Internet Post On Depression Among Elderly

DEPRESSION AMONG ELDERLY PATIENTS AT_______________________________ A THESIS PROPOSAL PRESENTED TO THE FACULTY OF GRADUATE SCHOOL ______________________ BY: _________________ DECEMBER 2009 CHAPTER 1 PROBLEMS AND ITS BACKGROUND Introduction People's later years can be a time of rest, relaxation and retirement, as elders enjoy life with their spouses, children and grandchildren. Ageing, on the other hand, is understood to bring with it an ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- to second amongst health conditions worldwide, taking into consideration associated disability and premature mortality. Depression tends to last longer in elderly adults; it increases the risk to death and constitutes the most common diagnosis in elders who commit suicide. Additionally, elderly adults with depression are more likely to commit suicide than younger people who may be so characterized (Abu-Rayya, 2009) According ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- glance they seem very similar. Depression generates emotions such as hopelessness, despair and anger. Energy levels are usually very low, and depressed people often feel overwhelmed by the day-to-day tasks and personal relationships so essential to life. A person with anxiety, however, ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- . Older people may lose loved ones and have to adjust to living alone. They may become physically ill and unable to be as active as they once were. These changes can all contribute to depression. Loved ones may attribute the signs of depression to the normal results of aging, and many older people are reluctant to talk about their symptoms. Depression in later life frequently coexists with other medical illnesses and ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- lung disease, Alzheimer's, Parkinson's, and arthritis. Alongside physical conditions that accompany depression or conduce to it, multiple social factors may worsen elders' psychological conditions. Such factors include the loss of family members, friends, work, and social status—all changes that emphasize the relative lack or loss of control associated with this stage of life. A decline in social involvement and in getting support, however, may be the most prominent factor in the deteriorating psychological life of ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- to alteration. Contact with others, whether at social clubs, religious associations and assemblies, or friends' get-togethers, may provide purpose and meaning in elders' life. Further, sharing interests, thoughts, and enthusiasms with others may help elders to maintain strong connections to the community, expose them to new people of different age groups, and ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- and depression and keep elders physically and psychologically active, conducing to their feelings of having a lot to offer and to the amelioration of their sense of confidence, self-worth and wellbeing. Depressive and anxiety symptoms are common in elderly patients. However, true prevalence of clinical depression and anxiety is uncertain. The researcher thus aimed to assess and evaluate the level of prevalence of clinical depression and/or anxiety in elderly ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Statement of the Problem The general problem of the study is: “How is the level of depression among elderly patients affected by the demographic characteristics of the respondents?” Specifically, it sought to answer the following: What is ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Gender Age Reasons for admission Educational attainment What is the level of depression among elderly patients? Is there a ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- to specified demographic profile? What program/s can be proposed to alleviate the level of depression among the respondents? Hypotheses of the Study The following hypotheses were drawn based on the above problems: There is no significant difference between the age, gender, reason for admission ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- There is no significant difference in the level of depression among elderly patients. Significant of the Study The study will determine the level of depression among the elderly patients at _______________________. The result of the study will be of benefit to: Elderly. This study will hopefully serve as a guide among elderly to reduce distress so as not to provoke undesirable behaviors that manifest depression. ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- and vibrant throughout their golden years. Significant Other/s. The study’s findings will assist significant other/s to understand the needs of the old-aged family members. Optimistically, ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- this study can strengthen the relationship between elderly and family members. Nursing Service. This ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- elderly. Through this study, the nursing service can develop an appropriate care management to improve the quality of service to patient’s or clients. Institution Personnel. It will ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- . Significantly, it would be of great help in the program development to decrease the depression level of the clients. Nursing Students. This ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- on services offered by the department as well as their future role in health care system. Future Researcher/s. The ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- to this topic. The dissertation may provide essential data and literature review. Scope and Delimitation of the Study This study is limited in determining the level of depression among elderly patients at __________________in _______, ___________City. This research ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- admission. Responses of the respondents were based on Beck’s Depression Inventory, a standardized instrument for assessing the level of depression. During the time of data gathering, there were eighteen (18) elderly admitted in ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- y not capable of responding to the questions presented. CHAPTER 2 REVIEW OF RELATED LITERATURE This chapter is composed of discussions of principles, facts and empirical data related to the topic. It includes a summary of literature and studies, which the researcher considers relevant and important in this present study. Related Literature Depression may be described as feeling sad, blue, unhappy, miserable, or ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- of us feel this way at one time or another for short periods. Some people say that depression feels like a black curtain of despair coming down ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- irritable all the time for no apparent reason. The symptoms vary from person to person. (www.depression.com) True clinical depression is a mood disorder in which feelings of sadness, loss, anger, or frustration interfere with everyday life for an extended period of time. As described by Beck (2009), depression is defined in terms of the following attributes: a specific alteration in mood, where there is sadness, loneliness, apathy; ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- wishes, as seen on desires to escape, hide or die; and vegetative changes, such as anorexia, insomnia or loss of libido. Low self-esteem is common with depression. So are sudden bursts of anger and lack of pleasure from activities that normally make you happy, including sex. Depression, one of the conditions most commonly associated with suicide in older adults, is a widely under-recognized and undertreated medical illness. ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- within a month before death. These findings point to the urgency of improving detection and treatment of depression to reduce suicide risk among older adults. The risk of depression in the elderly increases with other illnesses and when ability to function becomes limited. Estimates of major depression in older people living in the community range from less than 1 ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- and to 11.5 percent in elderly hospital patients. (www.nimh.nih.gov) A study conducted by Hybels CF and Blazer DG (2003) revealed that despite the burden of depression in late life, its origins present a paradox to investigators and clinicians alike. They review biological (genetics and heredity factors, neurotransmitter dysfunction, endocrine changes, vascular disorders----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- disadvantage and impaired social support) origins of late-life depression based upon an extensive though not exhaustive review of the extant literature. In addition, modifying psychological and social factors are discussed. Results rendered that older adults appear to be at greater risk for major depression biologically, such as depression resulting from vascular changes, yet the frequency of depression is lower compared to younger adults. Older ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- wisdom, compared to younger adults, and perhaps relatively protected from social risks. As a conclusion, researchers deemed that a biopsychosocial approach to evaluating the origins of late-life depression is heuristically valuable, a continual reminder of the many factors that contribute to the onset and persistence of clinically significant symptoms in late life. (www.cababstractsplus.org) According to Franklin (2003) once, women most vulnerable to change-of-life depression are those with a history of past depressive episodes. An old theory, ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- show no increase in depressive illness among women at this stage of life. As with younger age groups, more elderly women than men suffer from depressive illness. Similarly, for all age groups, being unmarried (which includes widowhood) is also a risk factor for depression. Despite this, depression should not be dismissed as a normal consequence of the physical, social ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ) About 800,000 persons are widowed each year, most of them are older, female, and experience varying degrees of depressive symptomatology. ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- widows/widowers meet criteria for major depressive episode in the first month after the death, and half of these remain clinically depressed 1 year later. These depressions respond to psychotherapy and standard antidepressant medications. Depression is more common in women than men and is especially common ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- . Therefore, women may only have more documented cases of depression. Depression often runs in families. This may due to your genes (inherited), learned behavior, or both. Even if your genes make you more likely to develop ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- or unhappy life event usually triggers the onset of a depressive episode. ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- that in the elderly, depression is also frequently characterized by excessive concerns about bodily aches and pains. Many older individuals ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- to signs and symptoms of depression for fear of being seen as weak or crazy. (healthguide.howstuffworks.com) Older adults don't always fit the typical picture of depression. Many ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- to feel sad at all. They may complain, instead, of low motivation, a lack of energy, or physical problems. In fact, physical complaints, such as arthritis pain ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- have gotten worse, are often the predominant symptom of depression in the elderly. Older ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- wring their hands, pace around the room, or fret obsessively about money, their health, or the state of the world. The ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- system. But depression is not a normal or necessary part of aging. In fact, most seniors are satisfied with their lives despite the challenges of growing old. Left alone, depression not only prevents older adults from enjoying life like they ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- effective ways to help, you or your loved ones can remain happy and vibrant throughout the golden years. Studies of nursing home patients with physical illnesses have shown that the ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- increases the likelihood of death from those illnesses. Depression also has been associated with increased risk of death following a heart attack. For that reason, making sure that an elderly person you are concerned ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ) Tom (2010) wrote that the loneliness, depression and sadness that the elderly feel, are often brought about by loss of someone close, or by the chronic changes of aging that include the loss of mobility and personal freedom, the ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- and independent individuals. This can produce a helpless, discouraging feeling that is not easily communicated to family members and even personal doctors. Doctors may not recognize the depression because they may be more focused on the physical symptoms of disease in the patient. Because the elderly may be alone, or even isolated because family and friends move away, they become even lonelier and it takes a longer period of time before the depression is spotted and treated. The depression may remain undetected for a long while because the elderly remain isolated, are reluctant to discuss their feelings, and because it is all too ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- process. (in-lawsuite.com) Loss is painful—whether a loss of independence, mobility, health, your long-time career, or ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Losing all hope and joy, however, is not normal. It’s depression. Although depression in the elderly is a common problem, only a small percentage gets the help they need. There are many reasons depression in older adults is so often overlooked: Some assume seniors have good ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- in older patients, concentrating instead on physical complaints. Finally, many depressed seniors are reluctant to talk about their feelings or ask for help. The consequences of this oversight are high. Untreated depression poses serious risks for older adults, including illness, alcohol and prescription drug abuse, a higher mortality rate, and even suicide. So it’s ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- , whether they’re 18 or 80, has to live with depression. Smith (2006) mentioned manifestations of elderly depression. Among ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- , withdrawal from usual activities, feelings of worthlessness, unreasonable fears, feelings of guilt, including self reproach for minor failings, delusions (false fixed beliefs that are characteristic of \"
psychotic\"
depression), hallucinations (false sensory experiences that characteristic of \"
psychotic\"
