Putting the gold back in the golden years
Glenda Dekkema-de Vries
My uncle recently passed away. He was in his “golden years.” Although the funeral ceremony was jubilant — with laughter, assurances of life after death and song — the years leading up to his death were emotionally and physically difficult. He suffered with cancer. He was on dialysis. He could no longer do many of the activities he previously enjoyed.
Uncle Gerry recently told his son-in-law, “I’m not living in the golden years. You are.”
Each person’s experiences with aging affects him or her to different degrees: Bodies wither; cognitive abilities decline; loneliness sets in; disease takes its toll; aches and pains are felt; friends and relatives die.
It is no wonder these difficult issues facing the elderly can trigger a major depressive episode. According to Health Canada, five to 10 percent of seniors living in their own homes will experience a depressive disorder compared with 30 to 40 percent of the elderly living in care facilities.
These numbers may be inaccurate for two reasons:
1. Those living in care facilities are more closely observed by professionals than those living in their own homes.
2. Depression may be overlooked as a normal part of aging and the accompanying losses, or it may be confused with, and intertwined with, the symptoms of a medical condition or side effects of medication.
According to Health Canada, once the depressed receive treatment, 80 percent will make a full recovery. This is a strong incentive to appropriately diagnose and treat.
Normal grieving versus depression
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), depression is a “a disabling condition in which the person suffers from low self-esteem, low mood and a loss of interest or pleasure, for a prolonged period of time, in activities that one normally enjoys.”
Considering the elderly may have difficulty doing or enjoying their previous activities because of physical ailments, or the loss of their social network or finances, it is very difficult to determine if they are clinically depressed based solely on the DSM criteria.
A more helpful determination for clinical depression is as follows: In normal grieving one can still feel moments of pleasure or happiness — for example, appreciating a good joke, or enjoying nature, fishing or the grandchildren — whereas in clinical depression the low mood and feelings of hopelessness and despair are constant.
I interviewed Dr. Grant Mullen, Christian, family physician and author of Emotionally Free, a book about living a transformed life, on his views concerning depression in the elderly.
“Yes, they do have the additional issues you have mentioned, but the symptoms, diagnosis and treatment are the same as for others suffering from a mood disorder.”
He said, “The elderly will benefit from a regular support group for mood disorders, just like anyone else. Support groups specifically designed for depression are very comforting because one realizes that others are struggling with the same issues.”
Depression can be divided into mild, moderate and severe depending on duration and intensity. Clinical studies show that people suffering from mild to moderate depression and/or situational depression can benefit to some degree with lifestyle changes, exercise, a change in scenery, social support, a positive attitude and dietary alterations. However, severe depression usually requires prescription medication and professional counseling.
The body, soul and spirit
Dr. Mullen says, “Individuals are made up of the body, soul and spirit.” He goes on to explain that the “body” can be affected by a chemical imbalance, often necessitating medication. The “soul” is the personality, involving current life experiences and wounds of the past, and its healing will often require counselling. The “spirit” will require spiritual support and/or pastoral care.
“We need to address the body, soul and spirit of those suffering with depression because they are all intertwined. If we deal with only one or two of these aspects of a person, there will be some recovery, but not to his/her full potential.”
Seniors suffering from clinical depression will certainly benefit from effective mental, emotional and spiritual support. Their remaining time on this earth can be lived to the fullest. Wouldn't that be golden?
Glenda Dekkema-de Vries B.A., is a former Registered Nurse who has worked in residential care homes, oncology and psychiatry.