A question from Annie on OurAlzheimer’s posed a very interesting and disturbing question; “What can be suggested for anyone who no longer wants to live?”
Annie wrote, “My grandma isn’t suicidal, she’s just tired of living. Anti-depression pills for it and for her mild Alzheimer’s don’t seem to have any effect, anymore. She’s 85 and I remember when she was 79 she said she didn’t want to live to see 80, that she never thought she would live for this long… She reminds us that if she was a pet animal, we could put her down”
I am sure that most doctors, nurses, and some caregivers, have come across patients who persistently say they want to die because they feel they have lived too long. When someone talks about wanting to die how should a caregiver cope and help their relative, friend or patient?
Finding the Right Approach
First, just because she is old does not mean that death should be seen as a solution to a situation. Caregivers should not stop searching for a cause and strategies to help people with Alzheimer’s find purpose to their lives. Most people, no matter what their situation, need help dealing with health, social, psychological problems, in this case Alzheimer’s disease, and often decreased mobility and cognitive abilities. In general, all people
- Need something to look forward to
- Activities they like doing
- Find people they enjoy meeting
Day care centers can offer social activities, different stimulating environments and friendship. In this case, early stage Alzheimer’s disease should not preclude people from looking at social clubs or day care centers for the elderly. People with more severe middle and late stage Alzheimer’s may need to access social care centers that cater for people with dementia. Social services or Alzheimer’s Association should be able to help you with ideas and local groups. Getting a sitter or someone who is unfamiliar to them can be helpful to wake up interest in conversation and activities give a feeling of purpose.
Regular trips out, even short drives and walks to places you know would have given them pleasure in the past; gardens, a park, an art gallery, a museum, visits to grand children, old friends are further examples.
Painting or bird watching can help. For some people caring for an animal, a cat or a dog can be central to recovery from depression.
Distraction or ignoring comments about their apparent wish to die can be helpful for some people especially for people with perserveration, (uncontrolled repeating of phrase, gesture or piece of information over and over which can be a feature of brain injury or disease)
Being angry will not be helpful. It can be very stressful for caregivers, especially if you share the same home, but empathy, understanding and support are the tools you need to use.
Depression is common in people with Alzheimer’s. Major depression is associated with some structural changes in areas of the brain. Alzheimer’s and the degenerative brain damage it causes may well contribute or be the cause of her symptoms. Neurological degeneration has also been identified in animals subjected to chronic stress. Either way, Annie’s grandmother may still be depressed and on the wrong antidepressant or treatment program.
Quick Facts about Depression in the Elderly
Rates of depression in older people are less common, generally, than in younger people. However depression does seem more common in the elderly than in adulthood and the middle aged.
There is research that suggests rates of depression increase in the very old, in people aged 85 and older.
Symptoms of depression can often be misunderstood and symptoms such as loss of energy, problems with memory, and bodily symptoms can be seen as signs of senescence rather than depression. This means that depression is under reported and treatable depression goes untreated.
Poor health, social isolation can easily lead to hopelessness and, in some cases, to suicide.
Depression appears to compromise the immune system resulting in disease. It can also predict a more serious outcome when older people get sick
Apparently the lower rates of depression in older people recorded in statistics may well be due to the lack of adaptation in diagnostic criteria for depression. If this did occur it would, many researchers believe, show a more valid picture of the size of the problem of depression in the elderly.
More Information About Depression