Dealing w/Depression in Older Parents

[Paige]

How do you deal with depression in your older family members? My MIL has battled depression for years, but seems to be in a worse place now. I don't think anyone knows how to help. DH and another sibling live too far away to do much in person, and I suspect that those who live nearby are experiencing carer fatigue and frustration. It's not fair to expect them to do everything and be everything for her. 

 

MIL's DH passed away about 2 years ago, and she feels it is just grief, but I think it is far beyond that. This is not new. Being with her DH did seem to keep her moods a little more steady, but she's been depressed on and off, needy, and occasionally suicidal for decades. 

 

She is in poor health but she doesn't need medical assistance. She can walk, talk, eat, breathe, drive, and care for herself and her own needs if she wants. DH encourages her to see a counselor (which she seldom does) and she is on anti depressants already. What else would be helpful? We often get texts from worried friends saying she is not doing well, but we feel pretty helpless living 10 hours away! 

 

MIL believes that if her kids and grandchildren would spend more time with her then she would be better. She has very few interests outside of them, however, and I doubt any amount of attention would be enough. When her local DD visits, she's often unappreciative, and she'll cancel plans and fail to show up when invited to things with her grandchildren that live nearby. She wants to be cared for, does not want to make new friends or participate in new activities, and I know that's all because of her depression, but as much as everyone loves her, we can't give her what she wants and maintain our sanity. I'm not sure if the other sibling (and family) that lives far away knows the full situation- she seems to always paint a rosy picture for them and they don't seem to know. It could just be how they choose to deal with it, however, and it's not my place to question them.

 

I'm looking for ideas or ways to support depressed senior adults that have actually resulted in the loved one leading a happier, more fulfilling life. I've googled and not seen anything practical: show you care, see a doctor, don't take control, etc....All of that is useless advice that anyone who makes an effort would try. I do not want her to live with me and I don't think she'd do it because of how far away we are and I don't think she wants to lose her independence. She'd probably love to stay with us for months at a time but I would lose my mind and then we'd probably lose our novelty to her and she'd start eventually acting like she does with those who live locally. 

 

Help- Advice- Commiseration? All are welcome. 

 

[Catwoman]

If you don't mind my asking, how old is she?

[matrips]

Is she able to hire a companion? My mom didn't realize how lonely she was until she moved to an assisted living place (unwillingly, but medically no choice), and caregivers would pop in throughout the day to chat. She loves it. Plus she has an aide that comes once a week. Mainly just hangs out, runs little errands or picks up a takeout dinner or such. It provides that extra attention she needs. She also is one that likes being taken care of. She doesn't want friends that are old people; that's why she likes the aides and caregivers. They're younger. She doesn't like any activities aside from happy hour and live music.

 

I also think she's on anti depressants. Last time she was hospitalized, she was so pleasant afterwards. I remember looking at her meds and a new one was in there, and her nurse said it was an a.d. Wow, she could have so used them years ago! Maybe the one your mil is on isn't working? The difference in my mom is night and day.

[Paige]

If you don't mind my asking, how old is she?

I think she's about 70-72; not all that old. 

 

Is she able to hire a companion? My mom didn't realize how lonely she was until she moved to an assisted living place (unwillingly, but medically no choice), and caregivers would pop in throughout the day to chat. She loves it. Plus she has an aide that comes once a week. Mainly just hangs out, runs little errands or picks up a takeout dinner or such. It provides that extra attention she needs. She also is one that likes being taken care of. She doesn't want friends that are old people; that's why she likes the aides and caregivers. They're younger. She doesn't like any activities aside from happy hour and live music.

 

I also think she's on anti depressants. Last time she was hospitalized, she was so pleasant afterwards. I remember looking at her meds and a new one was in there, and her nurse said it was an a.d. Wow, she could have so used them years ago! Maybe the one your mil is on isn't working? The difference in my mom is night and day.

