The population of older adults in the United States is growing at an unprecedented rate. From 2010-2020, the number of Americans aged 65 or older grew by 34%, with no signs of slowing down (United States Census Bureau, 2020). This large aging population presents several challenges for the healthcare industry, from housing to pharmacological complications to behavioral health issues. In recent years, research has begun to examine how all of these factors contribute to a rather high incidence of mental health conditions. In fact, 1-in-5 adults over the age of 55 experience some kind of mental health concern (National Council on Aging). One of the more prevalent of these conditions for older Americans is depression.
Risk Factors for Depression in Older Adults
As we go through life, we inevitably live through periods where life is unkind. From losing loved ones to slowing down physically, among other things, we’ll all face times when feelings of sadness are unavoidable. For older adults, this process can be amplified, putting them at risk of depression.
Depression, however, does not just mean feeling appropriately sad as the result of an adverse event. Depression is a treatable medical condition, which, according to the DSM-5, presents as having five (or more) symptoms for a 2-week period, which represents a change from previous functioning (Florida Behavioral Health Center). These symptoms include (National Institute on Aging):
- A mood that is constantly low, anxious, or numb
- Feelings of despair, guilt, worthlessness, or helplessness
- Getting easily annoyed, restless, or fidgety
- Losing interest in activities that used to be enjoyable, including sex
- Feeling tired or drained of energy
- Slowing down in movement or speech
- Having trouble focusing, remembering, or making decisions
- Having problems with sleeping, either too much or too little
- Changing appetite or weight, either eating more or less than usual
- Having thoughts of death or suicide or attempting suicide
While depression can occur among anyone, it’s especially prevalent among older adults living with Alzheimer’s or dementia. When depression surfaces as a comorbidity to these other conditions, it can prove to be acute. In fact, researchers have noted that individuals with dementia and depression are at an increased risk of dying by suicide (National Institute on Aging).
Though these statistics are sobering, there are concrete steps your organization can take to improve the mental health of the older adults in your community.
How Your Organization Can Help
A great first place to start is to work with primary healthcare providers in your area and ensure they are properly conducting mental assessments of their patients. This could be as simple as asking how their patients are feeling and then taking that conversation more in-depth if they notice any of the signs of depression listed above. Tactics like this will allow healthcare providers to notice if their patients need help from a behavioral or mental health professional before depressive episodes lead to suicidal ideation or even attempts. To that end, research has shown this approach to be highly effective in reducing suicide rates among older adults (National Institute on Aging).
Once an individual enters your organization for depression treatment, something to keep in mind beyond the normal standard of care is offering culturally competent assessments and care. Depression presents differently across cultural boundaries. For example, one study found that hopelessness more often presents as a symptom of depression among white Americans than it did Black Americans (Assari S & Lankarani MM, 2016). This tendency for cultural norms to dictate one’s displays of emotions related to depression has led one researcher to describe depression as “a chameleon, changing its stripes as it presents differently across racial and ethnic boundaries” (Bailey, Rahn, Kennedy et al., 2019).
To offer the best care possible to clients living with depression, it’s important to talk with them to get a sense of their cultural identity and how this influences their perception of their depressive symptoms. Once you understand how emotionality presents within their culture and how this could be affecting their response to their mental health condition, you can develop a culturally competent method of care.
Jordan Baker is passionate about e-learning and helping learners achieve their goals. At Relias, he works with subject matter experts across disciplines to shape healthcare content designed to improve clinical practice, staff expertise, and patient outcomes. Relias provides lifelong workforce enablement solutions for more than 11,000 healthcare and human services organizations and 4.5 million caregivers to drive measurable outcomes. Customers use Relias solutions to attract and retain talent, elevate care quality, and reduce risk with our technology, services, community, and expertise.
Sources
Assari, S and MM Lankarani, “Depressive symptoms are associated with more hopelessness among white than black older adults. Front Public Health. 2016; 4:82. Access via https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4854870/
Bailey, Rahn Kennedy, et al., “Racial and ethnic differences in depression: current perspectives,” Neuropsychiatr Dis Treat. 2019; 15: 603–609. Published online 2019 Feb 22. Accessed via https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6390869/
Florida Behavioral Health Center, “DSM-5 Criteria: Major Depressive Disorder.” Accessed via https://floridabhcenter.cbcs.usf.edu/wp-content/uploads/2021/03/MDD_Adult-Guidelines-2019-2020.pdf
National Institute on Aging, “Depression and Older Adults.”
The National Council on Aging, “Behavioral Health for Older Adults.” Accessed via https://www.ncoa.org/older-adults/health/behavioral-health
United States Census Bureau, “65 and Older Population Grows Rapidly as Baby Boomers Age,” 2020. Accessed via https://www.census.gov/newsroom/press-releases/2020/65-older-population-grows.html
