Inter-Generations: Alleviating Depression: How Family Members Can Help

Your Internet Guide to the resources devoted to serving older adults on
Cape Cod and the Islands.

Alleviating Depression: How Family Members Can Help

by
Deanna Myers, B.S.
Steven Greenwald, MSW, LICSW

Reprinted with permission of the Social Work Consulting Group

Moving to a long-term care facility is emotionally difficult for both the new resident and his or her family members. Many persons become anxious, sad and even clinically depressed during this difficult time. Often, family members feel frustrated and powerless watching the resident experience emotional pain. Fortunately, depression is a very treatable illness and there are many ways the family can help.

Family members are in a position to help by:

1. Learning some basic counseling skills starting from a foundation of remaining non-judgmental. This means leaving one’s own personal feelings out of the situation and recognizing that the resident has the right to think and feel however he or she chooses. In practice this means not trying to talk the resident out of negative feelings.

When the resident says, "I feel terrible. I can’t live this way," there is a tendency to try to talk him or her out of this by saying, "Oh, you don’t mean that. Don’t say that," or "You must not think that way!". What the resident needs to hear is, "You sound (seem) upset. What is on your mind?"
The most important skill in counseling is listening. Just be there to listen. This alone tells the resident that he or she remains important.
Do not be afraid to talk about difficult subjects, such as advance health care directives and end of life decisions. Often these issues weigh heavily on the person’s mind and there is a great sense of relief, control and reassurance when a loved one is willing to frankly discuss these matters. You won’t be "planting bad thoughts" in the person’s mind.

2.  Keep the person connected with religion and spiritual expression. Don’t underestimate the power and source of inner peace that prayer and worship brings. If a religion has not been important in the past don’t immediately dismiss its value now. At least introduce the topic in casual discussion.
3.  Keep the person connected with persons, places, pets, objects and hobbies that have been important throughout his or her life. Staying involved is one of the greatest methods of combating depression.
4.  Offer the resident choices. Loss of decision making and loss of control are huge contributors to depression. Even if the choices seem simple, continually offer the person the opportunity to choose. Would you like juice or water?" "Would you like to wear the white shirt or the red one?" "What would you like to read, a book or a magazine?" Avoid one word response questions, such as, "Do you want to go to activities this afternoon?"
5.  Allow the person to do as much for him or herself as possible while still showing your respect and promoting the person’s dignity. Sometimes when we jump in to help, we feel helpful and important but we may actually be delaying the person’s emotional recovery. No one wants to feel like an invalid. No adult wants to be dependent on others for basic care. If the person can stand independently, for example, don’t rush in to help. Even if this activity takes longer than it did previously, allow the person their freedom. Resist the urge to "rescue."
6.  Look to the resident for advice. Ask him or her to help you with a dilemma or solve a personal or family problem. Show the person that he or she remains vital and important. Let the resident know that you cherish and value his or her wisdom.
7.  Don’t underestimate the healing power of self-expression. Encourage singing, drawing, journal writing or poetry. Play the resident’s favorite music and sing together.
8.  Bring pictures, mail and "self-esteem" objects (things that are significant and important to the resident) from home to keep the person connected.
9.  Go for walks with the resident. Exercise can be psychologically healthy as well as good physically.
10.  Reminisce with the resident about loved ones and favorite memories. Life review is an age appropriate activity and a necessary step in the aging process.
11.  Provide reassurance to the resident if he or she communicates feelings of anxiety, being unsafe, unloved, sad, unhealthy, or abandoned. Remember, the depressed person is often internally focused and may need reassurance and positive affirmation. "You are important to me. I’m going to be here for you. We’ll get through this together."
12.  Remind the resident of difficult times in the past that he or she has been forced to cope with. How did he or she get through previous traumatic events? The circumstances now may be different, but the inner strength and faith that got the person through past challenges are still a part of the resident’s persona today.
13.  Finally, family members should network with others who are going through similar experiences to get ideas, gain support and recognize they are not alone.