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Advice by Alicia: Recognizing Depression in Those with Dementia

Thursday, January 26, 2023

Q. My dad has always been a bit reserved, but lately I’m noticing a change. I don’t know exactly what to call it because it doesn’t seem like despair or anger, just melancholy. This is a bit out of character for him, and I’m concerned something might be wrong. Is this something you notice often in your residents?

A. Calling it melancholy is one of the best descriptors you could have used. In fact, according to Merriam-Webster, melancholy is a “depression of spirits” or “a pensive mood.” It’s also stated to be “suggestive or expressive of sadness or depression of mind or spirit.” In other words, you’re describing depression – and it occurs often for those with dementia.

What Causes Depression in Dementia

While we know that those with dementia have a high likelihood of experiencing major depression, just how likely is it? Studies show that up to 40% of those with Alzheimer’s disease experience depression, and based on studies of those with other types of dementia, like Parkinson’s and Huntington’s diseases, the likelihood is up to 40%, as well.

What exactly can cause depression to occur in people with Alzheimer’s disease or other forms of memory loss? Some possible reasons may include the following:

  • Traumatic events or high stress
  • Medication side effects
  • Not enough social interaction or things to keep them occupied
  • Inadequate support
  • Poor sleep
  • Fears of the future
  • A health condition, separate from the memory loss

Signs of Depression in Seniors with Dementia

Loss of Interest

While those with dementia may experience a loss of interest due to the symptoms of dementia, this can be a sign they’re depressed, too; especially if it is out of character for them. If you notice your loved one is dealing with apathy, no longer cares about their appearance or doing the things they once enjoyed, or they stop pursuing their passions, they may be depressed.

Different forms of therapy – like music, art, reminiscence or pet therapy – can help. You can also search for activities that your loved one may find useful or meaningful. This can include being creative, helping you around the house or even holding a “spa day.”

Social Withdrawal

Depressed people with memory problems may find themselves withdrawing from social interaction with friends, coworkers and even family members. Whether this is because they are afraid their memory loss will show, they’re anxious that others may judge them, or because they are self-conscious, this can make depression even worse.

Try to keep your loved one involved and interacting with their friends and family members. It could help to:

  • Encourage them to revisit some old hobbies with their friends
  • Schedule phone calls
  • Assign a pen pal
  • Schedule visits when your loved one is at their best

Decreased Appetite

Have you noticed your loved one isn’t requesting their favorite foods? Has your loved one only had a couple of bites of one of their favorite meals? If you notice your loved one isn’t eating or is losing weight because of a lack of appetite, they may be depressed. Try these tips that can help.

  • If your loved one likes to cook, see if getting them involved will inspire them to eat
  • Ask what they’re not loving about their meals
  • See if there’s anything they’d like to eat or drink that would bring them joy
  • If there was a meal they loved as a child, consider making it

Increased or Decreased Sleep

Changes in sleep can be a telltale sign that someone with memory loss is dealing with depression. Take notice of whether your loved one:

  • Is having trouble falling asleep
  • Doesn’t stay asleep
  • Sleeps more often
  • Takes more frequent naps

While your loved one may simply be under-stimulated or bored, sometimes it can signify something more serious, so you may want to consult with a care provider.

Troubling Feelings

Another symptom of depression for older people with dementia may include troubling feelings. They may experience guilt, difficulty concentrating, apathy, worthlessness, hopelessness, irritability or even agitation.

Listen to your loved one if they’d like to talk about their feelings; assure them that you’re there for them and would like to help. Be patient and refrain from interrupting.

It’s also possible that their needs may not have been met, so assess your loved one for hunger, thirst, fatigue and pain.

Talk to Your Loved One’s Doctor

Additional support from your loved one’s healthcare provider will likely be needed. Because of this, it’s important to schedule a visit with them to discuss your loved one’s situation. They may be able to:

  • Manage their medications and assess if any negative interactions are taking place
  • Provide treatments for depression to either counteract or manage it
  • Establish if other medical conditions may be the cause
  • Suggest if care outside of the home would be helpful

We’re Here for You

To learn more about what causes depression in dementia, how to treat depression, or to learn other ways to help your loved one, contact the community nearest you. We’d be happy to provide you with some of our tips or have you join one of our support groups. Simply visit our website for more information and to register.

About Alicia

Alicia Seaver is the Vice President of Memory Care Operations for EPOCH Senior Living and a Certified Memory Impairment Specialist. Every month, she addresses a specific issue related to memory and memory care. If you’re interested in hearing about a particular topic, please send a note to [email protected].

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