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Recent Depression Advice

    Ruth, my mother-in-law, moved, 6-months ago, from her home with her husband to an apartment. She sold her household goods at a local auction.
    After my father-in-law's dementia worsened to the point of having him admitted to a nursing home in a neighboring town, we moved Ruth to a duplex near the nursing home at her request.
    She feels very guilty about putting her husband of over 60 years into a nursing home as they promised each other they would never put each other into a nursing home. She also feels very lonely and isolated since she no longer drives and doesn't know anyone in this small town. Family is within 20 to 30 minutes of her and visits often, but that doesn't alleviate her depression and feelings of guilt.
    She goes to the nursing home each day but is alone in her apartment each evening. She cries whenever family members leave after a visit. She has mentioned counseling but when an offer is made to get it for her she backs down Any suggestions?
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    Noreen C. , Geriatric Care Manager answers:
    What Ruth is going through is very normal, however that does not make it any easier for her or anyone in the family. She is doing well by visiting. Perhaps through these visits, she will begin to interact with other spouses going through the same loss. If not, I would suggest getting in touch with the social worker, or if appropriate, a pastoral care representative to identify resources or support groups that may be available. Also, Ruth might benefit by finding a regular activitiy outside of the nursing home visits to begin to gradually find a new life on her own. Time is healing. Also, with regard to the guilt...If her husband had a physical illness, such as cancer, she would hospitalize him, without guilt, for care and treatment. Depending on how advanced his dementia is, the physical location is no longer important. Ruth and other family member's visits remain important-even if your father in law cannot identify people by name; he knows that there is a positive emotion attached with your visits. Find peace in this. I wish you the best in this journey.

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    I will be 77 in Feb. I just gave out my social secuirity number to 'Social Security' online services. On the bottom of the advertisement to which I responded, it said: "Ads related to social security services". I tried to get them back to tell them to lose my number, and I can not find them. Can you help me?
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    Leonard B. , Elder Law Attorney answers:
    Please look to the "sent" folder on your emails - it is very likely that you will find the address where you sent the response. Also, please look to the Federal Trade Commission web site re tips for Identity Theft
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    Margaret H. , Geriatric Care Manager answers:
    I would recommend calling the better business bureau to see if they have any information on the company, notifying your local police department to see if there is anything they can do and most importantly have a credit bureau report done to make sure that no suspicious activity. I would then consider one of the programs to monitor your credit rating and that will alert you to any new activity with your social security number.

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    My grandfather has lost his wife (his second wife, not my grandma). And has been depressed since then. What could I do to help him. I really don't feel that the pills he is taking for his depression. What can I do to help make a positive impact on his mood?
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    David L. , answers:
    Consider, if she died less than 18 months ago, trying to get him into bereavement counseling or therapy, individual and/or group, or consider seeking counseling for him from a psychologist or psychiatrist with expertise in grief depression. Keeping as active as he can be maybe, with new activities, might be helpful too.
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    Janet K. , Geriatric Care Manager answers:
    You and your grandfather would need to talk about how he's feeling, and see if a family member can accompany him to his doctor re:medication since you are worried about him and his depression . Sometimes a psychiatrist is better suited to diagnose and administer medication for depression. Your grandfather if willing could find help by attending a bereavement/grief and loss group in his community. There is also one to one grief counseling that could be covered by his heath insurance. This is another way to support him as he works through the loss of his life partner.
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    Pearl M. , Geriatric Care Manager answers:
    Are there younger grandchildren who can visit him or is there a local after school care center that he can volunteer? Sometimes feeling needed by others and making connections with young people can be very healing. It is also helpful to let your grandfather talk about his feelings. He is probably very lonely and isolated. His partner is gone Find out what he misses. Don''t avoid the subject.
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    Benjamin M. , Elder Law Attorney answers:
    Perhaps a bereavement group could help him out.

