My mother died early this year at age 83 after a long, chronic illness that also took its toll on Dad. He, for the most part, cared for her at home until he was no longer able. She died only five days after she went to the nursing home. Dad says that she willed herself to die because none of her conditions was considered life-threatening, and he blames himself for her death.
Because my wife and I have been concerned that Dad might do something to himself, we finally prevailed upon him to stay with us for a while. He has now been here for four months, and while he has some good days, they are greatly outnumbered by the bad ones, and we have altered our lifestyle to make sure one of us is with him the majority of the time.
He takes six different medications for various conditions that my wife and I think contribute to his depression, but his doctors insist he needs all of them, and we continue to hear from them that "depression is just part of the aging process." While we understand that family doctors don't have time to deal with the emotional issues that have been apparent to my wife and me, we think that Dad should have been referred to a psychiatrist or psychologist or even hospitalized for a while to try to pinpoint the problem and treat it.
A: Based upon our discussions with several family physicians and our own life experience, we take issue with the mind-set that old age necessarily begets depression.
In fact, while statistics tell us that the number of elderly Americans who commit suicide each year is disproportionately high, according to the National Institute of Mental Health, comments such as those made by your father's physicians -- and shared by too many seniors -- contribute to lower rates of diagnosis and treatment of mental-health problems.
According to statistics, the risk of depression in elderly Americans heightens when a senior has other illnesses and has limited functionality. In fact, NIMH tells us that up to 75 percent of elderly Americans who die by suicide had seen a physician within a month before death. This leads to the inescapable conclusion that, like other illnesses, depression should be treated when it occurs because, if not treated, there will be delays in recovery and the potential for irreversible outcomes.
According to the physicians with whom we talked, treatment for depression may well involve modification of medication regimens over time, not to mention psychotherapy, through which seniors talk with trained health professionals. Together, medication and therapy may well contribute to effective treatment. And, depending on how many variables are involved, Medicare will pick up a large part of the bill for treatment of mental-health problems.
Taking the NextStep: You were wise not to sit back and wait for a disaster to happen. The least your family doctor can do is to refer Dad to a competent psychotherapist and review his medications. For more information, go to the National Institute of Mental Health Web site at www.nimh.nih.gov, and visit Medicare's Web site at www.medicare.gov/publications/pubs/pdf/mental.pdf to download the booklet about Medicare and mental health.