Tackling Depression in Older Adults: Engaging All Stakeholders - Research Paper

Introduction

The project has an array of audience ranging from the patients, physicians, the government, family members to the patients, and health care service units. All these stakeholders are if great importance in ensuring that the problem of depression in older adults is solved. The primary audience is patients with depression; secondary audience members are the patients' members of the family and the physicians. And the tertiary audiences are the government agencies and health institutions.

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Primary audience - the patients are the older adults who experience depression or those diagnosed with the symptoms of depression in older adults. They are the primary audience in this project since they are the ones directly affected by this problem. This project must be primarily directed to them because they are a vital player in helping themselves. A patient who is not willing to seek formal mental care service may make it difficult for other stakeholders to assist them. It is for this reason, therefore, that they need to understand the basics in this project, the symptoms, and the available options for treatments. This is because it would enable them to make informed decisions concerning their conditions.

Secondary audience - the physicians and family members form the secondary audience. These are the immediate people who can be reached on behalf of the patients in case there is need. The primary care physicians are very close to the patients most of the times, and this means they may have more information about the patient more than the patient themselves. They are, therefore an essential group of audience for this project as they need to understand some of the approaches they can use in ensuring that they take adequate measures that could assist in helping out the patients. Family members are also the ones who are consulted most of the time concerning the medication of the patients, and hence their significance in this project. There is a lot of information they need to understand from this project about their roles as family members or stakeholders.

Tertiary audience - government agencies and hospitals are key players in this problem. The government can come up with policies that govern the condition of LLD. In this project, we can see that the government is, unfortunately, one of the key contributors to older adults' depressions through its policies. The final project document will help them understand their role in the control of LLD, and maybe it could act by changing some of its policies.

Cover Letter

(Introduce yourself in one paragraph with your credentials, and serve a brief attention-grabbing description)

The project is about the diagnosis of depression in older adults. This is a topic that has been of controversy for a long time since in most cases when people talk about depression, they tend to ignore the older adults. It is therefore, in this project that I bring to your attention the significance of diagnosing depression in older adults, backing the arguments with facts and figures on the relevance of the project.

Finally, I would like to thank all the readers of this project for taking their time to go through it. Any comments concerning the project would be highly appreciated. It is with great honor that I present this project to all the interested parties to pass the information to them. Besides, it is for the best interest that welcome all kinds of reviews and commentaries from my readers whom I value very much for this project. Thank you very much for your time.

Diagnosis of Depression in Older Adults

Context

According to the American Psychiatric Association, depression is a serious and common illness negatively affecting how an individual feels, how they act, and how they think (Blackburn, Wilkins-Ho & Bonnie, 171). What is most fortunate about this disorder is that it can be treated. Some of the significant signs those undergoing depression experience is the feelings of sadness and loss of interest in the things they previously used to like or enjoy. Depression may also lead to an array of physical and emotional problems which could amount to a person's reduced ability to function at home and work (Smith et al., 110). Among the elderly populations, depression disorder is one of the commonly seen psychiatric ailments.

In most cases, Late-Life Depression or depression among older adults is the one that occurs in adults older than 60 years. However, there may be variances in the onset or cutoff definition (Blackburn, Wilkins-Ho & Bonnie, 171). World Health Organization (WHO) provides statistics that the prevalence of depression is 10-20% among the elderly (Avasthi & Sandeep, 1). However, in India, the data there shows quite a vast variance in the prevalence rate of depression. According to Blackburn, Wilkins-Ho and Bonnie, there is a variance of 8.9% to 62.16% in community-based studies, and in the clinic-based studies, the estimated depression prevalence range from 42.4% to 72% (171).

The most unfortunate thing about depression among the elderly populations is that it is usually considered to be common. And in most cases, it does not get recognized or diagnosed. Some of the significant factors identified to cause depression among older adults include the following; physical comorbidities, poor quality of life, premature mortality, difficulties with daily life activities, and cognitive impairment. Although there is similarity in terms of the number of depression incidences reported among the elderly and the adult populations, among the older adults, depression is linked with higher cases of frequent hospitalization, family burden, risk of suicide, and a higher number of consultations with the treatment agencies. It is, therefore, critical to recognize and manage depression among the elderly.