 

I think a companion would be great for her but I doubt she can afford it. I have suggested that DH and his siblings combine their funds and hire one for her. My mom did this for her mother and it helped her remain independent for years until she passed away at home. DH didn't move on my suggestion, but I'll try again. I don't know how MIL would react to it, though. Maybe we could find a college student from her church who would move into her spare room or something. She may see it not as someone hired to help her but as a mutually beneficial relationship. The student would not have to pay rent and MIL would get company. But the poor student...it could be too much for one young, untrained person. 

[Catwoman]

Has your MIL considered moving into a senior living complex, where she would have her own apartment in a building with other seniors? Those places usually have a lot of widows who are looking for friends, and there may also be group activities and trips.

[Loesje22000]

Does she walk / swim / cycle enough?

Depression can have a strong relationship with not moving enough.

 

In my case is a daily 30 min. walk and a weekly choir repetition (which gives me also practise during the week) just (not) enough to keep it under control.

 

(Having experience with the depression part, not the 70+ part...)

[Laura Corin]

Is a her depression medication at the right dose? It took some trial to get it right for my mum. Also, is she in pain? My mum didn't seek help for pain, and it really dragged her down. She's doing much better now.

[catz]

So many people in this position would do better in a senior apartment complex.  They'd get much more social time, be more active, get more human contact, get better follow up on health issues including mental health, etc.  It's also a better set up for later should she have more intense needs while possibly being able to avoid a full on nursing home situation.

[Janeway]

Unless she is approaching you about it, then it might be best to back off. She might not want to talk to someone else about it.

 

IF she does want to talk about it, she is brining it up, the best thing she can do is find an interest and get involved. Being busy can help with the depression issues.

[gardenmom5]

I would first start with a very thorough physical.  some nutritional deficiencies, relatively common in the elderly, can cause depression type symptoms.

I'd also get her thyroid checked as that can cause despressive symptoms all by itself.

 

then I would work on her attitude.  help her with a gratitude journal. starting with expressing gratitude for something everyday.  things need to be concrete, and can't repeat.  encourage her to get involved in activities - find some and how she can get to them in you need to.

 

eta: senior living is a good idea.   I tried to get my mom to move - until she was no longer able to live on her own. it was harder on her to move at that point.

Edited August 26, 2017 by gardenmom5

[Paige]

Has your MIL considered moving into a senior living complex, where she would have her own apartment in a building with other seniors? Those places usually have a lot of widows who are looking for friends, and there may also be group activities and trips.

 

She couldn't afford it. She has no assets since her home is owned by her step-daughter. They bought it years ago with the idea that MIL and her DH would live rent free until they died and then step-daughter would sell it. I agree it would be good for her.

 

Does she walk / swim / cycle enough?

Depression can have a strong relationship with not moving enough.

 

In my case is a daily 30 min. walk and a weekly choir repetition (which gives me also practise during the week) just (not) enough to keep it under control.

 

(Having experience with the depression part, not the 70+ part...)

Of course not. She literally spends all day on the couch. Part of it is the depression and part is physical pain- she has hip and back issues, but she refuses to do the PT the doctor wants and the doctor refuses to operate until she tries PT. 

 

Is a her depression medication at the right dose? It took some trial to get it right for my mum. Also, is she in pain? My mum didn't seek help for pain, and it really dragged her down. She's doing much better now.

 I'm not sure if it's the right dose, but it certainly doesn't seem to be helping. She does have pain (see above) but I don't know what can help. She is very uncooperative with self-care. She'll stay at home in bed for months because she's tired, in pain, etc. Then when an out of town family member comes, she'll kill herself running around and being active and doing more than she should and it then causes her to go back to bed for longer when they leave. This has been going on for years, but it seems like the time in bed is longer now than it used to be. 

 

Unless she is approaching you about it, then it might be best to back off. She might not want to talk to someone else about it.

 

IF she does want to talk about it, she is brining it up, the best thing she can do is find an interest and get involved. Being busy can help with the depression issues.

 

She will sometimes talk to DH but disregards his advice. I'm not comfortable sitting back and watching someone drown themselves. I wish she'd get some outside interests, but if wishes were horses...It's hard with an autonomous adult- if it were my child I could step in and make some changes. She is seriously badly depressed with long standing mental health issues- not someone I think backing off of would be a good idea for unless I'm ok with letting her kill herself. This isn't hyperbole or exaggeration. I guess if she attempted suicide and failed we could maybe get POA for one of her kids and hospitalize her, but that's assuming she fails. 

