Serving the Underserved: Caring for People Who Are Both Old and Mentally Retarded: A Handbook for Caregivers

By Mary C. Howell; Deirdre G. Gavin et al. | Go to book overview

on their former existence, so slowly that there are almost no landmarks. It's important to remember that the person afflicted with Alzheimer's, who may be much less of an active, engaged person than he used to be, is still socially connected, often witty, affectionate, and appreciative of what is done for him. It's a question of looking at a glass half empty, or a glass half full.


37
DEPRESSION

Mary C. Howell

Depression among the old is complicated by the natural experiences of loss that characterize old age in our society. Some losses, such as the deaths of kin and friends, are inevitable and age-related; other losses, such as retirement or institutionalization or loss of social status ("ageism"), are culture-related. Grief and mourning, as normal responses to experiences of loss, are both similar to and different from depression, but episodes of significant depression can be triggered by loss. Major physical illness is also associated with depression in about half of those afflicted.

An episode of depression can be especially debilitating for someone who is old. Maintenance of all functional skills--cognitive, physical, emotional, and spiritual--is essential, as functions that fall into disuse rapidly become irretrievable. Depression threatens maintenance of function when withdrawal of interest and attention, physical ("vegetative") slowing, and feelings of hopelessness combine to remove one from active participation, which is the substrate of functional competence.

The principal differences between people who are old and mentally retarded and their non-retarded peers, with regard to depression,

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