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How to talk to depressed elderly?

• Listen. This is the most important. Give your time, full attention and listen. Depressed elderly need an opportunity to put their feelings into words, to hear themselves explain the problem and to know that you are hearing them and attempting to understand. Be consistent and make fifteen minutes every day to spend alone with the resident.

  Don't tell your own stories or the stories of people you know. Every elderly person's depression is different. Your stories won't help. Your listening will.

  Don't change the subject when your loved one pauses. Instead, try echoing his/her words. For example, "You feel like you're disappointing your daughter when you don’t feel like going to her home for dinner." This encourages the elderly person to say more about it.

• Acknowledge the sadness, irritability or withdrawal. This means that you should respond to the feelings as much as to the words spoken. You might say, " Your sadness makes you cry very often." If you name the feeling, your loved one will know that he/she is being heard and understood. If your loved one doesn’t agree with the way you phrased it, she/he will explain the true feelings more carefully. Don’t observe a feeling and just leave. Distressed feelings need to be addressed when they are identified.

• Do not judge your loved one’s feelings. Avoid saying "You shouldn’t feel that way." Instead, restate the feelings you think you are hearing to see if that is actually what the person meant. Find out what is behind those feelings. For example, "you are wondering whether your life could ever be as meaningful as when you were in your 30’s."

• Resist giving advice. The solutions that "take" are the ones that the elderly person "owns" himself. If he thought of it, or believes that he thought of it, he is more likely to follow through and make the change. We all dislike thinking that someone else is running our lives. After letting your loved one express his concerns and feelings turn the ownership for the solution to him. Ask him what he thinks would help him to feel better or improve the situation that is problematic. Do discuss alternative solutions to problems with him and adopt an approach that encourages him to generate his own solutions. For example, "you need to discover what is best for you" "Tell me what are the solutions and their pro and con".

• Praise even minor accomplishments. Make sure that your praise is an honest acknowledgement of what progress has been made in any activity but particularly those that you know will alleviate depression. Engage your loved one in conversations about previous successes, what he does well and likes about himself.

• Be honest and promote realistic expectations. Unrealistic expectations can lead to further failure and feelings of worthlessness. Help your loved one set goals that he/she can meet. For example, "Two days ago you didn’t think you could walk into the dining room alone but today, you went there for breakfast".

• Be patient and don’t push the your loved one to respond. Depression slows many processes and oftentimes the elderly person needs time to formulate a response. Depression can numb feelings and it may take more time to feel and to even put a name on the feeling.

Learned Helplessness and Depression

One of the major issues for a depressed person is his/her pervasive feeling of being unable to control the people or events in his/her surroundings. This is sometimes called "learned helplessness." Learned helplessness means that no matter how hard one tries, one is unable to have any influence on others or on the environment. This results in giving up making choices and trying to influence. Planning for, encouraging and assisting residents to make as many choices as they are able and applauding their efforts when they do can become a turning point in reducing depressions grip on the frail elderly person.

continue to: Activities for Relieving Mild Depression in the elderly

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Reviewed: 03/2006