She’s in her eighties and suffers from congestive heart failure and crippling arthritis, among other problems. She’s also been depressed off and on for many years. Her daughter, a good friend of ours, takes her to the weekly doctor’s appointment, this time after a hard night of pain and insomnia for her mom.
The 82-year old didn’t want to get out of bed that morning and pushed away any help. Yet she could barely crawl to the bathroom, dressed with great difficulty and had no interest in eating.
At the doctor’s office, the physician asks how she’s been feeling lately.
“Oh, I’m fine.”
Her daughter sighs and explains exactly what’s been going on.
“Oh, she always exaggerates. Really, I’m doing just fine.”
The doctor knows better than that and asks our friend about home care. That’s what the daughter does. There’s no money for the level of daily, sometimes nightly assistance her mother needs, and insurance only covers an hour’s visit a day.
There’s no basis for admitting her to the hospital today so the doctor adjusts medications and asks the daughter to watch her carefully. Of course, that’s all the daughter’s been doing, on top of her job and managing her own depression. Despite what her mother says, she needs more and more attention.
Back home, the mother lies down and doesn’t want to move. She doesn’t eat and drinks very little water or any fluid. In two days, she has trouble breathing and no energy to do anything. Dehydrated and wrenched by that deep coughing I’ve heard from someone with fluid building up in the lungs, she’s readmitted to the hospital.
“I’m fine,” a nod of the head, an indifferent stare, or no response at all. Or it could be an angry dismissal: “Leave me alone! There’s nothing wrong with me!” Those are the answers I used to get when I was helping my mother in her later years or when visiting the elderly parents of friends.
Despite her denial, our friend’s mother is one of the lucky ones. At least her depression has been recognized and diagnosed, and she’s been taking medication - though therapy is a step she won't take. Depression often goes unrecognized or ignored, or it may be considered a natural part of aging.
But depression is not a natural part of aging and is just as treatable when you’re 80 as when you’re 20. Nor is it true that most people with serious illnesses get depression. They may well feel upset, resentful or “depressed” in the everyday sense of the word, but they don’t have the diagnosable illness of depression. These false beliefs, though, are part of the reason that the problem is under-treated, or not treated at all.
And then there is the “I’m fine” problem of refusing to talk about it. Many elderly people, like those of any age, may not even realize what’s happening or may believe that what they’re experiencing is nothing out of the ordinary. Of all the pains and problems that an elderly person might not mention to a doctor or might flatly deny, depression is probably first in line.
