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When individuals reach their geriatric years, there
is a statistically significant increase in the rate of suicide,
particularly with a move to a nursing home. With respect to suicidal
attempts, in general, the geriatric population has a 15-20% increase
over the general population.
In Native American Culture, elders are revered. They are looked
up to and embraced, their wisdom sought after. With each passing
year their value increases.
It is clear that in our nursing homes, there are either nonexistent,
or minimal at best, assessment tools available to assess the elderly
residents for depression. This is a grossly negligence, and needs
addressing, if not addressed by our healthcare providers, then by
family members of nursing home residents who bring it to their attention.
The Geriatric Depression Scale (GDS) is a short questionnaire used
to diagnose depression in an elderly patient. It is quick and easy
to administer. Please feel free to copy this:
| * |
1. |
Are you basically satisfied with your life? |
|
YES |
|
NO |
| |
2. |
Have you dropped many of your activities or interests? |
|
YES |
|
NO |
| |
3. |
Do you feel that your life is empty? |
|
YES |
|
NO |
| |
4. |
Do you often get bored? |
|
YES |
|
NO |
| * |
5. |
Are you hopeful about the future? |
|
YES |
|
NO |
| |
6. |
Are you bothered by thoughts you can’t get out of your
head? |
|
YES |
|
NO |
| * |
7. |
Are you in good spirits most of the time? |
|
YES |
|
NO |
| |
8. |
Are you afraid something bad is going to happen to you? |
|
YES |
|
NO |
| * |
9. |
Do you feel happy most of time? |
|
YES |
|
NO |
| |
10. |
Do you often feel helpless? |
|
YES |
|
NO |
| |
11. |
Do you often get restless and fidgety? |
|
YES |
|
NO |
| |
12. |
Do you prefer to stay at home ratherthan going out and doing
new things? |
|
YES |
|
NO |
| |
13. |
Do you frequently worry about the future? |
|
YES |
|
NO |
| |
14. |
Do you feel you have more problems with memory than most? |
|
YES |
|
NO |
| * |
15. |
Do you think it is wonderful to be alive now? |
|
YES |
|
NO |
| |
16. |
Do you often feel downhearted and blue? |
|
YES |
|
NO |
| |
17. |
Do you feel pretty worthless the way you are now? |
|
YES |
|
NO |
| |
18. |
Do you worry a lot about the past? |
|
YES |
|
NO |
| * |
19. |
Do you find life very exciting? |
|
YES |
|
NO |
| |
20. |
Is it hard for you to get started on new projects? |
|
YES |
|
NO |
| * |
21. |
Do you feel full of energy? |
|
YES |
|
NO |
| |
22. |
Do you feel your situation is hopeless? |
|
YES |
|
NO |
| |
23. |
Do you feel that most people are better off than you are? |
|
YES |
|
NO |
| |
24. |
Do you frequently get upset over little things? |
|
YES |
|
NO |
| |
25. |
Do you frequently feel like crying? |
|
YES |
|
NO |
| |
26. |
Do you have trouble concentrating? |
|
YES |
|
NO |
| * |
27. |
Do you enjoy getting up in the morning? |
|
YES |
|
NO |
| |
28. |
Do you prefer to avoid social gatherings? |
|
YES |
|
NO |
| * |
29. |
Is it easy for you to make decisions? |
|
YES |
|
NO |
| * |
30. |
Is your mind as clear as it used to be? |
|
YES |
|
NO |
*Appropriate (non-depressed) answers = "Yes." All others
answers = "No." Count the number of depressed ("No")
answers.
Score: __________ (# of "Depressed answers")
Values:
Normal: 5 (+/- 4)
Mildly depressed: 15 (+/- 6)
Very depressed: 23 (+/- 5)
Yesavage, JA, Brink, TL, Rose, TL et al. Development and Validation
of a Geriatric Depression Rating Scale, a Preliminary Report, Journal
of Psychology, 1983.
Sheikh, JI, Yesavage, JA, Geriatric Depression Scale, Recent Evidence
and Development of a Shorter Version, Clinical Gerontology, 1986.
TREATMENT:
Where indicated, low dose SSRI’s have been extremely beneficial
with minimal side effects, and surprisingly, enjoyment of others,
as well as life in general is dramatically increased in many cases.
One of the most important treatment interventions is social support
and family involvement. I can’t emphasize enough that this
should not be forced, but genuine and spontaneous. There is nothing
more effective for the geriatric population targeting their depression
than seeing their children and grandchildren.
In closing, aging is a privilege. Our societal view of aging is
somewhat different, and that is indeed our misfortune. Let’s
take care of our elders, as someday, our children will be taking
care of us.
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