depression). As for the behavioral changes, people around them may see increased or decreased body movements (e.g., psychomotor agitation or retardation); pacing, wringing their hands, pulling or rubbing their hair, body, or clothing; sleep disturbance: difficulty ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- but sometimes increased appetite, weight loss or occasionally weight gain; fatigue; decreased energy; preoccupation with physical health; believing they have cancer or some other serious illness when they don't (called somatic delusions); difficulty concentrating, thinking or making decisions; ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ; constipation; and unusually fast heart rate. (www.health.com) Conceptual Framework of the Study To provide a focus, a rationale, and a tool for the integration and interpretation of information to this study, the researcher opted to contemplate on Kubler-Ross’s “stage theory” of grief: denial, anger, bargaining, ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- and systematically organized, and thus this will give further direction and meaning to the study. The researcher’s feedback form will be based on the assessment of the level of depression among elderly patients at_______________. The independent ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- will be gauged through the 21 different major aspects of concern as reflected in the questionnaire. In order to understand the study, the researcher has designed the following research paradigm (Fig 1). Level of depression using the 21 key parameters Profile of the respondents:AgeGenderEducational AttainmentReason for AdmissionINPUT OUTPUT Feedback Fig. 1. Research Paradigm Definition of Terms The following terms are operationally designed for better understanding of the research. Age. The length of time t----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Beck’s Depression Inventory (BDI). A 21-question of multiple-choice self-report inventory, ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- , cognitions such as guilt or feelings of being punished, as well as physical symptoms such as fatigue, weight loss, and lack of interest in sex. (en.wikipedia.org) Depression. An illness that ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- sleeps, the way one feels about oneself, and the way one thinks about things. (www.medterms.com) Educational Attainment. Refers to the highest level of schooling a person has attained in terms ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- . (www.statcan.gc.ca) Elderly. The term, as ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- of an older person or an elderly. Gender. The condition of being female or male; sex. (www.thefreedictionary.com) Reason for Admission. This indicates the primary reason why the client is admitted at the ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- missing, sickness, or abandoned by significant other/s. ____________________________, _______City. Venue where the research had been conducted. The respondents are admitted clients of this institution at the time the interview was conducted. Chapter 3 RESEARCH METHODOLOGY This chapter presents the design of the research, the population or characteristics of the respondents, the construction and validation of the research instrument, the data gathering procedures and the statistical treatment that will be employ in the study. Research Design The researcher used the descriptive method of the research, to determine the level of ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- , loss of interest, indecisiveness, worthlessness, loss of energy changes in sleeping patterns, irritability, change in appetite, concentration difficulty, tiredness or fatigue, and loss of interest in sex. The ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- the form of a survey in the form of questionnaire to identify the level of depression. Locale of the Study The researcher utilized questionnaires and conducted interviews in the geriatric ward of ______________________, ___________________, _______________. ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- the period of data gathering, only ten (10) participated for the rest are mentally and physically incapable of responding. Description of the Respondents Regardless of the length of stay, the respondents referred to the total physically and ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- and admission reason of each client were noted to assist in the interpretation of data in the later part of the study. Respondents’ primary data are personally obtained to ensure accuracy. Research Instrument The study used the standardized Beck Depression Inventory (BDI) questionnaire for ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- No validity and reliability test was conducted for the research instrument since it is already standardized. However, it was scrutinized by the adviser and panelist during the pre-oral defense. The ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- such as name of the respondent, age, gender, educational attainment, marital status and reason for admission. Part II deals with the assessment of elderly level of depression. Each instrument contains twenty-one (21) key factors /parameters to assess for ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- and comprehension. Data Gathering Procedure After the preparation of the questionnaire, the researcher will seek permission and approval of the implementation of research from the medical director. ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- confined at the institution. The researcher will personally gather the data to obtain authentic answers and immediately seek clarifications if needed as the respondents participate in the interview. Recovered information will be treated with utmost confidentiality. The conduct of ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- gathered. The questionnaires will be distributed and respondents will be requested to answer. The method hopes to create a 100 percent retrieval of data. The data will ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- researcher will evaluate the responses of the target population and will verify its contents. The respondents will be guided accordingly about the content and meaning of each question. Queries will be clearly answered through the simplest terms so as to provide better understanding. After the retrieval of all questionnaires, responses will be checked for completeness and logical ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Hall (PH) Statistical package. Quantitative data processing will be determined to lead to the scientific analysis and interpretation of results. Statistical Treatment The results of the study were statistically treated and analyzed using the following: The frequency ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- was used to present the demographic profile. The following formula was used:

N=Number of respondentsWeighted mean ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- X=i=15fiwin

X =weighted meanfi=frequency for the ith value wi=weight for the ith value n=number of respondents The scale value, range of mean and interpretation is given below: Scale ValueRange of Weighted MeanInterpretation54.50 – 5.00Very High Level 43.50 – 4.49High Level 32.50 – 3.49Moderate Level 21.50 – 2.49Low level 11.00 – 1.49Very Low level F-test or ANOVA. It was used to measure the significant difference on the level of perception among the respondents.The researcher will use data----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- for Social Sciences (SPSS) for the statistical computation. The researcher will be opted for the five (5) percent level of probability with ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- be established at the level of significance at 0.05.

Internet Post On Depression Among Elderly

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