Professional Health Care Services, Inc.

Geriatric depression is the prolonged occurrence of depression in elderly-aged people. Difficult changes and loss that elders often face can lead to depression especially to those who do not have a strong support system. Depression to elder is not normal despite of some belief that it is a part of aging.

According to the study conducted by National Health Institute (NHI), approximately 35 millions of American age 65 or older suffers from mild depression and about 2 million suffer from advanced or full-blown depression. That is because most of elderly adults face significant life changes and stressors that put them at risk for depression. The most common causes of depression are the following:

• Loneliness and isolation – Living alone; a dwindling social circle due to deaths or relocation; decreased mobility due to illness or loss of driving privileges.
• Reduced sense of purpose – Feelings of purposelessness or loss of identity due to retirement or physical limitations on activities.
• Health problems – Illness and disability; chronic or severe pain; cognitive decline; damage to body image due to surgery or disease.
• Medications – Many prescription medications can trigger or exacerbate depression.
• Fears – Fear of death or dying; anxiety over financial problems or health issues.
• Recent bereavement – The death of friends, family members, and pets; the loss of a spouse or partner.

Recognizing Depression

Depression is different from grieving, although the two might have same depressive symptoms such as frequent crying and profound sadness, grief is a natural and healthy response to bereavement and other major losses. However, the depression is more than just grieving. It is more than the sadness or and low mood, more than the “low feeling” we all experience now and then but goes away when we do our favorite hobby or have coffee with a friend.

Depression is a deep feeling of emptiness, it makes you feel that life or everything around you is no longer interesting. Depression is a whole body disorder that affects the way you think, the way you feel, both physically and emotionally. Depression is not normal and it is not a part of aging process.

Signs and Symptoms of Depression Elderly Persons

1. Behavioral Changes
   • No longer interested or withdrawal from previously enjoyable activities.
   • Shrinking out from relationships with others.
   • Experiencing a relationship that is not supportive.
   • Experienced a personal loss of more than six ago.
2. Cognitive Changes
   • Weakened concentration
   • Worries about memory
   • Having difficulty in making simple decisions
3. Mood Swings
   • Generalized dissatisfaction with life which constitute mainly with irritability
   • Lacks hope for his/her future
   • Having suicidal thoughts
4. Physical Changes
   • Weight changes unrelated to physical problems
   • Preoccupied with aches and pains unrelated to physical problems such as unexplainable headaches backaches, digestive upsets, stomach pains and constipation
   • Changes in sleep pattern.

- Professional Health Care Services, Inc. (PHCSI)

As people get older they experience many changes. It may occur in physiological, psychological, and intellectual aspect of an elderly. Changes like retirement, the loss of loved ones, and the physical changes of aging can take its toll. Coping with changes is challenging, no matter how old you are but for elderly the changes and transitions are harder to accept.

Because of the rapid changes that occur in elderly they have special needs that require special attention. This is where the geriatrics care came in. Geriatrics is the branch of medicine that focuses on health promotion and the prevention and treatment of disease and disability in later life. It specializes for elderly care emphasizing on the social and personal requirements of senior citizens who need some assistance with daily activities and health care, but who desire to age with dignity.

Who Needs Geriatrics Care

There is no definite age to qualify in getting geriatrics care. People over the age of sixty have different degrees of disability and illness. At this age, some may have no problems at all, while others have many several serious health concerns.
General internists and family doctors are the one who commonly care for elderly but geriatricians are often sought to provide consultations and care for older persons in poor health and with serious health condition.

No matter what of an older person’s age, a geriatrician should be consulted when:

• An older person’s condition causes considerable impairment and frailty. These patients tend to be over the age of 75 and coping with a number of diseases and disabilities, including cognitive (mental) problems; or
• Family members and friends are feeling considerable stress and strain as caregivers and,
• When there are persistent or intermittent symptoms such as:

• memory loss,
• confusion,
• or other signs of possible dementia.

Who Can Provide Geriatrics Care

Generally, the geriatricians are primary care physicians who are board-certified to provide care for elderly. However, there are other trained health professionals who specializes in taking care for older adults. In some situations, a team of health care professionals will work together in the medical evaluation of an older patient. A geriatrics team may include any or all of the following health professionals:

• Geriatrician
• Nurse
• Social worker
• Nutritionist
• Physical therapist
• Occupational therapist
• Consultant pharmacist
• Geropsychiatrist

Healthy aging is not just about staying physically fit. It is about maintaining the sense of purpose and zest for life. Healthy aging means continually reinventing yourself, finding new things to enjoy, learning to adapt to change, staying physically and socially active, and feeling connected to your community and loved ones. Getting geriatric care can help your elderly loved one’s to live their life to the fullest even in their later days.

A stroke is a condition that leads to rapid development of brain functions due to compromised blood supply to the brain commonly caused by burst or blocked blood vessel. There are two types of stroke known as ischemic and hemorrhagic stroke. In ischemic stroke, there is obstruction to blood supply of part of the brain. This results in loss of function of that particular area of the brain. On the other hand, in hemorrhagic stroke, there is rupture of a blood vessel or some anomaly in the blood vessels of the brain. The blood vessel can rupture either inside the brain or inside the skull but outside the brain.

Home care for a stroke patient

No matter whether it is an ischemic or hemorrhagic stroke, the patient requires almost life long special care and rehabilitation measures. Almost no medical care unit is capable of taking that required care of the patients after certain period of time. Even patients feel home sick and loose compliance with the passage of time. It is for this purpose that we prefer home care and recovery measures.

Stroke rehabilitation is the process of returning to near possible life activities after having a stroke attack. It involves the mental and physical involvement of the patient in routine chores. It makes the patient learn to compromise with difficulties, avoid associating complications and educate the family members for their role and active participation in enabling the patient in getting back to normal healthy and active life style.

A rehabilitation team is multidisciplinary unit comprising of staff with various skills, work together to bring the patient back to his normal routine to the extent possible. The services required include:

• Physiotherapy
• Occupational therapy
• Speech and language therapy
• Physician trained in rehabilitation measures
• Psychologist
• Pharmacists
• Social workers
• Nursing staff

In addition it involves neuro-cognitive rehabilitation and assistive technology including wheelchair, walkers, canes and crutches may prove useful.

Majority of stroke patients requires physical and occupational therapy in the first place. Physical therapy comprises of re-learning functions as transferring, walking and other gross motor functions.

Occupational therapy involves exercises and training to help relearn everyday activities like eating, drinking, dressing, bathing, cooking, reading, writing and toileting.

Speech and language therapy is effective for all those patients with problems understanding speech or written words, problem forming speech and problems with swallowing. Daily rehabilitation exercises should continue to be part of the stroke patient’s routine.

Effective nursing care is essential for maintaining skin care, feeding, hydration, positioning and monitoring mental status of the patient. Rehabilitation exercises should continue on a daily basis. Complete recovery is unusual but not impossible and most patients will improve to some extent; nutritionally balanced diet and exercise help the brain in self recovery. Without rehabilitation, improvement is not possible. Stroke rehabilitation aims at targeted and organized plan to re-learn functions lost in the shortest period of time possible. It depends on the type of stroke patient is suffering from. After the hospital stay, people usually continue with rehabilitation facilities at least for next 16 days at home and later in an outside facility. Most of the patients improve in this time span, the brain keeps learning new and old tasks throughout life.