Stigma of 'mental illness' means many older people with depression suffer in silence

Depression can be a big problem for older people, with one in five people in the community suffering from depression and two in five people living in care homes.

Suicide is a significant risk for older people who are depressed, with older people less likely than younger people to talk about suicide, but more likely to carry it out. While older men aged 75 and over have the highest incidence of suicide - 11 per cent higher than the rates for all men aged 15 and over, according to the Samaritans.

Yet despite this, depression is often under-diagnosed and under-treated in many older people. This is because they come from the generation of the ‘stiff upper lip’ and are often reluctant to seek help and so they suffer in silence. ‘Mental illness’ still has a huge stigma and the idea of seeing a psychotherapist is complete anathema to many older people.

Home care workers need to be on the lookout for signs of depression

Consequently it is vital for home care workers, relatives and friends to be aware of the symptoms of depression and to keep a look out for them.

Depression can affect energy, sleep, appetite and physical health. Other signs are losing interest in hobbies, a reluctance to meet up with friends, an increased use of alcohol and poor personal hygiene. It is also important to look out for physical complaints, such as arthritis pain or worsening headaches, as they can also be a sign of depression in the elderly.

There are many things that can trigger depression. A lack of social interaction is a common problem for older people and the deaths of partners, close friends and family and poor health both of which occur more in later life, can exacerbate loneliness. Studies have shown how social interaction affects mental and physical health which links to depression, high blood pressure and cognitive decline with age.

Health problems can reduce people’s independence and prevent them from doing a lot of things they formerly enjoyed. Retirement is another contributory factor as it can be a massive adjustment for people when they retire, as their days lose a sense of structure and they lose that sense of purpose that working life brought.

Home care workers offer vital social interaction

For many older people, home care workers are the only people, they see on a regular basis. So home care workers have a very important role to play in providing that vital social interaction that helps to combat depression.

Mark Beeby, owner of home care provider, Right at Home South Trafford, has seen first-hand the benefits of social interaction. He says: “In our day-to-day elder care, we find that clients who enjoy more social interaction are generally less depressed and more energetic.”

He has found that “the summer holiday period puts our elderly generation at greater risk of isolation, as regular visitors may depart for a couple of weeks or more” leaving older people lonely and without regular company.

A recent report by the Policy Exchange think tank called for the Government to invest nearly £1bn in teaching older people basic internet skills such as how to send an email and using social media such as Facebook and Twitter.

Eddie Copeland, who wrote the report, said: “In an increasingly isolated and fast moving world it is vital that everyone in society is able to use the internet and understand the benefits.

“Being able to write a simple email or access a social networking site could provide older people with a way to stay connected to their friends and families, who may live hundreds of miles away.”

There are certainly benefits to getting older people online, however home care provider, SureCare, is concerned it may be seen as a replacement for spending actual time with older people.

A spokeswoman at SureCare, said: “Here at SureCare, we can see the benefits of encouraging older people to learn about the internet and how it could help them interact more regularly with loved ones, but we are also conscious of the need to ensure that families and friends do not see it as a substitute for spending real time with their older relatives and friends.

“There is also the reality that no matter how much the Government may invest in such a digital project, there will still be many hundreds of thousands, indeed millions, of older people who simply do not have the inclination, health or wherewithal to be able to learn such skills.

“Our carers at SureCare spend tens of thousands of hours each week caring for the elderly across England and the greatest desire of the majority is the companionship that they get from the time we are able to spend with them in their homes.

“While there are many tasks we will perform on their behalf, such as cooking, cleaning, making beds, collecting prescriptions, DIY tasks and gardening, the single greatest pleasure for many is just seeing a friendly face and being able to have a conversation with another human.”

She added: “So while we applaud any scheme which helps improve the lives of older people in the UK, we can’t help thinking that such an investment (approaching £1bn) would be far better spent on giving people the chance to have real conversations with real people.”

The importance of tackling depression in older people took on even greater significance recently after scientists discovered that the rapid decline in thinking and memory skills associated with mild cognitive impairment, which is known to contribute to Alzheimer's, increase if the elderly person suffers from depression.

Neuroscientist psychiatrist, Dr Robert Wilson of Rush University in Illinois, said “These findings are exciting because they suggest depression truly is a risk factor for dementia, and if we can target and prevent or treat depression and causes of stress we may have the potential to help people maintain their thinking and memory abilities into old age.”

There are many ways to treat depression and it is vital to seek support early on

Treatment for depression ranges from talking treatments such as counselling or cognitive behaviour therapy to various forms of medication. People with depression are also advised to do regular exercise as this is known to improve mood and sense of wellbeing as well as improving physical health. Peer support groups can also help, enabling people to share their experiences and advice.

A more unusual treatment for depression in older people, is brain-boosting computer games, according to a new study.

Scientists from the Institute of Geriatric Psychiatry in New York found a group of people aged between 60 to 89-year-olds, for whom anti-depressants had not worked, felt a lot better after four weeks of playing computer games that had been developed to improve brain fitness.

Depression can be debilitating, robbing people of the joy of living and yet home care workers need to remember, they have the ability to change people's lives for the better, by alerting healthcare professionals and encouraging older people to seek help.

More information on depression and older people can be found at www.ageuk.org.uk/health-wellbeing/conditions-illnesses/depression/

There is also a very useful leaflet for people aged 65 and over who have depression. It is also aimed at friends, relatives and carers. www.rcpsych.ac.uk/healthadvice/problemsdisorders/depressioninolderadults.aspx