Ryan:
Hello, everybody, and welcome to the Caregiver’s Toolbox, tools for everyday caregiving. My name is Ryan McEniff, and I’m here with Janet, and today we’re talking about dementia and depression in seniors in this episode, episode number six.

Let’s get right into it, Janet. Why are we talking about dementia and depression? What is it, and why is it important?

Dementia and Depression:  What To Know

Janet:
Okay. Primarily, I would say the difference between dementia and depression is, depression is a mood situation, and it can often be treated with medication or talking things through, things of that nature. Dementia is a cognitive situation. It’s a memory situation. The brain has been affected. Only a doctor can really tell you what the difference between the two is, but if someone, especially if they live alone, after the holidays and all, it’s considered the winter blues a lot of times, but very often with the elderly, one of the major sources of depression is fear of falling, and that can change the whole way they look at life. I know you’ve worked with a number of things regarding fall prevention, and maybe you can speak to some of those issues.

Dementia and Depression: Fall Issues

Ryan:
Yeah. I would say, with our business, preventing falling is number one, or one of the top reasons people call us up and use our services, because mom or dad has had an issue with a fall and then they’re worried about it occurring again, and because they’re so traumatic. Falls are the number one reason why older adults go into a hospital. They’re usually the number one reason why people that are older end up passing away, because when you have a fall and something catastrophic occurs, whether it’s head trauma or if it’s a broken bone, people don’t recover from those once they get older.

When somebody realizes that they’re not as stable on their feet as they once were, that can lead to depression, and then they say, “Well, I’m not going to go outside because who knows when … this next fall could be the fall that puts me in the hospital or the nursing home for the rest of my days. It’s almost like, “I’m going to give up my social life in order to keep my independence,” when they really go hand-in-hand. If you’re going to be independent, you might as well have a social life to go with it. That’s the real reason why people are depressed, because of those fall issues.

The only thing you can really do is, in my opinion, you have two options. You can make the home safer, and obviously, the kitchen and the bathroom are the two biggest fall areas, because you’re dealing with water. You’re dealing with people that are slick, whether it’s their feet are slick from getting in and out of the shower, or using the sink, or in the bathroom, you’re making a meal and water falls on the floor as you’re washing your vegetables, and you can slip on that.

You can put anti-slip pads down to try to prevent that. You can put grab bars in, you can put in shower chairs and many different things to try to eliminate that issue with preventing falls. Additionally, some modifications that you can make is make turning lights on easier. If there’s a lamp in the back of the room that needs to be turned on manually, we’ll move that to the front of the room so that you can do it once you enter it, versus going through a dark room to the back. Even having an electrician coming in and changing what lights turn on can be important.

Your real two options are going with that type of modification and really hoping that things work out well, and living your life and having a social life and enjoying the time you have left, or you can make the decision to go into either a facility or use private home care and have an aide in there that’s available in case you fall, so that you’re not sitting there for hours, in case you do fall.

Another option that you have, though, is to use a monitor. In case you do have that fall, then you have somebody that can come out and help you, but in my opinion, when I get to that age, I’m going to have to keep living life, because there’s no point sitting at home watching TV and letting life pass you by because you’re afraid of falls. Maybe one of the things you can talk about a little bit, Janet, is having a conversation with mom and dad with those falls, and bringing it up to them and talking about this issue.

Dementia and Depression: Social Activity

Janet:
Yeah. I think that’s an excellent idea because fear, let’s face it, fear is paralyzing, whether you’re a kid, an adult, an elder person. If you have a fear of water, you don’t want to get in the deep end of the pool, so you don’t go swimming.

I think that, in terms of having conversations with your parent or whoever the person may be, it’s their confidence that’s feeling rocky, and that’s where that anxiety and that depression is coming from. To talk with them and to reinforce, I understand you want to stay in your home. What can we do to make this safer? What types of adaptive equipment or … You know what? Let’s agree, I’m going to give you a call every morning around 10 o’clock and make sure that everything was okay. They can feel that, “Gee, somebody is going to call. I’m not going to be here by myself.”

If someone is afraid of falling, they will actually turn down medical appointments. Sometimes, maybe on an off day, on a weekend, do a dry run. Go with them into the car, go somewhere, get out of the car. Again, it’s taking away some of that fear, and if, in the course of some of these conversations, you’re finding that your mom or your dad can’t follow the conversation or they’re drifting off to something else, that can also be an indication that maybe it’s not just depression. Maybe there is some cognitive issues there, and you want to tuck that away and share it with the doctor the next time they’re going.

I think the idea of having someone get out, because the more they can get out, the more they’re going to use their muscles, the stronger they’re going to be, and that’s going to reduce their fear of falling. Part of falling, too, in depression, is somebody’s eyesight. Maybe it’s just a matter of really changing their glasses or fixing their hearing aid, and those are things that can be relatively easily addressed. Those can all lead to depression, and that’s not dementia, but if they have everything that seems to make sense for their safety, and then you find they’re still forgetting things, losing their way, and you see that it seems more of a memory issue, now maybe you’re dealing with something that’s dementia and you want to check that out.

Ryan:
Granted, anybody can hear this podcast anywhere in the country, but for a lot of older adults, they end up retiring to a different spot down in the South, whether that’s in the Virginias, the Carolinas, or down in Florida. If something like that happens, or if there is a location change, even if it’s within New England, maybe it’s time to start thinking about a one-story and a ranch rather than dealing with a two-story building.

Janet:
Absolutely.

Ryan:
That way, you’re not dealing with steep steps going up and down, whether that’s to the walkway, out to the driveway, or upstairs to the second floor. It might be time to think about making things as level as possible to reduce trip hazards, so when you’re having that conversation and mom and dad are saying, “Well, we’re going to retire in five years,” you might want to think about just a nice, level home, rather than having to go up and down stairs.

Janet:
Absolutely. That’s an excellent point. If you’re stuck with some stubborn Yankees that are born and raised around here and they don’t plan on leaving the snowy part of the world … I had a conversation with my own parents, and a decision was made that, you know, it really was best to live on the first floor, and was everything set up that that would work? In their case, the house worked quite well. Some people need modifications to do that, but where you can reduce the stairs … It also can be an issue of if it’s a couple and one can’t hear. The other one can be running around trying to get the other one to hear and that causes falls, so whatever you can do to improve communication and reduce steps, that’s a great idea.

Wrapping Up Dementia and Depression in Seniors

Ryan:
Awesome. Well, thank you very much for your input, Janet. We’ll wrap this episode up. Thank you very much for listening. We have new episodes come out every Tuesday, as always, so you will look forward to hearing from us next Tuesday. Have a great week.

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