time outside and to socialize more — things that are limited during the pandemic, she says. If you're worried about loved ones who seem seriously de-
pressed, check in on them every day, either by phone or video call, especially if they're living alone. If they are in an assisted living facility or nursing home, sometimes staff can assist with technology.
"If it seems as if they're not interested in the conversation,
or their behavior seems off, the family should be concerned and ask more questions,” says Parulekar. And don't be afraid to ask someone you're concerned about
whether they are having thoughts of suicide. “Asking about sui- cide is not going to put the idea in their head,” says Wright. “If they're thinking about it, they were already thinking about it. Asking can save a life."
Assessing an Older Adult’s Mental Health Needs We expect our older relatives to slow down as they age, but
a significant drop in energy level or a marked change in mood or behavior could signal a more serious matter. Here are some ways to assess your loved one’s mental health needs and seek treatment.
Identifying Depression Depression is a serious medical illness that often goes un- recognized and untreated among older adults, according to the National Institute of Mental Health. It’s normal for an older person to feel sad every once in a while or frustrated by health problems or financial concerns. If one of the following symptoms
Distinguishing Depression From Dementia
Depression sometimes gets misdiagnosed as dementia, a decline in mental ability that can be caused by Alzheimer’s dis- ease, stroke, brain tumor and other illnesses. People with demen- tia have problems with at least two brain functions, such as memory and language. An older adult with depression may exhibit dementia-like symptoms, such as forgetfulness, disorientation and inattentive- ness. This so-called pseudodementia sets in after the person has already shown signs of depression. Someone with depression- related pseudodementia will complain about memory loss, whereas a person with Alzheimer’s disease or another form of dementia will try to conceal memory loss. It’s also not unusual for a person with dementia to develop depression. Before depression sets in, however, mental decline will have already begun. Other psychological and emotional issues that can arise from dementia include anger, anxiety, loss of inhibitions and paranoia.
Pinpointing the Underlying Problem Could your relative have depression or dementia? Or is there another explanation for a change in energy level or behavior? To find out, take these steps:
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Ask a doctor or pharmacist if a medication — or combination of drugs — could be causing fatigue, depression or other symp- toms. Geriatric pharmacists are especially knowledgeable about how medications affect older people. A pharmacist can review all of your loved one’s prescriptions, not just those prescribed by a specific doctor. Visit the Board of Pharmacy Specialties website to find a geriatric pharmacist near you. Ask your loved one’s doctor if another health problem, such as anemia, could be causing fatigue. Also keep in mind that early pneumonia or a urinary tract infection can lead to depres- sion-like symptoms in a person who has dementia or has been disabled by a stroke. Ask your loved one if she’s feeling sad or anxious about something. Listen carefully, and offer emotional support. Like depression, anxiety often goes undiagnosed in older adults. The first step in treating anxiety is determining the source of the stress. Physicians also treat anxiety with psychotherapy and medications.
persists and interferes with daily life, however, your loved one could be suffering from depression: Prolonged sadness. Energy loss. Irritability, anger or pessimism. Nervousness or restlessness. Feelings of worthlessness, hopelessness or helplessness. Loss of interest in favorite activities. Difficulty sleeping or sleeping more than usual. Eating more or less than usual. Recurring thoughts of death or suicide.
Having a chronic illness or limited ability to function in- creases a person’s risk of developing depression. If your loved one shows signs of the disease, seek treatment. Left untreated, depression can affect one’s physical health and quality of life. Treatment can include antidepressant medications or talk thera- py — or a combination of the two.
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