Meeting mental health needs of older adults with depression : a resource guide for older adults and caregivers

Depression is the most common emotional disorder of advanced age (Blazer, 1989; Phifer & Murrell, 1986). Its effects can be devastating for older adults as well as for those who care for them. Unfortunately, depression in elderly people is often masked by co-existing medical conditions and/or other stressful life events, making it difficult to detect and treat. In addition, access to mental health services is often a problem for the elderly (Gatz, 1995). A number of barriers have combined to create this problem, including (a) social, cultural, economic, and psychological issues that impact on the use and delivery of services and (b) fragmented and uncoordinated mental health systems and policies for the aged. Most older adults are healthy, active, independent, and well-integrated in their families and communities. Equating an older population with a “service-needy” group reinforces ageist stereotypes of incompetence and dependency. In fact, studies of the normal aging process have found that later life presents the possibility of growth as well as decline (Baltes, 1987, 1997). Many abilities, once thought to undergo significant decline in adult years (such as some dimensions of memory and intelligence), have been found to be stable or even to improve in some individuals until the 60s and 70s (Schaie, 1995). Depression and other serious illnesses affect only a small minority of the older population and are not intrinsic aspects of the aging process. Nevertheless, as the population ages (particularly with the fast-growing category of persons aged 85 and over, who are the most frail) and as the traditional source of family support dwindles due to smaller family size and increased female labour force participation, there will be a growing need for services by the aged