Elsevier

Geriatric Nursing

Volume 36, Issue 1, January–February 2015, Pages 78-80
Geriatric Nursing

Department
AALNA Section
Depression in assisted living

https://doi.org/10.1016/j.gerinurse.2014.12.005Get rights and content

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Depression in older adults

An estimated 6.7% of U.S. adults experience major depressive disorder, with women being 70% more likely to face depression in their lifetime.2 In older adults the likelihood of depression is even higher. According to the National Alliance on Mental Illness (NAMI), 6.5 million of the 35 million Americans aged 65 years or older.3

While the average age at onset of depression is 32 years old, it can affect people at any point in the lifespan.1 Most older adults with depression have been experiencing

Signs and symptoms

It is important that every member of the assisted living care team understand, watch for, and report signs and symptoms of depression. These should never be attributed to “normal aging” or other assumptions. Any of these signs or symptoms should be reported to the resident's medical or mental health provider:

  • Persistent sad, anxious, or “empty” feelings

  • Feelings of hopelessness or pessimism

  • Feelings of guilt, worthlessness, or helplessness

  • Irritability, restlessness

  • Loss of interest in activities or

Types of depression

There are several forms of depression that vary in presentation of symptoms, onset, and characteristics. According to the National Institute for Mental Health (NIMH) they include:

  • Major depression: severe symptoms that interfere with one's ability to work, sleep, concentrate, eat, and enjoy life. An episode can occur only once in a person's lifetime, but more often, a person has several episodes.

  • Persistent depressive disorder: depressed mood that lasts for at least 2 years. A person diagnosed

Treatment

Treatment for depression may include psychotherapy, medications, and in rare cases electroconvulsive therapy.

Antidepressant medications work by manipulating neurotransmitters, especially serotonin, norepinephrine, or dopamine. The most popular antidepressants are selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac), sertraline (Zoloft), escitalopram (Lexapro), paroxetine (Paxil), and citalopram (Celexa). Serotonin and norepinephrine reuptake inhibitors (SNRIs) are

Suicide

Suicide is a very real risk for older adults who are depressed. In fact, according to the NIMH, older white males age 85 and older have the highest suicide rate in the United States.1 Although residents may attempt suicide without telling anyone in advance, in many cases there are warning signs. If you resident talks about suicide or “wanted to end it all” this should be taken very seriously. Residents may verbalize a “lack of desire to go on” or other vague statements that hint at their

Conclusion

It is your goal as an assisted living provider to maximize the quality of life for every resident you care for. Monitoring for signs and symptoms of depression and assisting with treatment for those who are diagnosed is a critically important responsibility. Review this information with every member of your care team and implement strategies to ensure the best care possible for your residents. Depression is never a “normal” part of aging.

About AALNA

Founded in 2001, the American Assisted Living Nurses Association is the only national non-profit association dedicated exclusively to nursing in assisted living. Operated by nurses, for nurses. It is the vision of the American Assisted Living Nurses Association that Assisted living nurses practice within a holistic framework that can maximize and maintain the assisted living resident's well-being and pursuit of quality of life. Learn more at www.alnursing.org.

About the author

Josh Allen is a Registered Nurse with over 20 years of experience in senior living. As the Director of InTouch at Home, Josh oversees all aspects of business development, care, services, and operations for the organization. As a part of the SRG Senior Living family of companies, InTouch at Home delivers personalized care and services to clients living in senior living communities as well as private residences across three states.

Josh also serves on the board of the American Assisted Living

References (3)

  • Residents Living in Residential Care Facilities: United States, 2010. Centers for Disease Control and Prevention,...
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