The total American population is made up of 12% older adults, and by 2030, this percentage is expected to rise to 20% (Rosenberg et al., 223). This creates a growing demand for mental health services. Despite depression not being a normal response to the changes occurring to older adulthood, many older adults get affected by this medical problem. Widely, this problem is under-recognized and undertreated. The condition has the capability of impairing the ability of an older adult to function normally and independently contributing to poor health outcomes. It may also cause family disruption and suffering, and if not treated, the symptoms of depression can last for years.

One of the most crucial parts in the delivery of effective care to older adults is the relationship that you form with them. To build a therapeutic relationship, you need to demonstrate your competence of the aging depression issues, show respect to the older adult, and empathetically communicate with the older adult. Another essential part of the development of a therapeutic relationship is to demonstrate an understanding of the older adults in terms of their age group and cohort. This especially if you are considerably or relatively younger. Each generation can identify historical events and or cultural norms influencing their ways of coping with problems, outlook on life, and family relationships. Most of the older adults of today grew up during the era of racial segregation, some served during World War II, while others remember the Great Depression.

Depression in older adults is also known as late Life depression (LLD). Its identification and treatment in clinical practice are essential, especially in primary care or general medical practice. It is in these areas where common mental disorders in the elderly are treated, and not in specialty mental health. For antidepressant treatment, the primary goals are to prevent recurrence and relapse of a depressive episode, achieve remission of depressive symptoms, and to yield functional recovery. Several factors influence the outcomes of depression treatment. Some of them include an appropriate diagnostic assessment, including the identification and management of underlying psychological factors and comorbidities, affecting the correct choice of the existing treatment resources and options.

Literature Review

Reasons for Difficulty in Diagnosing Depression in the Elderly

Depression in the elderly is usually underdiagnosed by non-specialists. There is a tendency by older adults to seek medical rather than psychological services when they experience signs of depression. And in most cases, they tend to prefer their primary care physicians. Again, comparing younger adults to older adults, older adults are more hesitant in reporting cases of mental health difficulties to the professionals (Mitchell, 99). According to a study by Mitchell and his group, personal care physicians accounted for 47% of the discoveries of depression in older adults. Prevalence of depression is one key factor influencing its detection since it is more difficult to spotless common conditions. According to the study, it is also difficult to rule out depression in non-depressed individuals. Any mistake in individuals with no depression is a potential misidentification and could result in inappropriate treatment.

Detection and Assessment

For late-life depression, it is more effective to detect it when precipitating, and predisposing risk factors are considered. Some of the factors considered as predisposing are chronic and clinical disabling sicknesses, previous clinical depression, persistent sleep difficulties, and problematic use of substances like multiple uses of medications and alcohol (Miller, 1). Psychological predisposing factors are things like personality traits such as being a widowed, dependency, being socially disadvantaged, being divorced, having caregiving responsibilities for others with significant illnesses, and lacking social support (Blackburn et al., 172). Precipitating factors include change of residence, recent bereavement, and adverse life events like marital problems, separation, loss, declining health, and financial crisis.

Patients that are recently bereaved should be a screen for depression then a clinical determination done based on their agitation, thrive, and delayed rehabilitation. DSM-5 criteria is a general procedure usually used in the screening of late-life depression (Blackburn et al., 172). There may be confusion or overlap between the criterion of diminished pleasure or interest and apathy of dementia. In DSM-5, these conditions are classified as a major neurocognitive disorder. Physical illness or significant neurocognitive disorder may also result in loss of weight and appetite. Chronic pain, physical ailment, or substance use may also result in sleep disturbance.

Depression and Cultural Differences

Differences in ethic and culture affect the understanding of depression among older adults. It also affects their incentives to engage in and seek treatment and their feelings of stigma. Different ethnic minority and racial groups understand and approach depression treatment in different ways. For example,...