of illness or treatments

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How does a depressed person act?

• Act distressed and fearful
• Say they want to die, complain or being
  worthless, helpless, hopeless
• Say they feel guilty
• Complain about pain or illness
• Complain about poor memory or concentration
• May move slowly or be agitated and restless
• In severe cases may lose contact with reality

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Treatments

• Medication / Physical Treatments

• Psychological Talking Treatments

• Social Support
• Exercise/Relaxation

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Conclusions

• Get an early diagnosis.
• Use appropriate treatments.
• Seek counselling if required.
• Depression can be successfully treated.

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Depression can be successfully treated
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Depression Co-exists with(Co - morbidity)

• 25-50 of people with dementia
• 25 of people with cancer
• 40-65 of heart attack survivors
• 1027 of stroke victims

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Dementia - Definition

• Not a single disease but a syndrome of which
  there are many causes.
• The development of multiple cognitive deficits
  including memory impairment and one or more of
  the following
• Aphasia loss of the ability to use/understand
  words.
• Apraxia loss of the ability to execute or carry
  out learned. (familiar) movements.
• Agnosia a failure of recognition, visual,
  auditory or tactile.
• Disturbance in executive functioning problem
  solving, planning skills.

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Symptoms

• Decline in memory and other areas of thinking,
  loss of memory,
• inability to concentrate and poor sense of time
  and place
• Difficulty in finding the right words, or
  understanding what people are saying
• Difficulty in completing simple tasks and solving
  minor problems
• Mood changes and emotional upsets, sometimes with
  depression.
• Tendency to over estimate cognitive functioning
• Decline in social domestic occupational
  functioning
• Changes in personality
• Changes in behaviour

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Dementia - Management

• Medical referral to diagnose and treat reversible
  causes
• Possible referral to specialist for medication
  treatment (Approved for Alzheimers disease)
• Care and education to individual referral to
  support services
• Education and support to family
• Planning for the future

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