Depression in the lives of the Elderly

Since concentrating on topics relevant to the health care needs of the elderly I have often thought about how much of the elderly population might suffer from depression or other related mental health issues. I often wonder if these issues might not be recognized because the elderly population tends to be stoic or if simply it is a lack of knowledge about exactly what mental health is that prevents a portion of the elderly population from seeking help. In my 30-something age group we have been bombarded by the reality of how common depression is for example. In our generation we don't necessarily think twice about a family member or co-worker is taking some sort of medication for depression.

In many ways when thinking about the elderly people I have spoken to in the past it seems that they are stoic in their attitudes toward life and its tribulations. It appears in my opinion that when the elderly are having difficulties in dealing with life's hardships that many may feel like their complaints may be interpreted as whining or complaining and oftentimes do not seek any type of medical help. The elderly in my opinion have always had the belief that they have to take whatever life hands them and make the best of it regardless whether it may be financial help, social dysfunction or emotional difficulties. Our current generations of elderly have been taught from early on that they must deal with their problems with a strong resolve but they must also keep these issues private. I believe that this is the reason that many times depression in the elder population often goes undiagnosed.

For those elders that are diagnosed with depression I have noticed that is often a subject that they seem ashamed about admitting. My mother and my aunt who are both in their 60's have both disclosed to each other and me that they have both taken medication for depression but this information is seems should be contained in a folder stamped with the words "top secret". Although I have many times tried to explain to them that this information is nothing to be ashamed of they will not under any circumstance see this my way. I have asked them why this is on many occasions and their answers seem to be parallel to other elders I have questioned. Elders in my experience seem to think that admitting to any kind of mental health issue is the equivalence to admitting that they are crazy. The elders that I have spoken to about this believe that admitting that when they were my age having any kind of mental health issue was enough to be committed to an institution and being deemed crazy. I also noticed that in the cases of my mother and aunt who were both suffering the repercussions of a death in the family (my mother the death of my father and my aunt the death of my uncle and her only daughter) and had very legitimate reasons for being depressed and being on anti-depressive medication but yet they both only took their medication for a short time. Their reasons for this was that they needed to deal with their problems on their own and not use a crutch like medication so they could see everything through rose-colored glasses. I still often wonder if their motives for taking themselves off their medication were to escape the stigma associated with depression.

I'm not sure if the ideas that the elderly have concerning depression and all mental health issues for that matter can be reversed. I do believe that it is our obligation as the younger generation, who have become more informed about depression in particular, to help our elders recognize that seeking help for their emotional well being should not carry a negative stigma. I believe also that we should take the time to ask the elders in our lives more questions about the situations and emotions that they may be facing in order to be able to possibly intervene and possibly even convince them that seeking medical attention.

Mandatory Testing for Elder Drivers: Ageism or Safety?

My last post was inspired about one of the many stereotypes that surround the elderly population and this post turns to another subject that many might consider a form of ageism but many others might consider it a simple safety issue. With the baby boom generation about to completely transition into what is considered the elderly population I believe that a great deal of focus must be placed on the precautions that must be taken to keep all drivers safe on the roads. Living in Florida, a haven for retirees, I believe it is crucial that some mandatory testing be implemented for drivers reaching the status of elderly.

My mother just turned 69 year old a couple of months ago and although she thinks she is still a "spring chicken" I notice differences in her driving abilities. She will never agree with me on this subject and the approach of this subject with her could cause a huge disaccord between us, so thank goodness she isn't reading this. The truth of the matter is that although I don't consider her necessarily dangerous on the road I do believe that her driving abilities are not what they used to be, her reaction times are slow, she seems to take her eyes off of the road more often than not, and her use of the brakes is enough to cause whiplash sometimes. Now my mother's driving and her refusal to agree that she doesn't drive as well as she did when she was 20 years old is relevant to this subject because well the reality of the situation is she would never listen to me as her youngest daughter. She would have many choice words to tell me, tell me she's been driving longer than I've been alive and basically no matter how bad it was she would never ever relinquish her keys to me of all people. However, if Florida was to pass standardized testing that must be passed by her and all those 65+ then many children like myself would have the burden taken out of our hands and the roads would be safer. I think many children of the elderly would be appreciative to have this become a standardized and regular protocol of getting older. Just like following the doctor's orders for taking certain medical test yearly as you get older taking a yearly driving and vision test to renew your driver's license should be required. Just like passing a glucose tolerance test, if you pass you can carry on with life as you have for years, if you don't well then you have to take certain measures. Why should driving be any different?

