In the essay I will be looking at depression associated with low mood in the elderly. I have chosen a client with this condition in my current placement, which is a day hospital. This patient will represent this client group and a brief background history of this patient will be discussed highlight social impart on health. I will explore the determinate of health and social care needs by looking at such areas epidemiological data, psychological, sociological, cultural and social needs of this client group. This essay will be summed up by looking at the role of nurses in the delivery of care to this group and my personal experience of care in this placement, which will impart on my learning. In accordance to the NMC code of professional conduct (2002) the patient consent was taken verbally and a written consent singed by my mentor is attached as appendix 1.
Client History
This patient will represent elderly affluent British women with depression. Elderly in this essay will be referring to older persons of the age of 65years and over, following the government specified pension able age, (Weir et a, 1992.) This patient was diagnoses of depression associated with low mood at the age of seventy – five. Before the diagnosed of depression she has lived happy life and was working, enjoying good health until she had fall and broke her leg in the process. The broken leg meant she could no longer drive her car, therefore she had to stop working as a result she loss her major contact. The restricted mobility and sudden changes to her life style led to these episodes of low mood. She also experiences pains in her head and the back of her neck due to arthritis.
Epidemiological research of low mood
Depression associated with low mood in the elderly is the focus of the assinment, however depression varies widely and can be characterised by varieties of symptoms. Stuart & Laraia, (1998) states depression is an abnormal extension of sadness and grief, feeling of hopelessness and guilt, self isolation, loss of sleep, appetite or loss of interest and pleasure in usual activities. While at placement, I found this issue of interest as it was a common diagnoses among the elderly patient in the centre.(Valente, 1994) states that out of every 7 people over the aged of 65 years, 1 is being affected of whom 1.3% are meanwhile 3% are women.
The prevalence of depression symptoms such as social class, disabilities, suicidal, sleep changes and pain were found to be high throughout in the older persons life span, according to (Hiamilton, 2001) study. The highest prevalence was found among women because they report more of the depressive symptoms than men did. This study also comforted with (Valente, 1994) statistical value. According to Mirowlskl $ Ross (1994) depression in older person is due to high correlation with loss that could lead to social isolation, and this was the case of this client in my placement. 20-40% of the elderly will experience depression episode, but only 12% requires treatment (Valente, 1994) depression is a widespread problem that could be severe and debilitating and even fatal in the event of suicide.
Determinant factors of low mood depression in elderly people
Depression factor will be explored as mentioned in the introduction: I will start by looking at the psychological theory influencing this condition. In beck’s (1979) theory 2of depression we form assumption, beliefs or schemata about the future, the world and ourselves. This belief helps us to make sense of things going on, some of these beliefs are rigid, resistant to change, counter productive and dysfunctional. These beliefs are structured around three areas which are ‘I must not fail’, ‘if I do not pass, I am a failure,’ acceptance ‘nobody loves me’. All these negative feelings are thoughts that may influnce low mood in older persons due to cognitive distortions or faulty information processing and depressenogenic schemata. AA depressenogenic schema entails extreme emotions and unrealistic goals created by an individual that could not be possible fullfilled.
This could trigger sad mood, lead to negative thoughts, affect the sleep pattern, appetite, and motivation. All these could lead to low mood in the elderly (beck’s 1979). Another psychological determinant of low mood in older persons could be physical pain, such as terminal illness, stroke, arthritis and cancer. Pain can cause fatigue, create physical disability, interfere with sleep pattern and these stressors can induce low mood the study of (keela, et aln1992) revealed that pain in elderly people is one of the depressive symptoms of low mood. In order persons negative feeling such as delusions that impart on the cognitive impairment such as memory loss. Looking at ythe client group in this clinical placement, all these theory seem to have significantly proven the reasons behind low mood in the older people and it is sometimes use to detrimental stereotype in judging the older people (Harrison, 1999).