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Elder Issues
Depression
Self-Neglect
Substance Abuse
According to the
Geriatric Mental Health
Foundation, approximately 15 out of every
100 adults over age 65 (in the United States) are affected by
depression. The disorder affects a much higher percentage of
people in hospitals and nursing homes.
As in younger adults, clinical
depression may be precipitated by adverse life events, including
poor health, loss of friends or loved ones, loss of physical
functioning or loss of self-esteem related to aging.
Depression is not a normal part of aging, however, the process of
aging can be lonely and increase one's vulnerability. In addition,
medications for other health-related problems can also trigger
depression.
Recognizing depression in the
elderly is not always easy. It often is difficult for the
depressed elder to describe how he or she is feeling. In addition,
the current population of older Americans came of age at a time when
depression was not understood to be a biological disorder and
medical illness. Therefore, some elderly fear being labeled "crazy,"
or worry that their illness will be seen as a character weakness.
The depressed person or his/her family members may think that a
change in mood or behavior is simply "a passing mood," and the
person should just "snap out of it." But someone suffering
from depression can not just "get over it." Depression is a
medical illness that must be diagnosed and treated by trained
professionals. Untreated, depression may last months or even years.
When it is properly diagnosed and
treated, more than 80 percent of those suffering from depression
recover and return to their normal lives. The most common
symptoms of late-life depression include:
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l persistent
sadness (lasting two or
more weeks)
l feeling
slowed down
l excessive
worries about finances
or health
l frequent
tearfulness
l feeling
worthless or helpless
l weight
changes |
l pacing or
fidgeting
l difficulty
sleeping
l difficulty
concentrating
l physical
symptoms such as pain or
gastrointestinal problems
l withdrawal
from regular social activities
l neglect of
personal appearance or basic
needs such as cooking/eating |
Like many illnesses, there are varying levels
and types of depression. A person may not feel "sad" about anything,
but may exhibit symptoms such as difficulty sleeping, weight loss,
or physical pain with no apparent explanation. This person still may
be clinically depressed. Those same symptoms also may be a sign of
another problem -- only a doctor can make the correct diagnosis.
If you or a loved one is
experiencing signs of depression, contact a physician right
away or visit our
resource page for
contact information for helpful organizations in the Valley region.
Left untreated, depression is a dangerous and even life-threatening
condition.
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Self-neglect by older adults is a
serious problem. Recent studies indicate that nearly one half of all
elder abuse cases and two thirds of elder neglect cases
(investigated by authorities) involve self-neglect.
Self-neglect occurs when older
adults, by choice or by lack of awareness, live in ways that
disregard their health or safety needs, sometimes to the extent that
this disregard also becomes hazardous to others. Older
adults who neglect themselves are not willing or able to perform
essential self-care tasks such as:
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l obtaining
food, clothing, adequate shelter
l obtaining
adequate medical care
l obtaining
goods and services necessary to maintain physical and
mental health, well-being,
personal hygiene and general safety
l managing
financial affairs |
There are several signs or
symptoms of self-neglect that you can look for. Poor overall
self-care is a major indication of self-neglect. Specific signs to
look for include:
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l dehydration
l malnutrition
l
hypothermia/hyperthermia (exceptionally low/high
temperature)
l excessive
dirt or odor, hazardous, unsafe or unclean living
conditions
l inadequate
or inappropriate clothing
l absence of
needed eyeglasses, hearing aids, dentures or prostheses
l unexpected
or unexplained deterioration of health
l bedsores
l signs of
excessive drugging, refusal to take medication or other
drug misuse |
Older adults who neglect
themselves usually have certain characteristics. Knowing about these
characteristics can assist those who are trying to help. For
example, older adults who neglect themselves are more likely to live
alone.
They are also more likely
than others to suffer from mental illness or physical illnesses such
as Alzheimer's disease, decreased physical abilities, and/or alcohol
and drug problems. There are also some gender differences. More
women than men neglect themselves, but this may be because more
women than men live alone.
There are relatively clear signs
that can help in determining if older adults are neglecting
themselves. However, it is less clear what steps family members,
friends and formal care providers can take. It may be helpful to
consider legal and other intervention strategies in self-neglect
situations and/or to contact a physician or mental health
professional for advice. For contact information about helpful
organizations in the Valley region, visit our
resource page.
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The
American
Society on Aging reports that among the over-60 population as
many as 17% misuse alcohol or medications. Among older people,
alcohol-related hospitalization rates for older people are similar
to those for heart attacks, and older people consume 25% of all
over-the-counter medications available without a prescription.
Yet with older adults, substance abuse is frequently an invisible
problem because it can be masked and complicated by lack of
awareness, provider behavior, and health and age-related issues.
Who is at risk?
According to The
Journal of the American Geriatric Society, older people may be
especially likely to become addicted to alcohol or prescription
drugs if they suffer from depression, loneliness, boredom, stress,
or chronic pain. Women are more apt to abuse prescription
drugs, especially if they have experienced the stress of a late-life
divorce, widowhood, or poor health. A history of substance
abuse increases the risk, but even an older person with a spotless
past can suddenly succumb to a new addiction. Often the
drugs of abuse are those prescribed to relieve suffering from stress
and pain, but if the patient become addicted, the drugs then become
part of the overall problem.
Which substances are most
likely to cause addiction?
When older people
misuse a substance it is most likely to be alcohol. Roughly 2.5
million older adults have alcohol problems. Alcohol is socially
acceptable, readily available, and, for many people, powerfully
addictive. Changes in the body make older people more sensitive to
alcohol, and it may take relatively few drinks to cause intoxication
or feed an addiction. Health authorities recommend that
people over age 65 have no more than one drink per day.
Addiction to prescription drugs
is second to alcoholism among the elderly. Though still relatively
uncommon, it's affects are no less devastating. Barbiturates,
Diazepam (Valium), Morphine and other pain killers are the most
commonly misused.
What are some warning signs
of substance addiction?
Hardly anyone,
young or old, ever admits to an addiction voluntarily. It's up to
friends and family members to spot signs of trouble before it's too
late: these include complaints of anxiety, depression,
disorientation, apathy, panic attacks, mood swings, changes of
appetite, sleep problems, paranoia, hallucinations, tremors, and
failing memory. Conflicts at work, or with family members are also
common. Finally, anyone who plans the day around drinking or goes
from doctor to doctor seeking prescriptions is raising a red flag.
If you or someone you love is
experiencing a substance abuse addiction, it is important to
seek help immediately. Contact your physician, or
visit our resource
page for contact information for helpful organizations in the
Valley region.
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