 

I would first start with a very thorough physical.  some nutritional deficiencies, relatively common in the elderly, can cause depression type symptoms.

I'd also get her thyroid checked as that can cause despressive symptoms all by itself.

 

then I would work on her attitude.  help her with a gratitude journal. starting with expressing gratitude for something everyday.  things need to be concrete, and can't repeat.  encourage her to get involved in activities - find some and how she can get to them in you need to.

 

eta: senior living is a good idea.   I tried to get my mom to move - until she was no longer able to live on her own. it was harder on her to move at that point.

 

I will have DH bring up a new physical with her the next time they talk. She hasn't been taking our calls recently, which is worrisome, however. I know she has thyroid issues, but that's been treated for at least 15 years. She seems to be doing pretty well b/c when she's not her weight really goes up. She's at a healthy weight. 

 

She's the type to readily admit she has a million things to be grateful for, can list them all, and then will cry because it doesn't make her feel better and that must mean she's a terrible person.  :crying:  I'll check into the local senior center and see if they have a bus. Her DH used to go, but she never would. I think meals on wheels may be good for her too if I can set it up without her cooperation. 

[Catwoman]

What a lousy situation, Paige. :grouphug:

 

I know you live far away from her, but if she's not taking your calls, do you think you should make the trip to see her in person so you will know how she's doing? What about other family members -- are they involved in her life or do they at least live closer to her so they could go check in on her?

 

Has she seen a different doctor about her pain issues? Maybe she really does need surgery. It's easy for doctors to prescribe physical therapy, but sometimes it truly is too painful for the patient. I guess what I'm saying is that the doctor could be wrong and she could be right about what she needs. I think a second opinion from a well-regarded specialist may be a good idea.

 

I feel sad for her. It's sounds like she's very lonely but might be too shy or insecure to put herself out there to make new friends, and if she's in pain when she moves around, that makes things even worse for her.

[catz]

Since this is your MIL, what does you DH think?  How involved does he want to be?  Is he worried?

[Laura Corin]

Pain relief that my mum uses for ancient and arthritic joints: regular paracetamol (similar to acetaminophen, I think), narcotic pain patches applied every three days, liquid morphia in case she needs it at night, ibuprofen gel. She doesn't want to have joints replaced.

 

My mum is older though, so we are all more concerned about comfort than possible addiction.

[Laura Corin]

Fwiw, we had to just stand back and watch, because she was a competent adult, until my mum had a mental and physical health crisis and ended up in hospital. The professionals there convinced her that she needed support, and she now lives with us.

 

If I had tried to strong arm her at an earlier stage, I believe I would have lost her trust and not been able to step in at that point. However, we almost lost her. It's so hard.

Edited August 26, 2017 by Laura Corin

[City Mouse]

Fwiw, we had to just stand back and watch, because she was a competent adult, until my mum had a mental and physical health crisis and ended up in hospital. The professionals there convinced her that she needed support, and she now lives with us.

 

If I had tried to strong arm her at an earlier stage, I believe I would have lost her trust and not been able to step in at that point. However, we almost lost her. It's so hard.

Our family went through a similar situation. As she a competent adult, there isn't anything you can do if she doesn't want help. It is hard to watch people self-destruct but that is what has to happen some times. Sounds like she not willing to make the changes necessary to help her get better, and forcing such changes will only backfire.

[Paige]

What a lousy situation, Paige. :grouphug:

 

I know you live far away from her, but if she's not taking your calls, do you think you should make the trip to see her in person so you will know how she's doing? What about other family members -- are they involved in her life or do they at least live closer to her so they could go check in on her?

 

Has she seen a different doctor about her pain issues? Maybe she really does need surgery. It's easy for doctors to prescribe physical therapy, but sometimes it truly is too painful for the patient. I guess what I'm saying is that the doctor could be wrong and she could be right about what she needs. I think a second opinion from a well-regarded specialist may be a good idea.