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    My mom is 82 years old and has been living in her apartment for 40 years. She raised her family in the apartment. Now she lives there alone. She has been collecting more and more stuff and now the apartment is cluttered beyond belief. I think she needs to see a psychologist to discuss her issues. She seems depressed to me. She refuses to get help. What can I do?
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    Barbra L. , Geriatric Care Manager answers:
    Have you considered asking your mother what is going on? Maybe there is a simple explanation for the clutter, such as removing trash and newspapers are difficult for her to do. Sometimes an emotional attachment to 'things' mirrors a lack of attachment to people. Is she stimulated and engaged? Perhaps a day program would give her a structured activity. Many others in this forum have suggested psychiatric services or medical consults. Both good ideas but planning for, not with your mother is sure to be met with resistance. Ask what's going on and then discuss your concerns for her safety and well being. Come up with a plan together.
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    Joan R. , Elder Law Attorney answers:
    The family should certainly meet with a geriatric consultant to assess whats really going on and to come up with some suggestions as how to attack and then advocate for this problem.
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    Barbara P. , Geriatrician MD answers:
    Clutter can be a sign of mental illness and self neglect. If an elder refuses to leave home, you can call in mobile psychiatric crisis unit or adult protective services that has a psychiatrist. Either can come to the patients home. Local police or hospital should be able to tell you what kind of resources are available in your community.
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    Penelope M. , Elder Law Attorney answers:
    Your mother is an adult, she is free to do as she wishes as long as she hurts no one or herself. The only intervention you can do is by being appointed her guardian by a Court proceeding.
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    Jordana S. , Geriatric Care Manager answers:
    Depression in the elderly is very common. Before you reach out to a psychologist, I would speak with her primary doctor. Many doctors are comfortable prescribing low dose anti depressants . If the doctor isn't comfortable with a prescription your mother might be more receptive to advice from her doctor, who can then refer her to an appropriate geri psych. But for now there are a few things you can look for, for example, is she socially disconnected? What social opportunities are available to her in her community? Is she eating properly? Is the food in her fridge old and rotted? Would she agree to have the apartment cleaned up? Does she need help at home? Or is it time to look at an alternative living environment, one that would offer more social opportunities.

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    I am not really excited about giving my 84 y.o. parent anti-depressants. Since my mom died over ayear ago, my Dad has been staying inside his house, and not doing the things that he used to do, like painting and card games.

    His doctor has recommended an anti-depressant but that makes me feel uncomfortable. I don't like the idea of someone his age taking a drug, especially not with all the other medications that he taks.
    Are there any activities or practices that you can recommend he do, to help him get out of his depression?
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    Nancy W. , Geriatric Care Manager answers:
    I am sorry about your family's loss. Your father is grieving (as is the whole family), and his reluctance/refusal to leave his house or participate in previously pleasurable activities are signs of depression, which is a part of grief. However, as it has been over a year, he may need additional help through this process. Individual counseling has proven very effective in resolving grief and alleviating depression, and can provide your father the emotional support he needs at this time. I am glad you also are paying attention to how much medication your father takes. While antidepressant medication can also be effective in treating depression, caution must be taken to guard against overmedication, side effects and drug interaction issues. My agency provides in-home counseling and support to seniors, for just those instances where a person may be reluctant to leave the house, and may be in need of counseling. Maybe I can help.

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    My elderly uncle is acting very depressed after he lost his wife and I am worried about him what can I do to help him. I live very far away and he is not close with his kids.
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    Jordan R. , answers:
    There is a difference between the normal process of grief and depression. One might naturally expect your uncle to be grieving after the loss of his wife. In fact, his not grieving would be a warning sign in and of itself. Grieving, however, can extend into depression when after a certain period of time, perhaps a month or two, your uncle is not able to resume living. If you feel that your uncle is in fact, after a normal period of grieving, no longer able to derive enjoyment from the things that used to bring him happiness, he may in fact be depressed. At that point, you might want to consider speaking with him about depression and suggest that he meet with a mental health professional. If you can, try to phrase your words to him keeping in mind that what you interpret as depression may be grieving. In my work with bereaved parents (i.e. parents who have lost children), I have found that each person (indeed, each spouse) goes through and processes bereavement differently. In the event, that this is no longer bereavement, but rather depression, keep in mind that your uncle may feel that depression is un-masculine, and that he should just tough that out. Try to share with him stories of people he knows, or people he admires, perhaps FDR, who were depressed and who by seeking mental health help, got better. Good luck.
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    Donna C. , Nurse and Care Manager answers:
    It would be wise to have him evaluated by a geriatric physician. First, you can encourage him or attend his physician's appointment with him. Help him address his loss and how he is feeling with the physician, or call ahead and express your concern to the physician. While he may not discuss his case with you due to privacy laws, he can listen to your observations. If the physician is unwilling to address his depression you may want to take him for a neurophsych evaluation. Often someone with dementia shows signs after a spouse has passed. The spouse is often doing much for the person and masking the symptoms of their loved one. If there is no dementia and the physician feels he is depressed , he may benefit from antidepressant therapy. Sometimes after the death of a a spouse this is a short term treatment. Once he is through the mourning process he may perk up and engage with others again. It is probably a good time to ask him about his wishes regarding healthcare power of attorney, and resuscitation now. If family are not close he may want to appoint you the person to speak for him in the event he cannot.

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