Pathways Courses - Out of the Shadows

Out of the Shadows
Uncovering Substance Use and Elder Abuse

Module 4: Screening and Assessment - Page 11 of 16

Screening for Depression

Signs of elder abuse often are difficult to separate from signs of general depression. Elder abuse, substance abuse, and depression may go hand in hand, indicating the need for screening in all three areas. Depression is a difficult diagnosis to make among all ages, but particularly with people over 65. Older adults may not know how to describe how they feel, or they may fear being labeled as weak. Families often minimize the signs of depression -- explaining the symptoms as a bad mood or a "normal part of getting old." In reality, depression can result from a range of causes, including:

Genetics
Biological changes in the brain
Illness
Adverse drug reactions
Stressful life events, such as the loss of a spouse, the sale of one's home, or retirement

Depression can be treated effectively with appropriate diagnosis and follow-up care. Symptoms of depression include: ref

Physical Signs of Depression

Aches, pains, or other physical complaints
Marked changes in appetite
Change in sleep patterns
Fatigue

Emotional Signs of Depression

Pervasive sadness
Apathy
Decreased pleasure
Crying for no apparent reason
Indifference to others

Changes in Thoughts and Feelings

Feelings of hopelessness and helplessness
Feelings of worthlessness
Impaired concentration
Problems with memory
Indecisiveness
Recurrent thoughts of death and suicide

Persistent sadness and serious depression are not inherent to aging and can be treated.

Changes in Behavior

Loss of interest in activities previously enjoyed
Neglect of personal appearance
Withdrawal from people
Increased use of alcohol
Increased agitation
Talking about "the end"

If you suspect depression in an older adult, the following can be effective tools:

Geriatric Depression Scale
Before You Say, "I'm Fine" -- a National Institute of Mental Health tool for older adults