Let’s face it, growing old means lifestyle changes – for better or worse, in sickness and in health. But how we evolve with our bodies and how we manage new age-related changes, issues and diseases, like depression or dementia, is up to us. When you get right down to it, the only person with the power to respond to the physical and mental challenges of aging—is you yourself. And a positive attitude and firm determination to live life to the fullest is an important first step.
Many people—including health professionals—think that characteristics associated with depression like fatigue, insomnia and forgetfulness are an inevitable part of aging. Recent research spearheaded by Certified Clinical Nurse Specialist Rose Madden-Baer MSN, MSHA, who leads the Behavioral Health program at the not-for-profit Visiting Nurse Service of New York, shows hands down that they don’t have to be. Nearly 30-50 percent of primary care providers fail to screen for, recognize or detect depression.
When nurses on Rose’s behavioral health team visit with seniors throughout New York’s five boroughs, they see firsthand how these common misunderstandings about aging can sometimes undermine the health of their patients. Using evidence-based practice protocols and visit guidelines, they’ve been able to help many homebound seniors manage certain age-related changes and reengage in life with a positive attitude.
Here are common myths that VNSNY’s Behavioral Health Nurse Laura Lau frequently hears from elderly New Yorkers and their family caregivers. She works to clarify the facts and reverse misperceptions to help keep her Brooklyn patients healthy, independent and living well at home.
1.I can pull myself out of depression without help
FALSE. Depression is a result of a chemical imbalance. “Often times a depressed person will acknowledge feeling down or having ‘the blues,’ but there are real chemical changes happening in the brain,” says Lau. “Just like diabetes or high blood pressure, depression is a disease that you have to manage.”
Untreated depression can cause problems with memory, changes in appetite, decreased energy and other physical symptoms, like delayed wound healing.
2.Dementia is a natural part of the aging process
WRONG. It is estimated that between four and five million people in the United States are living with some degree of dementia – but it does NOT affect everyone, and it is important to know which symptoms are benign and which should prompt a visit to your doctor. “There are normal aspects of aging that can be managed once understood, but some situations require special attention. We use an assessment tool to screen for dementia, and we educate patients and their families about signs and symptoms that may be an indication of disease progression. We also teach coping mechanisms to help family caregivers day-to-day with a loved one who suffers from dementia or Alzheimer’s,” says Lau.
Dealing with dementia can be frustrating, and there’s also a fear of being stigmatized. It is important to keep in mind that screening for dementia is not a diagnosis, and screening could be the first step to getting the help that you or a loved one needs.
3.Asking for help is a sign of weakness
NOT TRUE. “Who is more likely to bounce back? Someone who feels fragile and who seeks treatment or someone who feels debilitated but does nothing about it?” asks Lau. Often when you don’t feel comfortable asking for help, there is an underlying issue, like pride or a belief that asking for help means you are not in charge of your life. Lau uses Cognitive Behavioral Therapy (CBT) techniques to uncover these underlying issues with her patients.
People have a hard time adjusting to change, and so it is important to remember that there are qualified people out there who want to help – sometimes all we need to do is ask.
4.Retirement is the “end of the road”
WRONG AGAIN. Whether you work part-time or retire from your career altogether, retirement can be a time to pursue pleasures that were left by the wayside and also a time to explore new ones. For many people, no longer having a full-time job means less structure in the day, and unless this time is replaced with meaningful activities isolation and depression can set in.
Lau encourages her patients to reflect on forgotten hobbies or activities that may have been set aside while raising a family, building a career, or taking care of other responsibilities.
Along with pursuing things you love, it is important to maintain social networks and engage with others.
5.Psychiatric medication is just a way to “shut me up”
WE BEG TO DIFFER. Without treatment, diseases and symptoms can get worse, so it is important to give psychiatric medications a chance – even if they are uncomfortable at first. Several studies show that patients who experience more severe side effects are likely to discontinue therapy prematurely. Lau says, “I work hard with my patients to monitor their side effects, and in consultation with their physician, we adjust the medication or advise to ride out the initial, sometimes uncomfortable, side effects.”
Starting medication may make you feel different, not like yourself, and this foreign feeling may be scary, but if you’ve endured the same routine over and over again, why not try something new. If your health professional suggests medication, consider giving it a chance – what have you got to lose?
To learn more about the VNSNY Behavioral Health program, and how you or someone you love can stay mentally sharp and maintain health and independence long into retirement, visit www.VNSNY.org or call 1-855-VNSNY-NOW.
