From the category archives:

Alzheimer’s & Communication

In today’s post on Depression Later in Life, I will focus on the fact that depression is treatable.

Most depressed elderly people can improve dramatically from treatment. In fact, there are highly effective treatments for depression in late life.  Some treatment prescribed by physicians include:

  • Psychotherapy
  • Antidepressant medications
  • Electroconvulsive therapy (ECT)
Depression

Antidepressants work by increasing the level of neurotransmitters in the brain.  Neurotransmitters are the brain’s “messengers.” Many feelings, including pain and pleasure, are a result of the neurotransmitters’ function.  When the supply of neurotransmitters is imbalanced, depression may resul.

A frequent reason some people do not respond to antidepressant treatment is because they do not take the medication properly.  Missing doses or taking more that the prescribed amount of the medication compromises the effect of the antidepressant.  Similarly, stopping the medication too soon often results in a relapse of depression.  In fact, most patients who stop taking their medication before four to six months after recovery will experience a relapse of depression.

Usually, antidepressant medication is taken for a least six months to a year.  Typically, it takes four to twelve weeks to begin seeing results from antidepressant medication.  If after this period of time the depression does not subside, the patient should consult his or her physician.  Antidepressant drugs are not habit-forming or addictive. And because depression is often a recurrent illness, it usually is necessary to stay on the medication for six months after recovery to prevent new episodes of depression.

Electroconvulsive therapy (ECT) is a treatment that unnecessarily evokes fear in many people.  In reality, ECT is one of the most safe, fast-acting and effective treatments for severe depression.  It can be life saving.  ECT often is the best choice for the person who has a life-threatening depression that is not responding to antidepressant medication or for the person who cannot tolerate the medication.

After a thorough evaluation, a physician will determine the treatment best suited for a person’s depression.  The treatment of depression demands patience and perseverance fore patient and the physician.  Sometimes several different treatments must be tried before full recovery.  Each person has individual biological and psychological characteristics that require individualized care.

In tomorrow’s final post on Depression Later in Life, I will discuss caring for the depressed person.

Elayne Forgie has been a professional geriatric care manager for over 20 years and was a founding Board Member of the Florida Geriatric Care Managers Association. She is the President/CEO of ElderCare at Home, Inc. and The Alzheimer's Care Resource Center. Information on this website or contained in this article is not intended to replace the medical advice of your doctor or health care provider.

Dressing

Dressing and putting on clothes can be frustrating for the person with dementia. The person may not remember how to dress or may be overwhelmed with the choices or the task itself.
To assist:
  • Simplify choices. Keep the closets free of excess clothing. A person may panic if clothing choices become overwhelming. If appropriate, give the person an opportunity to select favorite outfits or colors, but try offering just two choices.
  • Organize the process. Lay out clothing in the order that each item should be put on. Hand the person one item at a time while giving short, simple instructions such as “Put on your shirt,” rather than “Get dressed.”
  • Pick comfortable and simple clothing. Cardigans, shirts and blouses that button in front are easier to work than pullover tops. Substitute Velcro® for buttons, snaps or zippers, which may be too difficult to handle. Make sure that clothing is loose fitting, especially at the waist and hips – and choose fabrics that are soft and stretchable.
  • Choose comfortable shoes. Make sure the person has comfortable, non-slip shoes.
  • Be flexible. If the individual wants to wear the same outfit repeatedly, buy duplicates or have similar options available. It’s all right if the person wants to wear several layers of clothing, just make sure he or she doesn’t get overheated. When outdoors, make sure the person is dressed for the weather. Offer praise, not criticism, if clothing is mismatched.
  • Be patient. Rushing the person can cause anxiety and frustration.

Grooming

A person with dementia may forget how to comb hair, clip fingernails or shave. He or she may forget what the purpose is for items like nail clippers or a comb.

  • Maintain grooming routines. If the person has always gone to the beauty shop or a barber, continue this activity. If the experience becomes distressing, it may be possible to have the barber or hairstylist come to the person’s home.
  • Use favorite toiletries. Allow the person to continue using his or her favorite toothpaste, shaving cream, cologne or makeup.
  • Perform tasks alongside the person. Comb your hair, and encourage the person to copy your motions.
  • Use safer, simpler grooming tools. Cardboard nail files and electric shavers can be less threatening than clippers and razors.

Elayne Forgie has been a professional geriatric care manager for over 20 years and was a founding Board Member of the Florida Geriatric Care Managers Association. She is the President/CEO of ElderCare at Home, Inc. and The Alzheimer's Care Resource Center. Information on this website or contained in this article is not intended to replace the medical advice of your doctor or health care provider.