Screening for depression can provide beneficial information for function and health of seniors.
October 8 was National Depression Screening Day, and October 3-9 was Mental Illness Awareness Week. The Covid19 Pandemic has been especially tough for our seniors, who are most at risk, and already have increased difficulty getting around and and staying connected. Concern for health, decreased activity, and decreased connection are factors that may challenge mental health.
It is easy to overlook screening for mental health in senior care, when you are focused on immediate physical safety and function. Seniors who are recovering from an illness or dealing with increased chronic health issues, may frequently develop symptoms of depression or anxiety due to the significant adjustments, increased stress, or physical changes in their systems. It is helpful to have a quick and easy tool to help identify possible areas of concern, in order to refer and provide thorough care for our patients.
A validated depression screen can be a great addition to your geriatric assessment.
Seniors have many areas in which they may struggle with mental stress. Losing a life long partner, moving out of your long time home, or watching your physical or cognitive independence decline, are just a few. As I talked with a new patient recently I was reminded of the importance of addressing mental health needs for seniors. This patient had lost her spouse and then moved into a senior residence within a few months. She had decreased her activity level, had fewer responsibilities, and she was lonely. She had undergone several difficult changes quickly, and was struggling.
Seniors who are caregivers for loved ones with physical or cognitive issues may struggle as well. I have been familiar with screening for depression using the PHQ2 (Home Health Nurse, 2010) from my experience in home care. However, I have found in outpatient care, where it is not required for documentation, it is easily overlooked but often still appropriate! This screening tool could be used to provide data to help a patient see their need for care, and/or to help demonstrate improvement as they recover or adjust. The PHQ2 is taken from the PHQ9 (MD CALC) which is a more thorough mental health screen. Being familiar with both (Department of Health, New York), and utilizing them for screening as appropriate may help seniors and their caregivers receive the education, treatment, or referrals that they need.
General tips regarding mental health for seniors and their caregivers:
Eat a healthy diet.
Get a good amount of sleep, and address sleeping issues if present.
Try to stick with a schedule.
Perform routine, appropriate chores. Everyone benefits from feeling needed.
Take part in regular mental stimulation- games, puzzles, etc.
Listen to familiar music, and enjoy looking at special photos.
Make time for positive social interaction. There are many new electronic devices that make texting and ‘facetime’ calls easier for seniors.
Look for ways to volunteer or make a difference for someone else. Many seniors stay active checking on and helping their friends and neighbors.
Moderate alcohol and caffeine.
Limit or find healthy ways to deal with stress.
Seek help when needed. Talk to your physician about medication and mental health counseling. Don’t ignore symptoms.
I would love to hear what you think! Do you screen for depression or mental health regularly? Do you have any tips for assessing or improving mental health for seniors? Subscribe to my blog for health care information and tips, and receive a few FREE downloadable printables to help improve patient education and compliance!
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