When my mother made the decision, after yet another fall that shook her sense of safety, to move to the nursing home where my dad lived, my whole family was relieved. I'd received some pressure from siblings to get her to move, but I felt since I was here to keep an eye on her, it would be far better if the decision came from her.
However, as soon as the words were out of her mouth, I was on the phone getting her room arranged. I knew that because of chronic falls and advancing dementia, this move was our best option. By the end of the day, she was in the same home as Dad.
We couldn't get her into a private room right away, so she spent a couple of weeks with a roommate (Dad was in a private room). Strangely, this didn't go too badly, likely because she knew it was temporary. Within two weeks a private room became available so we moved her up one floor and into her new room. That is when her behavior changed.
Mom had always been a clean freak. She'd kept an immaculate the house, and I had helped her keep her apartment clean - much cleaner than my own house, I'll have to say. She also loved her daily shower and was very particular about her clothes.
After the move to her new room, I noticed on my daily visits that she was wearing the same clothes each day. The laundry was fast about getting clothes back, but I knew they weren't this fast. About the third day after her move, I noticed Mom didn't smell any too fresh. It was evident that she was wearing the same unwashed clothes each day. This was totally the opposite of her natural behavior.
Her phone wasn't yet hooked up, and that was her lifeline to her friends. She'd endured two moves - one from her own apartment, and then again from her double room to her private one. That's a lot of change for anyone, let alone someone with her problems. I was aware that not only was she more negative than usual, she was depressed.
Depression Can Be Circumstantial or Clinical and Chronic
I'd had some experience with clinical depression, as I have a family member with this chronic disease. Medication and/or counseling can be used to treat depression, and clinical depression often requires both.
For mom, my sense that she was depressed was on target. I discussed it with the nurse on her floor and we both felt that her depression was circumstantial and that it would lift - especially when a private room opened up on the same floor as dad. We were right and Mom came out of her depression.
However, not all elder depression will clear up on its own. The indignities of an aging body can cause many people to slump into chronic depression where medical help is needed. Even more often, the death of a spouse sends an elder into clinical depression.
If you spot a newly widowed elder not caring about life at all, please try to get that person medical help. Maybe grief counseling will do the job, but sometimes they need medication or ongoing counseling. We all grieve differently, and we need to give elders time to grieve the loss of a spouse in his or her own way. But we also need to keep any eye out for danger signs, because extreme self-neglect, or even suicide, can be the result of depression.
An Alzheimer's Diagnosis Can Cause Some to Slip into Depression
Let's face it, for most people, an Alzheimer's diagnosis fits into one of life's categories where we say, "before the diagnosis" or "after the diagnosis." The same goes for cancer and other serious health problems. These are life-altering events.
As with the death of a spouse, we will see some people take the bull by the horns and work their way thorough, doing what they need to do to cope with the change in their lives. However, this tremendous resiliency isn't part of everyone's makeup. And even the most resilient people will have times where they may drift into depression. The key is, will the person gradually get better or will he or she sink deeper into despair?
If a person is not progressing after a decent amount of time since a major change, or is sinking further into despair, they need medical help and those close to the person may have to push for action.
Depression Can be Stealthy and Hard to Detect In Someone With Dementia
If a person coped all right with the diagnosis, but seems to be showing signs of depression later on, the person's doctor should be notified. Many dementia patients need to be treated for depression, and they can improve if the right anti-depressant can be found.
While my family member who suffers from depression is young and doesn't have dementia, this person still needed many different tries to find the right medication. Detecting whether the medication is helping or hurting - and the wrong anti-depressant can make some people worse - is harder in someone with dementia, as they are always changing and it's difficult to know if the symptoms you spot are depression or just increasing dementia.
Health Central's depression site lists these symptoms for depression:
1. Depressed mood on most days for most of each day
2. Total or very noticeable loss of pleasure most of the time
3. Significant increases or decreases in appetite, weight, or both
It's obvious to those of you who have a loved one with Alzheimer's that these classic signs could be hard to tease apart from other Alzheimer's symptoms. That is why your doctor must be kept alert. If you suspect depression in your loved one who has dementia, keep a journal about what you observe and then present it to the doctor treating the person with dementia.
If the doctor agrees that an anti-depressant should be tried, keep very close tabs on your loved one. The medication could work very well or it could backfire. The side effects may be minimal or they may be intolerable. There are many anti-depressants and they work differently in different people, so don't give up. Just stay in close contact with the doctor.
As with all medications for elders, anti-depressants can be tricky. But they do help many people. If you suspect depression in your elder, no matter what other illness may be present, the possibility should be examined by a competent doctor. Proper diagnosis and treatment could mean an uptick in quality of life.
Published On: May 01, 2010