Depression or being “down in the dumps” over a period of time is not a normal part of getting older. However, older adults are at an increased risk because depression is more common in people who have serious illnesses or whose functioning becomes limited.
Older adults are often misdiagnosed and undertreated. As a person ages, the signs of depression are much more varied than at younger ages. Confusion or attention problems caused by depression can look like Alzheimer’s disease or some other brain disorder. Mood changes can be caused by medicines older people may take for high blood pressure, arthritis or heart disease. Doctors may mistake an older adult’s symptoms of depression as just a natural reaction to illness or the life changes, and therefore not see the depression as something to be treated. Older adults, themselves, often share this belief and do not seek help because they don’t understand that they could feel better with appropriate treatment.
Family caregivers are also at risk for depression. The Family Caregiver Alliance estimates that about 20 percent of family caregivers suffer from depression, twice the rate of the general population. Women caregivers experience depression at a higher rate than men. Unfortunately, feelings of depression are often seen as a sign of weakness rather than a sign that something is out of balance.
How do you know when you or a family member needs help? Here is a list of the most common signs of depression. If you or a family member have several of these and they last for more than two weeks, you or your family member should see a doctor:
- An “empty” feeling, ongoing sadness, and anxiety
- Tiredness, lack of energy
- Loss of interest or pleasure in everyday activities
- Sleep problems, including trouble getting to sleep, very early morning waking, and sleeping too much
- Eating more or less than usual
- Crying too often and too much
- Aches and pains that don’t go away when treated
- A hard time focusing, remembering, or making decisions
- Being irritable
- Feeling guilty, helpless, worthless or hopeless
- Thoughts of death or suicide or a suicide attempt
(From National Institute on Aging)
If you are a family member or friend of an older person, watch for clues; don’t ignore the warning signs. If left untreated, serious depression can lead to suicide. Listen carefully to someone of any age who complains about being depressed or says that people don’t care. That person may really be asking for help. See your doctor or take your older family member to see his/her doctor.
Medicare benefits will cover mental health care. Mental health care includes services and programs to help diagnose and treat mental health conditions. Medicare helps cover outpatient and inpatient mental health care, as well as prescription drugs. For more information, see Resources listed below.
The Older Adults Transitions Program (OATS) provided by El Camino Hospital at the Mountain View campus supports the mental health and wellness of our older adults. The Behavioral Health department provides additional services and programs to assist older adults and/or their family members with depression and other behavioral health concerns.
Misuse of Alcohol and Drugs
As we get older, our bodies begin to react differently to alcohol and medications than when we were younger. Many older people take many different medications, which may not mix well with each other or with alcoholic drinks. If older adults do not allow for these changes in their bodies and do not use medications wisely, they may experience problems with substance misuse without even knowing it. Some physical and mental problems that people think are just a normal part of aging or the result of an illness may actually be caused by drinking too much, incorrect use of medications or mixing medications with alcohol unsafely.
There are some specific ways our bodies respond differently to alcohol and medications as we age:
- Increased sensitivity (we feel the effects with less alcohol)
- Decreased tolerance to alcohol (you can’t drink as much as you used to)
- Slower metabolism (blood alcohol levels are higher for a longer amount of time after drinking)
These changes mean that there is an increased danger of accidents, falls, and injuries for older adults even many hours after they drink alcohol. (From Geriatric Mental Health Foundation)
Many medicines—prescription, over-the-counter, or herbal remedies—can be dangerous or even deadly when mixed with alcohol. Many older people take medications every day, making this a special worry. Before taking any medicine, ask your doctor or pharmacist if you can safely drink alcohol.
If you have concerns about your or a family member’s use of alcohol and/or medications, you should talk to your doctor or a counselor familiar with substance use and older adults. You may contact the staff in our OATS program for referrals to programs. El Camino Hospital offers support groups focused on alcohol and narcotics issues. For information about treatment options and services, call our eldercare consultants who can provide you with referrals to local and out-of-state programs and services.
Compulsive Hoarding and Clutter
Most of us like to keep possessions that bring us comfort or appear to have value. But when one’s daily activities and quality of life are compromised by an accumulation of these possessions, then a person might have a problem with compulsive hoarding. Having too many things can cause concerns about safety, fires and health hazards. Too much clutter can limit one’s mobility and cause falls, impede one’s access to exits in case of a fire or emergency and spoiled or old food can breed rodents and other health risks.
While people of any age may have issues with hoarding and cluttering, most compulsive hoarders are aged 50 or older. Most hoarders live alone and many believe that they collect or hoard things now as a result of having lived through a period of poverty or deprivation. There is some evidence that hoarding behavior may be stepped up after a loss of a spouse or family member.
What are some of the signs of Compulsive Hoarding and Cluttering?
- Accumulating objects in your home, car or office
- Difficulty discarding or parting with objects
- Compulsively acquiring free items such as advertising flyers, straws from restaurants
- Compulsively purchasing items simply because they are “bargains” to have as “extras”
- Feeling distressed or overwhelmed by the amount of possessions you have
- Interference with everyday life and tasks because of excessive clutter
(From the Institute on Compulsive Hoarding and Cluttering, Mental Health Association of San Francisco)
The important thing to keep in mind is that there are services that can help you or family members if you have concerns about hoarding and clutter. Family members also need to be sensitive to the underlying behavioral issues with hoarding and realize that just cleaning out the house won’t solve the underlying behavior. Our eldercare consultants can assist you with resources and services available to help you get support and to help you organize and/or dispose of unneeded belongings.
Medicare Mental Health Benefits, Medicare
Caregiving and Depression, Family Caregiver Alliance
Depression (in Older People), National Institute on Aging
Helping an Older Adult who is Depressed, National Alliance for Caregiving
Center for Elderly Suicide Prevention/The Friendship Line; 24-hour Helpline: 800-971-0016
Older Adults and Alcohol: You Can Get Help, National Institute on Aging
Aging, Medicines and Alcohol, Substance Abuse and Mental Health Services Administration (SAMHSA)
Educational Resources on Compulsive Hoarding, Institute of Compulsive Hoarding and Clutter, Mental Health Association of San Francisco