Senior depression can be triggered by various factors:

• the death of loved ones
• isolation
• illnesses
• fears
• adjusting to a life where they need help from others.

Even after these changes, people typically regroup after a reasonable period. My grandfather on my father’s side, for instance, was a slightly less vibrant version of himself after my grandma passed away, but for the most part, he was his same old self.

On the other hand, my grandma on my mother’s side became a completely different person – eating minimally / losing weight, withdrawing from activities, sleeping constantly, and always in a gloomy mood. This was a woman who previously always had a beautiful smile on her face. Obviously these were huge red flags.

If you see sadness, mixed with bits of happiness and hope, it may not be depression. However, when your loved senior is experiencing some of these signs on a constant basis for more than 2 weeks, you will likely want to consult a doctor about depression:

• Sadness, prolonged crying, and/or anxiety
• Sleeping a lot; loss of energy
• Loss of interest or happiness in everyday activities
• Sleeping problems
• Weight loss or gain
• Irritability
• Constantly negative; feeling worthless, guilty, helpless
• Incessant aches and pains
• Talk or attempts of suicide

As you know, depression is a serious condition, and because your parent may not be rational, it is critical that you monitor their mental well being to watch for any dangerous signs. If you do not live near your parents, make that sure you, or someone you trust, spend enough time with them to see what their behavior is like on a regular basis.

Start by approaching their primary physician for treatment. They may be able to change or prescribe medication (possibly anti-depressants), recommend a counselor/therapist, diagnose a disorder or vitamin/nutrition difficiency, or recommend alternative medicine options. If it is depression, your loved one can’t snap themselves out of it themselves, so try not to get frustrated with them. Take it seriously and don’t wait because the chance of heart attack or even suicide increases a great deal with depression.

For depression prevention, see previous article “3 Ways to Age with Grace”.

If we no longer have this ability, we will make very poor decisions. We will not be able to analyze situations. We will be illogical. We will think things are one way even though they do not make sense in the present.

This 10 part series covered the following topics abstract thinking, multi-step tasking, personality changes, impulse control, initiation, empathy, attention to task distortion, rationalization, and reasoning ability.

These nine areas of functioning do not evaporate all at once. The person’s skills and abilities will fluctuate daily, especially at the initial onset of Alzheimer’s and related dementias. It will seem as if the person is riding a wave, with periods of no impairment and then other periods with severe impairment or confusion. As the disease progresses the moments of confusion occur more frequently and for longer durations of time.

As Alzheimer’s progresses throughout the brain, the Cerebral Cortex becomes affected. This part of our brain stores our long-term memories and it also controls our ability to have conscious thoughts.

What does this mean for someone who has Alzheimer’s? As stated before, all new information can no longer travel through the Hypothalamus, all short term memory does not exist. This forces the person to function in their long-term memories. They can tell you what happened 10, 15, 20, even 50 years ago but they cannot tell you what they did yesterday or even 5 minutes ago. However, the longer they have the disease, more and more of the cerebral cortex will be affected. This results in the person seeming to go “backwards” in time.

They will go farther and farther into their memories. They will expect to see things and people the way they were 10 years ago, then 20 years ago, then 30 years ago, and so forth. They will even begin to expect to see themselves as a much younger person. They will begin to talk to themselves in the mirror, and think they are talking to their mother or grandmother because in their minds eye they do not have wrinkles or gray hair. In their minds eye they may think they are 30 years old, not 60, 70, or 80.

It is important to remember that as all of this is occurring, the person is losing the ability to rationalize and reason. As they begin to look for things the way they were years ago, you cannot force them into today’s time. Alzheimer’s disease has robbed them of the ability to function in today’s time. It is ok for them to go backwards in time. They were more successful back then and they were happier. We call this reminiscing about the “good ole days”.

–Guest Blogger: Jennifer Scott has presented numerous speaking and educational presentations about Alzheimer’s disease and how to care for those suffering with dementia. Ms. Scott is on the faculty of the Center for Health Services Education and Research, where she teachs the upper level division courses in Assisted Living Management and Alzheimer’s and related dementia care. She is also a guest lecturer for the University of Texas Pharmacy School, and on the speakers bureau of the Alzheimer’s Association, Star Chapter.

1. Prepare a budget: Seniors are typically on a fixed income, so overspending can cause unnecessary anxiety. Assisting them with lists and shopping can really ease their worries (do your best to truly assist – not take over).
2. Let them help: Give your loved one tasks such as peeling potatoes, setting the table, writing place cards, or reading to/holding babies and younger children. It’s easy to get caught up, and sometimes seniors get lost in the shuffle, so be sure to include them.
3. Share memories: This is a great time to walk down memory lane with stories, photos, videos – it can be soothing to the soul for everyone. Whether you’re still in the process of grieving a loved one, or you’re remembering happy memories, the holidays are a bonding time for all.
4. Maintain the routine: Before and after the various events you have, continue to prepare healthy, nutritious meals, provide exercise assistance, offer companionship and social interaction, etc. for your loved one. Try to limit the number of activities (you can always get a temporary caregiver if you need to do some extra grocery or present shopping).
5. Watch for over-exhaustion: Be sure there is a quiet place for seniors to take a break. They may need a nap, or just a chance to get out of the chaos of kids and music, etc., so be sure they have an easily accessible retreat.
6. Watch alcohol consumption: Because alcohol is so readily available during the holidays, keep an eye on the number of drinks your loved one has had or should have. Also be sure that they don’t have any alcohol that interferes with their medications.

These tips should help make your senior’s holiday more happy and healthy.

