Mental illness has long been a taboo topic in our society—but even more so when it comes to older adults. While ageism influences many to assume it’s just “normal” to be sad when we get closer to end of life, the truth remains that depression has become one of the greatest preventable epidemics to hit the aging population. So, why aren’t we talking about it?
Research shows depression is the seventh most common chronic condition in assisted living facilities, affecting nearly 30 percent of residents. The National Council on Aging says it’s as prevalent as heart failure in aging adults—so prevalent that it’s led to “disturbingly high” levels of suicide. In fact, although adults over 65 make up just 13 percent of the U.S. population, they account for 20 percent of suicide-related deaths. And yet, currently, the screening and treatment of depression or mental disorders in assisted living communities is not consistently mandated. Imagine if the facilities caring you did not consistently monitor your blood pressure, cholesterol, or diabetes. In many cases, that’s exactly what is happening when it comes to depression and mental illness—to our great detriment.
More needs to be done to keep us healthy—and happy—in our second phase of life. The following are just a few things we can all do to increase our longevity in the face of depression and mental illness.
Acknowledge the problem. First, acknowledge that depression is not a normal part of aging. It is a health condition that needs to be addressed like any other, from high blood pressure to cancer. Indeed, depression in older adults can double the risk of cardiac disease, and research shows that when nursing home patients suffer both physical illness and depression, the chance of death is significantly increased. Accept the problem for what it is: a preventable chronic health issue.
Talk about it. When my grandfather—a muscular WWII vet and former semi-pro football player—became depressed, it was clear to me and everyone around us. Once a perfectionist, he didn’t just stop mowing his lawn—he was adamant that no one else help with it. He no longer took pride in the things he used to care about. Family and caregivers share a responsibility to notice these changes in personality and interests and discuss them openly, without shame or judgment. Numerous simple screening tests for depression are available online. Don’t be afraid of the words, “Have you considered suicide? Have you thought of ways to do it?” They might be hard to say, but they could save a life.
Advocate. Many assisted living facilities today do not properly train employees or residents to recognize or treat depressive symptoms. Make sure you chooses one that does. Says memory care specialist Judy Berry, “New places opening are boasting ice cream parlors and indoor movie theaters without increasing the direct care staff ratios that are critical to assisting seniors with dementia to use such facilities. Persons in memory care thrive, first and foremost, when their emotional needs are met, and they are treated and respected as valuable purposeful human beings.” Pressure owners and operators to put more money into higher staff ratios, ongoing training, and support, rather than more building amenities.
Push for new models. Only 2,000 of the 16,000 nursing homes in the United States have less than 50 beds, and most have more than 100. While small-house models like The Green House Project don’t always draw the same major investments—or monthly profits—larger ones do, they offer more opportunities for personal interaction, and the chance for caregivers to get to know residents more intimately. Other models welcoming mixed-age MS and ALS patients are also a good option for helping residents feel like people—not “old people.” Push community owners to make healthful outcomes—not income—the primary goal of their communities.
By law, care facilities can only welcome patients they can truly support. But when mental health is not part of the resident pre-screening process, that’s impossible to know. Communities need to take responsibility to screen, train, and support residents for all their health needs—both physical and mental—and family and friends need to be ready to make sure it happens. Depression does not need to be a normal part of aging. It’s up to all of us to acknowledge—and address—the risk.