Many will argue that this is a form of ageism and possibly It could be considered just that, unfortunately statistically it is proven that the elderly are at increased risk for accidents. As nation ages, elderly drivers present greater risks on the road, an article in USA Today quotes Paul Fischbeck from the Center for the Study and Improvement of Regulation at Carnegie Mellon saying that "You always hear about teenage (driver) risks being so incredibly high, but to me the amazing thing is there are two clusters you really have to focus on": teens and elderly drivers." That is a shocking statement considering that you are comparing drivers that have been on the road only for a short time to drivers that have been driving many times for decades. A reason for this is that "normal aging causes medical problems that affect driving. Reflexes, flexibility, visual acuity, memory and the ability to focus all decline with age. Medicines that treat various ailments also make it more difficult to focus and make snap decisions" (USA Today). I believe that this along with many negative statistics surrounding elderly drivers is enough reason to warrant elderly drivers to subjected to yearly mandatory testing.

Am I Stereotyping the Elderly or just being Polite?

 

I must admit that I have never considered stereotypes regarding age until just recently when I was forced to consider them. When taking the time to consider if I myself have participated in the perpetuation of any of these stereotypes I realize that in my attempt to be respectful of my elders, I indeed might have. When I encounter a person considered my elder I try and go out of my way to "do the heavy lifting" because well, they are old and it is has been my belief that it is my responsibility to take on that burden because of my youth. Upon forced retrospect, I am beginning to wonder if this act of "politeness" on my part is in actuality rude and moreover a form of ageism.

On many occasions, I have toted my kids to the supermarket for my mid-morning grocery run and upon completion of payment I have been asked by the elderly baggers in the checkout line if I would like to have help out to my car. A simple request that many would simply say yes or no to without a second thought, right? This however is not the case for me. I have never thought about why the thought of accepting help with something as simple as my groceries fills me with such guilt and feelings of pity; after careful thought I believe a great deal of my feelings come from my very traditional Hispanic upbringing.

In the Hispanic culture you are taught that you must take care of your elders. As a member of the younger Hispanic culture you are never allowed to disagree with the members of the older generation regardless of their level of wrongness. You are never allowed to get annoyed with their rudeness or their unequivocal meanness, but most importantly you are never allowed to let your elder do any type of hard work or task that would require them to exert any type of strength or energy for that matter. In the Hispanic culture, your elders have earned the right because of their age to sit on the sidelines and watch everyone do the work while they call out the orders. This type of behavior on my part and that of my elders has always been the norm.

After reading about the aging process and the theories that may extend and shorten the lifespan I realize that our cultures thoughts about being respectful of our elders may indeed be partially the reasons why Hispanics as a culture have a shorter life span than some other races. Health in the Later Years written by Armeda F. Ferrini and Rebecca L. Ferrini states that "[a] higher level of physical activity also is associated with a lower death rate, not only from heart disease but from all causes of mortality. The higher the degree of fitness, the lower is the risk of death. Even individuals who increase their activity level in midlife can realize a significant reduction in death rate" (Ferrini 35). Unfortunately for our culture this is the exact opposite of what is expected of our elders. In my opinion, Hispanics become less active, oftentimes in midlife, and follow that slippery slope of a sedentary lifestyle as they age. I am now starting to believe that we as the younger generation of our Hispanic culture should initiate more activities for our elders instead of just allowing them to be spectators to everyone else.

As for me personally, I believe I need to take a closer look at my actions in regards to the elder population because in my attempts to show respect and be polite I might actually be offending. The elderly should not automatically be considered frail because they are partaking in physical activity, I see now that they might actually be enjoying the activities they are performing; neither pity nor guilt should automatically be felt because an elder is performing a physical activity in the workforce. So in an effort for me to start changing my ways of thinking about the elderly, the next time one of the friendly seniors working as Publix baggers asks me if I would like help with my groceries I think I will "politely" say, "Yes!"

 

Ferrini, A. F., PhD., & Ferrini, R. L., MD, MPH. (2008). Biologic Aging Theories and Longevity. In Health in the Later Years (Fourth Edition ed., pp. 28-49). New York, NY: McGraw-Hill.