Why handling depression is an important part of dementia care
Depression is very common among people with dementia but recognising the symptoms of depression may not be as easy as you may think.
Many of the symptoms of depression are shared with those of dementia, and Alzheimer’s disease in particular, and it is not uncommon for people to assume they just have to put up with their symptoms as an inevitable part of the disease.
This is simply not the case however. Not only is treatment available for depression, it can be remarkably effective for dementia sufferers and can significantly improve quality of life.
Recognising the symptoms of depression in someone with dementia
While a diagnosis of dementia can lead to intense feelings of sadness, hopelessness, fear and even guilt, the cognitive impairment caused by the disease can make it difficult for the person to articulate their feelings adequately.
The Alzheimer’s Association issues this advice which is helpful in deciding when to seek help:“For a person to be diagnosed with depression in Alzheimer’s, he or she must have either depressed mood (sad, hopeless,discourages or tearful) or decreased pleasure in usual activities, along with 2 or more of the following symptoms for 2 weeks or longer:
Social isolation or withdrawal
Disruption in appetite that is not related to another medical condition
Disruption in sleep
Agitation or slowed behaviour
Fatigue or loss of energy
Feelings of worthlessness or hopelessness, inappropriate or excessive guilt
Recurrent thoughts of death, suicide plans, or a suicide attempt
People with depression, whether they have dementia or not, are not able to think themselves out of it by sheer force of willpower, so simply telling them to “Snap out of it” or “Cheer up” is not going to help. Support, reassurance and medical help are all required.
The most effective treatment is likely to involve a combination of medicine, counseling and gradual reconnection to people and activities that bring contentment. Seeking help from your GP is important. This will allow you to explore the full range of options available.
Ways for carers to help
Plan a predictable daily routine. This can provide reassurance and purpose. Try to schedule activities the person challenging at the time of the day they are best able to cope.
Find ways the person can contribute to family life, and make a point of recognising his/her contribution. Remember to celebrate even the smallest successes and occasions.
Acknowledge the person’s feelings and frustrations while continuing to express positive messages about the future.
Encourage regular exercise, particularly in the mornings, as this is a great mood enhancer.
Make a list of activities, people and places the person enjoys. Try to visit/incorporate these more frequently into your diary.
Seek out local support groups. It can be a huge source of comfort to know that you are not alone in dealing with this and that there are others in a similar position. Groups can provide fun and meaningful activities geared specifically to those with memory and cognitive problems, are a great way of maintaining social contacts.
What part can care homes play in helping dementia patients cope with depression?
Isolation and boredom are two key factors in contributing to depression in older people. Care homes that specialise in dementia care are experts in tackling these problems.
Good design and well trained staff mean they are able to maintain a stimulating, yet reassuringly safe, environment that provides facilities and therapies simply not available to people in their own homes. Together with increased opportunities for social interaction, engagement, and 24 hour care, this can really help improve quality of life for someone living with dementia.