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Assessing an Older Adult’s Mental Health Needs

Change in mood or behavior can signal a serious matter

Article Highlights

  • Depression vs. Dementia
  • Know the best practices and treatments
  • Don't ignore remarks about suicide

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.

See also: Questions to ask the doctor.

Identifying Depression
Depression is a serious medical illness that often goes unrecognized 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 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 increases 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 therapy — or a combination of the two. Learn more about depression.

Distinguishing Depression From Dementia
Depression sometimes gets misdiagnosed as dementia, a decline in mental ability that can be caused by Alzheimer’s disease, stroke, brain tumor and other illnesses. People with dementia 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 inattentiveness. 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. Refer to AARP’s Health Encyclopedia to learn more about diagnosing, treating and coping with dementia.

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:

  • Ask a doctor or pharmacist if a medication — or combination of drugs — could be causing fatigue, depression or other symptoms. 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 Commission for Certification in Geriatric Pharmacy 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 depression-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.

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