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Depression in Nursing Home Residents and Intergenerational Connections

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Prevalence of depression in the elderly

Symptoms and risks

Depression in the elderly is concerningly common but often undiagnosed and untreated. Elderly individuals more commonly report vague symptoms or dismiss symptoms of minor depression as normal parts of aging. (Birrer, and Sathya P. Vemuri) Between 10 and 20 percent of nursing home residents suffer from major depressive disorder, and up to 30 percent may have minor depression (Kramer). The elderly are the most at risk age group for suicide, and major depression is the most common diagnosis in elders who commit suicide. Especially in the elderly, depression can co-occur with other chronic illnesses, including heart disease, diabetes, and Parkinson’s disease; such comorbidity can worsen symptoms of both conditions and make diagnosis more challenging. Dementia is also a factor in difficulty diagnosing elderly patients with depression because dementia and depression share some symptoms (Birrer, Vemuri).

Increased prevalence of depression in nursing homes/long-term care facilities

Studies suggest that depression is more common in long term living facilities than in the independent elderly population, yet diagnoses and treatment in these facilities is seldom adequate. (Kramer, Allgaier, et al.) Furthermore, social isolation and resulting loneliness are associated with reduced health status and quality of life even in elderly individuals who don’t experience clinical depression. (Jongenelis, et al.) Studies suggest that this social disconnectedness, which can be exacerbated by nursing home environments, and perceived isolation can have negative health effects besides correlating to depression (Cornwell, Waite)

Social isolation, loneliness, and depression across generations

Depression across different age groups has shared factors and factors that are unique to the age group. For the elderly who live in nursing homes, the environmental factors that make it difficult to get diagnosed and treated are age related. Factors that are unique to each age group are important to consider when discussing depression. Though comparing these factors brings to light differences that are relevant to treatment and management of depression at different ages, doing so also reveals similar challenges that different age groups face.

  • adolescent depression is an intersection of many factors, including genetic, but social isolation and loneliness are two independent factors correlated with it (Mathews, Danese, et al.)
  • differences in levels of social isolation and loneliness vary depending on age because of the different social conventions for different aged people
  • older adults are more likely to have health problems and experience bereavement that would cause them to require social connectedness (Cornwell)
  • social isolation in is correlated with a myriad of health consequences, including cognitive decline and death from pre-existing conditions like coronary artery disease (Cornwell), (Barnes, de Leon, et al.),(Brummett, Barefoot, et al.)
  • a Case Western Reserve study on loneliness and depression in independent living retirement communities found some correlation between loneliness (by the UCLA loneliness scale) and depression (by the Geriatric Depression Scale), and associated both experiences with fewer visitors, reduced social activity, and grieving a recent loss (Adams, Sanders, Auth)

Connections

This is a song inspired by the shared melancholy experienced by adolescents and the elderly as they age. Please listen to it and think about the emotions you might share with people of other ages despite your different experiences.

I wrote this piece to convey my feelings about aging, primarily connecting the bittersweet phenomenon of growing up, losing naïveté, and gaining responsibilities with a post-middle-age feeling that one doesn’t have anything left to look forward to in life. Reflecting upon my point in early life and the positions of my parents and grandparents, I attempted to show that, despite the feeling of loss as one goes through the changes of aging, growing older can be hopeful. Though I hate to see my recent past becoming memories, moving forward to new (perhaps happy or exciting) experiences requires some loss. I hope that hearing this message in my piece will encourage you to build friendships across generational divides and accept aging optimistically.

Below is the sheet music for my composition. In my recording, I played violin, my twin sister played cello, and I mixed the synth and electric piano in GarageBand.

Though my research focused on clinical depression in residents of nursing homes, age-related sadness isn’t limited to severe depression in the elderly. Aging can cause emotional strain on people at any age, from adolescent sadness at lost childhoods to midlife crises to the hopelessness of approaching death. Therefore, I encourage you to use the universal experience of aging as a point of connection with individuals of different ages.

Photo by Cpl. Carlos Cruz Jr. at the Kaede Nursing Home in Iwakuni, Japan

While coming to terms with one’s own death is difficult, it shouldn’t be hopeless and miserable. I’ve discovered, both through personal experience with family members and while researching, that the belief that depression is a natural part of aging is a relatively common misconception amongst the elderly. I hope to combat this misconception through my music and service, and I invite you to raise awareness about depression in nursing home residents.

How can you get involved?

  • be aware of warning signs in the elderly you know and advocate for them to be evaluated and find medical treatment; depression requires treatment beyond what friends and family can offer, so seeking medical care for your loved one and providing support are your priorities
  • nursing homes often have opportunities to volunteer in activities like leading games, helping host meals, and helping with holiday events; though such social activities can’t treat clinical depression, they can reduce the loneliness experienced by residents
  • many nursing homes are open to music performances such as a studio’s recital or an individual or small group playing for residents; such opportunities are fun for you and the residents!
  • build cross-generational friendships and learn to see elderly individuals and people– relationships have value beyond helping your community
  • serve older adults more generally by volunteering with organizations like CARIE to provide support, reduce social isolation, and connect with people of different ages
  • Raise awareness or volunteer to prevent elder abuse through the National Center for Elder Abuse
  • Use EldercareLocator to find volunteer opportunities to serve elders in your are

Made with Padlet

Works Cited

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COMMENTS: 5
  1. April 24, 2019 by Tess Blake

    Hey Patricia! This is AWESOME I love it. I volunteer at an old folk’s home and I see how vulnerable this population of people are to depression and other mood disorders. I also think that this is a topic that is not talked about enough so thank you for discussing it!

  2. April 25, 2019 by John Yen

    Patricia, this is great. I recently attend the Hive Be Good event at Poly, and was moved by the testimony of the speakers and their message regarding the elderly. They charged us with the challenge of finding ways to connect with the elderly beyond service. I found your musical composition to be very moving and thought-provoking, and drawing your insights from both your research and personal experiences, very effective. Thank you for your advocacy, creativity, and insight.

  3. April 25, 2019 by Margaret Kenny

    What a wonderful project, Patty! Your research is insightful, and your composition is beautiful and moving. I appreciate your thoughtfulness both in raising awareness about this serious topic of depression in elder members of our communities who are often overlooked and in addressing the importance of maintaining connections between people of all generations. Your suggestions and encouragement for your audience are inspiring!

  4. April 26, 2019 by Luciano Ferrato

    Hey Patty,
    Your project is beyond amazing! You go above and beyond in your connection, and your composition is uniquely moving. I appreciate your thoughtfulness in raising awareness about why it goes under diagnosed. Are you suggesting that we ameliorate the affects of stigmatizing the aging process through connecting with older adults? Your suggestions toward working with organizations like CARIE are great for creating grassroot action.

  5. April 30, 2019 by Samira.Kethu

    Patty your project is very inspiring! It’s amazing that you composed your own piece and incorporated it into your project! I never knew about this issue and I’m so glad that I do now. You’re doing a great job raising awareness!

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