Bonus: 2 gift ideas:

1. For your senior relative that lives alone, try making prepared meals in containers that can be frozen and microwaved.
2. Seniors love to go the mailbox. Purchase a “dessert of the month” plan (or some other type of monthly club), or create your own club by bringing them something each month (just be consistent!) to maintain a consistent connection.

In simplistic terms it means to be able to think things through, step by step, and to come to a conclusion that makes sense. If we do not have this ability, we will think that “we are right” all the time. It’s our way or the high way. No amount of “convincing” will get us to change our mind.

People with Alzheimer’s eventually lose all ability to function with rational thinking ability. They will become argumentative and they will make poor decisions, regarding their own care needs, money matters, driving decisions, and household safety.

There is an important phenomenon that begins to happen as a person travels down the road of the Alzheimer’s and related dementia. It is called Anosognosia, which is from the Greek term which means To Not Know. This is a very important thing to understand and recognize. This means the disease itself takes away the persons’ ability to recognize their own skill level. They will think they are functioning just fine and that they don’t need any help. This causes huge power struggles with the caregivers. Typical power struggles are over the person’s ability to drive a car safely, to live alone, and whether or not the person needs helpers to come into their home. The person with the illness will deny that they are in need of help. This is not the same as “denial”.

The best thing to do as a caregiver is to not argue with the person. This is not always easy by any means, but every effort should be made to not argue or to try to convince the person that they are wrong. Including the person is very complex difficult decisions will result in arguments, confusion, and frustration and it is highly likely that the person will not remember the conversation later so even if the caregiver “wins” the situation will be repeated again later. It is better to agree in the moment whenever possible.

Remember the person is functioning with very impaired judgment and reasoning ability. Go into their reality, as they will unfortunately not be able to function in yours.

–Guest Blogger: Jennifer Scott has presented numerous speaking and educational presentations about Alzheimer’s disease and how to care for those suffering with dementia. Ms. Scott is on the faculty of the Center for Health Services Education and Research, where she teachs the upper level division courses in Assisted Living Management and Alzheimer’s and related dementia care. She is also a guest lecturer for the University of Texas Pharmacy School, and on the speakers bureau of the Alzheimer’s Association, Star Chapter.

• Asking the same questions repeatedly
• Becoming lost in familiar places
• Being unable to follow directions
• Getting disoriented about time, people, and places
• Neglecting personal safety, hygiene, and nutrition

Dementia is a progressive deterioration caused by the death of brain cells. It may affect memory, mood (fear, anxiety, confusion, emotional stability), attention, communication, and problem solving abilities. Dementia itself is not a disease, but a set of symptoms.

These symptoms may be caused by a disease, such as Alzheimer’s, Parkinson’s, Multiple Sclerosis, and more. It also may the result of a stroke. Some symptoms may just mimic dementia (such as high fever, dehydration, underactive thyroid, brain tumor, emotional problems). Some conditions that cause these symptoms can be reversed, while unfortunatelly others can not.

Dementia is extremely common in seniors. According to WebMD, people rarely have dementia before age 60, but after age 85, up to half of all adults have it.

Dementia is both extremely frustrating for the person experiencing the symptoms, and for those caring for the person. It is important to research the condition, join a support group, and seek out responsible caregivers such as those available with Mom’s Best Friend Senior Care who can give you breaks when needed.

–Guest Blogger Claire Maestri, Director of Dallas/Ft. Worth Senior Care Services

Without this ability, the person with the illness will begin to have difficulty with any task that takes a long time to finish. They will find it difficult to sit and finish lengthy meals, or to sit and participate in long activities. They may also begin to talk about one thing and then quickly begin to talk about something different in the middle of a sentence.

The person may start a task the caregivers asks them to but would be unable to finish them. The person becomes easily distracted and they need constant redirection to remain on task.

This is frustrating for the caregiver because they will give the person something to do, so they can take care of something else, like paying the household bills, but the person they are caring for ends up stopping the task and they come to look for the caregiver. The caregiver gets very little time for themself, or the time they need to take care of other chores (or the rest of their family!).

To minimize distraction, be sure to have several different tasks available for the person that can be introduced as soon as they lose interest in the preceding task.

–Guest Blogger: Jennifer Scott has presented numerous speaking and educational presentations about Alzheimer’s disease and how to care for those suffering with dementia. Ms. Scott is on the faculty of the Center for Health Services Education and Research, where she teachs the upper level division courses in Assisted Living Management and Alzheimer’s and related dementia care. She is also a guest lecturer for the University of Texas Pharmacy School, and on the speakers bureau of the Alzheimer’s Association, Star Chapter.

When the person loses this ability, they may say things that hurt other people’s feelings and have no remorse for doing so. They may also think that “everything is about them” and it does not matter who else is involved. They may not say “thank you” for nice things being done for them and they may also not say “sorry”.

The loss of empathy can be extremely hard for the caregiver. They may be accused of things like stealing “mom’s” money and the person who has the disease can say some very hurtful things to the caregiver. Furthermore, they may say things to friends or strangers that are quite surprising, for example calling a heavy set person “fat” and they may use racial slurs that are no longer acceptable.

As a result of this loss, people with Alzheimer’s are sometimes labeled as “Mean”, or “Surly”, or “Selfish”. Generally this is incorrect. The person simply does not understand that what they are saying is hurtful and/or social unacceptable. It is a cognitive loss issue, not a behavioral issue.

–Guest Blogger: Jennifer Scott has presented numerous speaking and educational presentations about Alzheimer’s disease and how to care for those suffering with dementia. Ms. Scott is on the faculty of the Center for Health Services Education and Research, where she teachs the upper level division courses in Assisted Living Management and Alzheimer’s and related dementia care. She is also a guest lecturer for the University of Texas Pharmacy School, and on the speakers bureau of the Alzheimer’s Association, Star Chapter.