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Depression can be overcome, even though it disabling to daily functioning, happiness and personal growth. People with depression can be helped to manage and stabilize the disabling aspects of the condition and result in lives, which continue to have meaning, personal growth and a sense of hope for the future. When frail elderly people are depressed, they need to be helped to exercise as many personal choices and decisions as they are able. Depression affects the whole person, body, mind and spirit. Because of this, any plans of care for addressing depression, must include all these dimensions. The final responsibility for overcoming depression rests with the frail elderly person. It is unlikely that they can do this without the help of their caregivers. Depression so extensively saps the energy and spirit of people that other resources are needed to initiate recovery.

It is essential for caregivers to have the knowledge, skill and attitudes to address the complexities which managing depression demands. The information here provides some of these competencies for family caregivers. When caregivers possess the competencies to manage depression, they will, in turn, be able to assist their loved ones to participate in their own care. The mutual involvement of caregivers and their loved ones result in keeping chronic conditions stable and enhancing the capacity for elderly people to successfully address and manage their complex chronic physical, psychosocial and spiritual issues.

Meeting Your Loved One’s Needs

Most therapists and senior organizations promote independence for frail elderly people. But, when frail elderly have depression it requires that family caregivers know that they can initiate actions to alleviate depression rather than expect the depressed person to initiate their own self-help activities. Depression saps energy and decision-making capacity. This leaves the depressed elderly person with only a small amount of energy to help him/herself. The progress of recovery from depression is very often slow and results are difficult to see. It is important for us to understand that depressed people can be very self-centered. Knowing that the responsibility for improvement lies with the individual can balance the, oftentimes, overwhelming responsibility which the caregiver feels.

Physical/Biological Needs

Frail elderly, in particular, express depression through physical symptoms such as headaches, backaches, backaches, stomach distress and constipation. Often medical evaluation has determined there is no organic cause for these symptoms. Physiological needs for balanced, nutritious meals, regular exercise and adequate, usual, uninterrupted sleep are of utmost importance for health and improvement of depression. Depressed people are often sedentary and have no motivation to move. Yet, exercise is known as a positive force for relieving depression. Exercise activates serotonin and norepinephrine and increases socialization, both known to enhance mental health.

Safety and Security Needs

Depression causes preoccupation with self, which may result in ignoring potential environmental hazards. For whatever reason, depressed persons feel a very strong need for a predictable, lawful, orderly world in which unexpected, unmanageable or other dangerous things do not happen.

Love and Belonging Needs

A depressed person is at risk for not having his/her needs for love and belonging met because of feelings of being a burden to others, of being no fun and spreading doom and gloom to others.

Self-esteem Needs

Depression is often the cause or result of feeling inadequate as a person. Some people with depression have been unsuccessful in handling their emotions alone. Feeling powerless and giving up can result when repeated attempts to help their own depression have failed. Depressed people have very negative opinions about themselves and feel very negative about their future. They often can’t describe one good thing about themselves and one thing they enjoy. They minimize past achievements, concentrate on present failures even minor ones. They feel they have nothing to look forward to. This leads to abandoning previous roles because they can’t be perfect and are afraid of failing. This leads to withdrawal of activities.

Self-actualization Needs

Depression needs to be freed first because it is unlikely there is any energy left for these creative self-expressions and personal achievements.

continue to: How to Talk to A Depressed Elderly Person

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Reviewed: 03/2006