When a person with dementia has depression

Hello everyone,

Last week we discussed apathy in people with dementia, and approaches to use during care. Like apathy, depression is common in people with dementia, often in the early to middle stages of the disease.

According to a recent article by DailyCaring.com, depression symptoms in people with Alzheimer’s disease tend to be less severe than in those who are depressed but don’t have dementia, and people with both Alzheimer’s and depression may have noticeable irritability and social withdrawal but not many of the other common symptoms of depression.

 A person with dementia may also have depression if you observe:

  • Social withdrawal/isolation
  • Apathy or lack of interest in previously enjoyed activities
  • Irritability
  • Crying
  • Lack of appetite
  • Lethargy

For people who are living with dementia and depression, a combination of treatments can be effective, including non-pharmacologic approaches and anti-depressants if needed. Many experts identify inactivity as a major problem for people with dementia and depression, and keeping these people engaged in the world around them and participating in purposeful activities is crucial to their well-being. Practically speaking, if we keep someone engaged in activities that they find fulfilling, they have less time to be isolated and depressed.

Below is a link to full article by DailyCaring.com with more helpful information:

http://dailycaring.com/when-depression-and-dementia-collide/?utm_source=DailyCaring&utm_campaign=5a1e15d846-DC_Email_2018-02-20&utm_medium=email&utm_term=0_57c250b62e-5a1e15d846-123152321 

And here’s another link to a recent article about older adults with dementia needing MORE physical activity. The study shows that people with dementia who have good balance, muscular strength and mobility are less likely to suffer from depression. http://sciencenordic.com/elderly-people-dementia-need-more-physical-activity

Have a great week!

Educating family members on person-centered care

Educating family members of your residents about your efforts to reduce the behavioral and psychological symptoms of dementia through person-centered behavioral approaches is critical. Family members can support staff and be a useful resource when determining what may motivate a resident to participate in his/her own care and engage in activity, and thereby decrease agitation, apathy and resistiveness to care.

One of the ways you can educate family members is by including information in your facility’s newsletter or other regular mailing or email to your residents’ loved ones. Below is a pre-written piece to help get you started:

Research repeatedly shows that older adults can improve their physical and mental health, slow cognitive decline, and increase their ability to participate in personal care needs like bathing and dressing by engaging in regular physical activity. Physical activity can also help decrease symptoms of dementia such as agitation, aggression, resistiveness to care and depression. Even short spurts of 10 minutes of activity can result in significant physical and emotional benefits. Being able to care for oneself as much as possible also helps preserve the dignity and independence that we all hope for as we age.

With this in mind, our staff will be working with your loved one to participate as much as possible in personal care activities and to engage in physical activities such as walking or self-propelling in their wheelchair to the dining room or doing some stretching and strengthening exercises while waiting for meals. You can help too. Go for a walk with your loved one when you visit, or ask a staff member to show you some exercises you can do with them while you visit. Ask their caregiver what activity goals they have for them and encourage your loved one as they try to reach their goals. Finally, support your family member’s caregivers as they use their knowledge and skills to involve your loved one in their care and other activities in order to transform expressions of distress into expression of well-being—a goal we all share.

Feel free to contact us if you have any questions about working with family as we move forward.

Environmental influence on resident behavior

As promised, here is the first of the “Weekly Tidbits” we’ll be sending every Sunday to provide ideas and motivation to you and your staff as you work to address behavioral and psychological symptoms of dementia (BPSD) with your residents. If you’d like additional members of your staff to receive the tidbits, please email Erin Vigne (vigne1@verizon.net), and she will add their email addresses to our list. Please feel free to forward these tidbits to staff, print and post on bulletin boards, or even publish in your facility’s newsletter or on your Facebook page!

This week, we’d like you to think about the environment in your facility and how it may influence behavior and/or encourage or discourage physical activity among your residents. Remember, if we can help residents stay engaged in pleasant ways, then they may be less likely to become anxious, depressed or agitated. They may also feel better if moving a bit more with less pain and generalized achiness.

Look around your common areas. Are there cues that would prompt a staff member to lead residents in physical activity, or do you just see a television? When family members are visiting, do they always sit in the resident’s room and talk, or are they encouraged by staff to take their loved ones for a walk outside where there are benches to rest? Does your activity director have custody of all the fun items that could encourage movement?

Start with common areas, where many residents spend the majority of their day. Consider placing a basket there with foam swim noodles (when cut in half, they are great for resistance exercise!), small weights or elastic bands, and movement scarves to throw and catch. Having these items out in the open can prompt nursing assistants and other staff to start some spontaneous exercise with residents when they are bored or need distraction. Is there a way to play music in common areas? Turn off those TV’s for a while each day and get staff and residents to dance! Staff can bring in their iPods or phones to plug in to speakers and take turns playing their favorite dance tunes.

Next, are your halls dull? Look at your main corridors. Residents use corridors for walking to a destination, exercise, and social interaction. Are there places to rest if it is a long hall? Is the hall cluttered with items that could cause a trip, or limit access to the handrails? Are there pleasant things to look at during a walk? Consider changing artwork periodically and adding art created by residents. Or choose a new theme each month and hang posters down the hall that correlate with the theme. The hall can then become a destination itself, and family members may be more likely to take their loved ones for a stroll. You could host a contest to see who can decorate the best resident door around a certain theme (summer, holidays, sports, etc). Involve staff and family members too, and offer prizes.

We look forward to discussing your ideas at our next meeting. Have a great week!