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Caregiving Chronicles

News and analysis on caregiving topics in MetroWest and beyond.

Caregiving Chronicles

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Caregiving Chronicles will present news and analysis on caregiving topics in MetroWest and around the world, in-depth Q&As with experts in fields related to caregiving and updates and announcements about caregiving resources available in MetroWest from CaregivingMetroWest.org Program Director Douglas Flynn.


Caregiving Chronicles Q&A: Discussing depression among caregivers and older adults
By Douglas Flynn / May 29, 2018

Editor’s note: The Caregiving Chronicles blog has partnered with the Natick Visiting Nurse Association to bring additional expert information and advice to the MetroWest caregivers we strive to serve at CaregivingMetroWest.org. The Natick VNA has allowed Caregiving Chronicles to get some valuable insight from its staff for our ongoing series of Q&A sessions with caregiving experts.  

In this entry, we discuss depression and how it affects caregivers and older adults. Providing insight is Juanita Allen Kingsley, Wilderness EMT, who is the Director of Business Development for Natick VNA. 

A health educator, she trains more than 2,000 people in the MetroWest region annually through her First Aid, Wilderness First Aid, CPR and AED classes in addition to the variety of health and safety programs she teaches. She holds a Bachelor of Science degree in Business Administration from Boston University and completed EMT training at Northeastern University. She received her Wilderness EMT training certification through Mountain Aid Training International. 

For more information, visit www.natickvna.org or call 508-651-1786.
 

Caregiving MetroWest: Let’s start with the basics. What exactly is depression and how is it different than simply feeling “down” or “sad”? What causes depression?
Juanita Allen Kingsley:
We all have moments or times in our lives when we are sad or down, but what we describe as depression is when these feelings interfere with our activities of living — our work, our sleep, our eating and our ability to enjoy those activities that bring us pleasure. 

CGMW: Depression is common among those caring for a loved one, especially a loved one with a chronic condition or a diagnosis of Alzheimer’s or another form of dementia. Why are caregivers so susceptible to suffering from depression?
Kingsley:
We do know that a stressful environment or life situation can contribute to causing depression or its sudden onset. Caring for a loved one certainly is both of those! In addition, caregivers are often sleep deprived, which makes us more vulnerable and we are often isolated as well, with fewer opportunities to get out and socialize.


CGMW: What can caregivers do to try to avoid depression or mitigate its effects?
Kingsley:
All the basics are important: take good care of your own health —your exercise, your diet, your sleep. Don’t wait until you’re depressed to join a support group — socializing with others who know what you are managing every day can be extremely helpful. Ask for help! 

CGMW: What are some of the signs or symptoms that could indicate depression?
Kingsley:
You don’t seem (or your family member can’t seem) to pull out of a feeling of being blue or down. Sleep patterns and eating patterns may change. Doing something with friends just seems like too much effort. 
Some of the signs and symptoms according to the Diagnostic & Statistical Manual of Mental Disorders 5, include the following:

• Prolonged sadness or unexplained crying spells
• Significant changes in appetite and sleep patterns
• Irritability, anger, worry, agitation, anxiety
• Pessimism, indifference
• Loss of energy, persistent lethargy
• Feelings of guilt, worthlessness
• Inability to concentrate, indecisiveness
• Inability to take pleasure in former interests, social withdrawal
• Unexplained aches and pains
• Recurring thoughts of death or suicide

CGMW: Depression is also common among the older adults that family caregivers are caring for. Are there any different signs or symptoms that a caregiver should know to look for to recognize that their loved one may be suffering from depression?
Kingsley:
My own mother lived with depression throughout her life, but it became more pronounced during her last few years when she was wheelchair-bound. Her depression was chemical in nature, but it was made worse by her isolation, her guilt for needing family members to care for her and grieving the loss of activities that brought her much pleasure such as walking and gardening.  She stopped engaging in conversation, she was often tearful. I realized at a certain point that it had been a very long time since I’d seen her smile. I also realized that my mother’s home health aides were wonderful, but they didn’t understand how important fresh air and sunlight were to my mother. We started having her sit outside as much as possible in her backyard  in good weather and opening up windows and curtains to bring in more sunlight. 

CGMW: What should someone do when they recognize the signs of depression in themselves or someone they’re caring for? 
Kingsley:
This is a great question. See your healthcare provider to see if there’s a physical cause to the depression. Ask about help through medications and working with a social worker or a therapist. We should be taking the same care in managing our mental health as our physical health. Saying things like “Count your blessings” or “look at the bright side” are not helpful at all.

CGMW: What types of treatments are there for depression? What kind of help or resources are available and how can it be accessed?
Kingsley:
Our primary care provider can refer us or our family members to a therapist. He/she may prescribe anti-depressants as well. 

CGMW: Being willing to seek or accept help is often one of the biggest barriers to treating depression. What are some strategies to convince someone to seek help or understand their own need to get help?
Kingsley:
Please don’t judge either caregiver or family member. Speak from the heart: “I’m worried about you. You seem to be feeling down. I think we should go see your doctor and find out what we can do.”

CGMW: Is there anything else caregivers should know about depression and how it can affect them or the ones they are caring for?
Kingsley:
There is help available. Also, please remember that if your family member is feeling depressed, it is not a measure of the care you are giving. Dementia or other chronic diseases such as Parkinson’s are really tough to live with and having your life change so greatly is really hard to accept.  Be assertive with family members and friends, neighbors, and fellow church members in asking for help. Be open about needing visitors or a break from the work of caregiving. 

(Editor: For more information about depression and local resources to help someone with depression, check out the section on Depression her on Caregiving MetroWest, as well as our listings of Elder Mental Health Programs in the area.)



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