Depression in Nursing Homes Is More Common than You May Think
For those of us unable to provide the level of care aging parents need, nursing homes afford us great relief. However, our loved ones often perceive them differently. Among patients, nursing homes may represent a lack of independence and autonomy. Even if they need the round-the-clock care and assistance these facilities provide, having to leave one’s outside life behind can have serious emotional effects.
Depression among nursing home residents is not a new problem: In 1991, the New York Times estimated that around 450,000 patients suffered from severe depression. A 2012 survey of the elderly in Australia found that over half the residents in these facilities showed symptoms of depression ranging from mild to severe. Unfortunately, caregivers may not consider treating, or even looking for, mental illness on top of patients’ other medical needs.
Why does that matter? Aside from suffering unnecessarily with negative thoughts and emotions, patients who display signs of depression upon or shortly after admission to a nursing home are more likely to be designated “high care” residents as compared to their peers without depression. Depression can affect one’s care needs and their receptiveness to treatment, setting them up for lower overall health. Doctors and nurses should pay attention to mental as well as physical health to boost patient outcomes.
The Nursing Home Connection
Among doctors, common wisdom assumes that the elderly are just more likely to be depressed, and there’s nothing to be done about it. As these populations lose their abilities and freedoms, the thinking goes, they lose sources of happiness.
Studies show this is not the case. According to the CDC, nursing homes have the highest depression rates of any managed care facility; 49% of their patients have been diagnosed. By contrast, options such as adult day service centers and hospice arrangements see depression diagnosed in only 20-30% of patients. This shows it’s not just a symptom of aging—it’s also a function of patients’ day-to-day circumstances and experiences.
No Diagnosis, No Treatment
One of the biggest issues with elder depression is a lack of awareness and attention from physicians. Though they are surrounded by caregivers, nursing home patients often only spend a few minutes each month with an actual physician. In such a short time it’s hard to learn enough about a patient to spot the signs of mental illness, much less make a complete diagnosis. Older patients often foster more stigma regarding mental illness and are therefore less likely to self-report.
Analyses of nursing home patients nationwide show that only between 40-60% of those with depression actually receive a diagnosis. However, clinicians estimate that around 75-80% can be cured of the condition if given proper treatment. Current nursing home practices therefore leave behind many elders in need of help. Not only does this result in a lower quality of life for these patients, but it may also affect the amount of attention they need for other health concerns.
It’s Not Just Feeling Blue
Most people associate the word “depression” with sadness, as we often use it to indicate negative thoughts or moods. However, as a diagnosis, depression signifies more than just occasional dejection. It can affect the mind in many ways—and the body, too.
Depression can lead to a quicker decline in health with symptoms ranging from a loss of physical ability to a drop in immune system function. Though doctors have not yet identified the mechanisms through which these changes occur, observation of nursing home patients has shown that those with depression:
- need more frequent doctor/emergency care,
- take more medication,
- need costlier outpatient care, and
- spend more time in the hospital
than those without the mood disorder. In some cases, the disease’s toll is too high for patients to bear. One study of nursing home residents showed that, over the course of a year, nearly half of those with depression passed away. For those without depression, only a quarter did not survive the year.
Can I Help Elderly Relatives with Depression?
Mental illness is treatable for most—but it relies on the patient receiving a proper diagnosis. When nursing home residents are denied frequent contact with doctors and clinicians, depression and other mental illnesses may go unnoticed or be misdiagnosed as dementia or Alzheimer’s. Families may be able to spot the changes in their loved ones, but they do not always know the cause.
Nursing homes with high populations often neglect their patients’ mental and physical health. Depression may be met with ignorance or avoidance. Further, the factors behind mental illness may go unaddressed. Isolation, chronic pain, and certain medications may lead to depression; harsh treatment by staff or other residents can also take a toll on patient health.
Though depression may cause your loved on to feel hopeless, there is help—and potential recourse as well. Brown & Barron, LLC focuses on helping the victims of nursing home neglect and abuse formally complain and ask for damages. We’re here to speak if you need someone to listen.