Depression in Long-Term Care

Moving into a long-term care facility can be a very difficult experience. Throughout our lives, many of us say “I never want to go into a nursing home – I want to stay in my own home until the end.”

Today, people do stay in their own homes longer and families often do their best to care for their loved ones as long as possible, but sometimes, due to the amount of care needed, a move into long-term care is the only answer. The move is stressful for everyone.

Common thoughts people have after moving into a long-term care facility include:

• This is the ‘end of the road’ the ‘last stop’
• There is no hope
• I’m losing control of my life
• I’m losing my independence
• I’m losing my place in society
• I will lose the support of family, friends

Moving into long-term care, plus the factors above, coupled with the likelihood that the person has complicated health problems, may be on multiple medications and have experienced other recent losses in their life puts them at higher risk of developing depression – especially in the early months after the move.

Early detection and treatment of depression is critical, so during the first few months healthcare professionals must be vigilant in screening for depression. Tools like the Geriatric Depression Scale are used for monitoring mood through a series of simple questions and answers.

At the same time, detecting depression in residents of long-term care can be a challenge. Depressive disorders sometimes mimic symptoms of dementia. There are many symptom similarities that can complicate differentiating between the two.

For example:

• Apathy: people with dementia often have little motivation or energy to do things. Apathy is an intricate part of the illness itself, however it ‘looks like’ depression.
• Memory: Difficulty with memory or concentration can be signs of dementia as well as depression and may be exaggerated by the move.

The importance of determining whether these conditions are related to dementia or depression is key because the symptoms of depression can be treated and provide the person with some relief – even in someone who has early stage dementia.

Benefits to living in long-term care

Although adjusting to long-term care can be stressful and difficult, there are benefits to it as well.

There are planned activities and programs that provide daily opportunities to engage and socialize with other residents and staff. You may even be able to help other residents by sharing your experience. It can be a new beginning, not the end of the road.