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Caregiver's Handbook 15
J. Emotional and Intellectual Well-being
Each human being is a combination of body, mind, and spirit; we should be aware of how these parts interact. For example, people may have powerful emotional responses while facing the many challenges which life presents. Thus, some may often appear cheerful and optimistic while others are anxious and unhappy. In later years, we usually continue our basic moods, but the ways we express our feelings often become more obvious.
33. Depression:
Signs and Causes
In the midst of losses, such as physical changes, death of friends or loved ones and reduction of income, older people may begin showing signs of depression. Some things to look for are:
__ inability to concentrate or make decisions,
__ lack of feelings of enjoyment, or enthusiasm even for doing those things that were favorites,
__ little interest in eating (causing weight loss) or changes in eating habits (overeating causing weight gain),
__ lack of interest in being with other people, or loss of sex drive (libido),
__ feeling unwanted and worthless, sometimes leading to the thought that life is not worth living,
__ sadness or crying spells for no apparent reason,
__ problems with sleeping (sleeplessness during the night or excessive sleep during most of the day),
__ feeling tired most of the time, regardless of adequate rest.
If older people brood about their unhappiness, much of their energy is focused on worry. Part of that worry may relate to the fear that they will become forgetful and unable to manage their affairs. This worry can lead down the path to more depression, which may cause physical problems.
In exploring the cause of depression, the following questions should be asked:
1. Is there a physical or medical problem causing the depression?
2. Have there been changes in hearing, seeing, moving, or other body functions?
3. What social contact does the care-receiver have?
4. What are the opportunities for usefulness?
5. What kind of personal losses (death of friends, relatives, or pets) have there been?
6. Is the older person getting proper nutrition?
7. What kind of mental stimulation is the person getting?
8. Has there been a difficult adjustment following retirement?
9. Is the focus entirely on the past or is there some enthusiasm about coming events?
10. Is there a possibility of reaction to medications?
11. Is there a dependency on alcohol or drugs?
Once these questions have been answered, steps can be taken to relieve the depression. It will take some work from both the caregiver and the care-receiver to change habits and routines. Prolonged depression causes biochemical changes in the brain, usually requiring treatment with medication. The doctor is a good person the contact to find help for treatment of depression. Other resources are County Mental Health Centers, psychologists, counselors or clergy.
34. Suicide Prevention
Suicide among the elderly is a significant and ever increasing problem. Statistics show that 27 percent of all suicides in San Diego county (1985-87) were committed by people 60 years of age and older. Nationally, elderly (65+ years) made up 12.3 percent of 1987 population and committed 21.0 percent of suicides. Elderly complete one suicide every 1 hour and 21 minutes, or each day 17.7 seniors committed suicide.
Unlike other segments of the population, the elderly do not often make threats or mention suicidal thoughts to others. Therefore, it is important that caregivers also know other warning signs:
__ Depression - feelings of sadness, hopelessness, a sense of loss and statements as "Life isn't worth living" are common before a suicide.
__ Chronic or terminal illness.
__ Withdrawal and isolation - suicidal people may pull away from family, friends and others close to them.
__ Behavior changes - sudden changes such as irritability, aggressiveness or changes in eating and sleeping habits can signal problems.
__ Making final arrangements - a suicidal person may give away valued possessions, making out a will, make a plan for suicide, or write a suicidal note in preparation. They may purchase weapons or stockpile medications.
Suicide can be prevented. If the person you care for shows any of the warning signs, you can:
__ Ask - don't be afraid to ask directly if the person is thinking about suicide. It is not a taboo subject. You will not be putting ideas into the person's head. It can be a relief to the suicidal person to talk openly about their feelings.
__ Listen - let the person express his/her feelings and concerns. Don't worry about saying the right things - just listen.
__ Show you care - tell the person you care and want to help. Take active steps to make sure the person is safe; remove weapons, pills, etc., and stay with him/her.
__ Get help - make sure the suicidal person gets in contact with a professional counselor or other helpful person who will know what to do. Or have the suicidal person call (suicide prevention/crisis intervention Hotline in your community. Telephone numbers for such local resources should be at the front of your telephone directory.) A crisis counselor can help figure out the best way to handle the situation and give referrals to other resources.
To Caregiver's Handbook Page 16
To Caregiver's Handbook Table of Contents
The elements and images found in these pages are copyrighted and all rights are retained by the author.
Questions or comments? John Cottingham is the author of this site.
