In Kerala, the state with the maximum life expectancy in the country, the quality of life beyond the age of 65 years is troubled by depression in 15 to 25 per cent of the subjects. Being a slow process, depression among the elderly is often mistaken by the relatives as a part of the normal ageing phenomenon.
Though there are multiple reasons for depression, a stressful life event such as the death of the spouse and retirement from an authoritative job are among the major reasons. The sudden feeling of being no use either to the family or to the society should be deliberately avoided by preventive steps undertaken by the close relatives.
Loneliness is not a treatable illness. However, being socially active and adopting a community living strategy with the consent of family members could go a long way in the majority.
Treatment of depression should include specific therapies and address associated causative factors such as fluctuating blood sugars, reduced duration of sleep, pain of diabetic neuropathy, forgetfulness, etc. Children of such people should take the lead for consultations with the doctor and purchase of medications.
Many medications used for treating the multiple illnesses in old age can aggravate depression. Anti-depressants and sedatives may impair the cognitive abilities and further aggravate depression and hence need to be carefully selected and combined with other therapies. Depression secondary to diabetes, high blood pressure, drugs and psychosocial factors need to be identified and promptly treated. In the vast majority of cases, loving and compassionate care will relieve depression.
