Depression is a common condition among residents of nursing homes. Unfortunately as many as fifty percent of all nursing home residents are clinically depressed. Nursing home staff frequently fails to identify depression in elderly residents, perhaps because it is so prevalent, but it is not just simply a normal part of the aging process. If someone you love is in a nursing home and suffering from depression, it should be treated.

Signs of Depression in the Elderly

The signs of depression among nursing home residents are no different than the signs of depression in anyone. Keep in mind that the signs will vary from person to person. If the elderly person you care about is exhibiting a combination of these signs, seek help:

• Abnormal agitation
• Feelings of being "down"
• Sudden change of weight or appetite
• No longer enjoying activities normally enjoyed
• Frequent talk of death or dying
• Lack of normal energy
• Feeling guilty or worthless
• Problems with sleep (too much or too little)
• Extremely slow movements
• Problems focusing and making decisions
• Trying to remain isolated from others

While some of these can be part of aging, if the symptom comes on suddenly and seems very abnormal for your friend, it is probably a sign of depression.

Difficulty with Diagnosing Depression in Nursing Home Residents

Because the signs of depression can mirror the signs of dementia, especially problems with focusing and concentrating, diagnosing depression in an older adult can be difficult. Also, there is not blood test or lab work you can do to successfully diagnose depression. Healthcare providers will use screening tests to determine whether or not an individual is depressed, so your accurate recording of problem behaviors is essential to an accurate diagnosis.

Most doctors will do a thorough physical exam to make sure there is not an underlying cause of the depression signs. If no underlying condition can be found and the depression symptoms have been present for at least two weeks, the doctor will likely diagnose and treat the patient for depression.

Those who know the nursing home resident well are the best advocates if depression is present. Because nursing home staff members have a frequent turn around and have not known your loved one for as long as you have, they may not notice subtle changes that indicate depression. You must speak up if you suspect a problem and get help for the person you care about.

Medical Treatment for Depression

If a diagnosis of depression is given, the doctor will evaluate the severity of the condition in order to decide on a course of treatment. If there is an obvious cause, such as pain or a reaction to medication, then that cause is treated first. Stronger pain medication or a cessation of the medication that is causing depression are both options.

Sometimes antidepressant medication is the best course of action. However, with elderly patients, this might not be the first option chosen, particularly if they are already on many medications, due to the possibility of side effects or drug interactions. Serotonin-reuptake inhibitors are the most common types of medication prescribed for nursing home residents suffering from depression.

Non Medical Treatments

Therapy, either individual or in a group setting, can help the individual work through the feelings of depression. Keep in mind that this option will not work for patients with any level of dementia.

Sometimes a nursing home resident will become depressed because of the setting, which feels less like a home and more like a hospital. You can help them by making their living quarters feel more personal. The more home-like the resident's quarters are, the less they will feel depressed.

You can also work as the individual's advocate, helping the staff members choose activities that the individual really enjoys, and asking them to make sure he participates if at all possible. Depressed people, no matter how old they are, tend to withdraw, but the best thing for them is to get involved in activities, leave their rooms, and interact with others.

If you feel the nursing home should be doing more to help your loved one's condition, ask. Make sure the staff is on the same page as you, and if you need help, get your friend's social worker involved (all nursing home residents have one). Remember, depression can and should be treated, so do not let it go unnoticed and overlooked any longer.