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Depression in older people: a guide to care

Depression is common in older people but it can be treated.

Depression is common in older people - it affects around one in five of those living at home, and around twice as many of those living in care homes. Although common, it should not be considered as a normal part of later life and it can be treated.

Sometimes, it isn't obvious that an older person is depressed and they might not even realise it themselves. This is because it can manifest as a physical problem such as tiredness, constipation or loss of appetite. Sometimes those affected lose confidence, feel anxious rather than low and can even become confused or forgetful.

Also, if an older person feels low, then they might not ask for help because they are concerned about being a nuisance or because they are worried about the stigma of mental health.

Longterm illness, loneliness, bereavement, and hospitalisation are all factors which can increase the risk of depression in older adults. Depression is two to three times more common in people living with a chronic physical problem. Dementia can also play a role, as can too much alcohol.

Depression can make an older person more prone to falls and can affect levels of recovery after illnesses and injuries.

Unfortunately, in the midst of other problems in later life, it is too easy to overlook or miss the symptoms and signs of depression. As a result, older people can suffer unnecessarily. Sometimes, even those older people who are diagnosed don't receive the care they need. Evidence shows that older people in England seem to be referred to talking therapy services less readily than younger people especially the over 75s. This is despite the fact that these services seem to be more effective for those aged people aged 65 or more. You can read more about access to IAPT in older people at the link below.

This video from the Royal College of Psychiatrists describes how depression can affect older people and how it can be managed.

You can help by championing support for someone you are concerned about.    If you are concerned then seek help as soon as possible. See the person not their age.

Find urgent help?

Contact the NHS by dialling 999 or 111

Speak to someone at Samaritans by dialling 116123 for free

Contact MIND the mental health charity - 0300 123 3393

Ongoing support?

Once treatment is underway, you can continue to help by watching out for any negative thinking, changes in behaviour such as avoiding social activities and contact with other people, signs of self neglect, feelings of hopelessness or changes in mood. This is particularly important during very stressful periods or at the start of treatment or during a change in treatment.

Find out more

Treatment pathways are generally the same for all adults regardless of age. They vary according to the severity of the depression and largely rely on two types of intervention – talking therapy and medication. Talking therapy entails help in the form of counselling, cognitive behavioural therapy (CBT) or other forms of psychotherapy. These services are often called IAPT services. Research shows that treatment outcomes are actually better in those aged over 65 than in younger adults. Medication is also effective in oder age groups but must be monitored carefully to manage any side effects or interactions with other medicines.

This leaflet from the Royal College of Psychiatrists gives more information about care and support for older people with depression.

IAPT stands for Improving Access to Psychological Therapies. IAPT services are also known as talking therapy services and offer support such as counselling, cognitive behavioural therapy (CBT) or guided self help. IAPT services are free NHS services that provide psychological treatment for people with common problems such as depression and anxiety disorders. IAPT also provide access to evidence-based psychological treatment for people with co – existing long-term physical health conditions (LTCs).

You can read more about IAPT services for older people in this report which was developed by Age UK and the British Association for Counselling and Psychotherapy (BACP)

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Published January 2022

 

The guide is not a substitute for personal  medical advice – always seek professional help. Remember, healthcare professionals will not share information about a patient unless they have been given permission to do so.

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