 

I feel sad for her. It's sounds like she's very lonely but might be too shy or insecure to put herself out there to make new friends, and if she's in pain when she moves around, that makes things even worse for her.

 

We have several family members and friends who check on her regularly and keep us informed. I think MIL is not taking our calls because she forgot DDs birthday and now feels too embarrassed or badly about it to talk to us. We honestly don't care about that and nobody is mad; we keep birthdays low key here. Birthdays are huge deals to her, however. 

 

She's seen many doctors and received 3rd and 4th or more opinions about her pain. It's possible she needs surgery but they all want her to try other options first. She had surgery for the same thing years ago and it helped but medical standards have changed and with the scar tissue from her prior surgery, nobody will do it as a first option. 

 

Since this is your MIL, what does you DH think?  How involved does he want to be?  Is he worried?

 

He's concerned but not proactive. I think he feels resigned and frustrated and it's his normal. 

 

Fwiw, we had to just stand back and watch, because she was a competent adult, until my mum had a mental and physical health crisis and ended up in hospital. The professionals there convinced her that she needed support, and she now lives with us.

 

If I had tried to strong arm her at an earlier stage, I believe I would have lost her trust and not been able to step in at that point. However, we almost lost her. It's so hard.

 

I think this is where we are- she really needs to move in with someone or have someone move in with her but she doesn't want to and we can't do anything until she has a crisis. She's very lonely but she doesn't want anything except to have her kids or grandkids sit at her house all day on the couch with her. It's not realistic. Adults have stuff to do and the kids (all of us, really) can only sit on the couch and watch tv for so long before going nuts. 

[Paige]

Our family went through a similar situation. As she a competent adult, there isn't anything you can do if she doesn't want help. It is hard to watch people self-destruct but that is what has to happen some times. Sounds like she not willing to make the changes necessary to help her get better, and forcing such changes will only backfire.

 

You're probably right. It's so hard to watch, though- especially when family friends keep sending us urgent texts saying MIL needs help. I want to make it better. She drives me crazy, but we all love her and want her to be happy.

[Catwoman]

Would your MIL be willing to move in with a family member so she wouldn't be alone so much of the time? If she still wants her independence, perhaps a home with a mother-in-law suite or a small guest house might be an option, or maybe even a tiny house on wheels so she could stay on different family members' properties for a few months at a time.

[Guest]

We are in same situation. The well meaning individuals needed to be told that MIL has refused to relocate at her dc's expense, take her doctor's advice, etc. We suggested they invite her over, give her activity ideas, swap recipes etc. They did suggest a monthly activity that involves free food and sitting, so she did that one. Basically its mental illness...no one can give up their job to come do chores and sit with her...and its been this way since the first flew from the nest. We asked the well meaning people to call an ambulance if the situation was urgent. Other than that, we thank them for lettng us know.

Edited August 26, 2017 by Heigh Ho

[Paige]

We are in same situation. The well meaning individuals needed to be told that MIL has refused to relocate at her dc's expense, take her doctor's advice, etc. We suggested they invite her over, give her activity ideas, swap recipes etc. They did suggest a monthly activity that involves free food and sitting, so she did that one. Basically its mental illness...no one can give up their job to come do chores and sit with her...and its been this way since the first flew from the nest. We asked the well meaning people to call an ambulance if the situation was urgent. Other than that, we thank them for lettng us know.

 

We must be related...the friends who tell us about her- I don't know what they expect us to do. All the "updates" only stress me out. They do go and sit with her often, make her food, and do some chores. They are good friends to her, but I think they think we have more sway over her than we really do.

 

DD called her today and she talked to her for a while, so that's good. I'm going to ask the friend who keeps telling us how bad she is to try to take her to the senior citizen center a few times to see if she would consider going on her own. I already checked into meals on wheels and they aren't taking new clients. 

[lauraw4321]

I think people tell you because some people get upset about being kept in the dark. And also they're probably covering their bases so that if something happens you won't say "you never told me it was so bad!"