Normally, aging is depicted as a time of reflection, rest and a chance to do things that one was unable to do during his youthful and young adulthood years due to career and family responsibilities. Nevertheless, this is not the case as various studies have shown that old age is associated with losses, including material loss, loss physical energy, loss of roles and responsibilities, loss of family members and friends among others. For example, aging individuals experience a loss of their financial resources, loss of control over their own lives as a result of loss of physical abilities like hearing, energy and sight among other losses. These feelings of loss leads to negative emotions like loneliness, anxiety, low self-esteem and sadness (Madianos, Gournas & Stefanis, 2007). These emotions in turn results in apathy and social withdrawal among the affected individuals leading to high levels of depression.
Aging is also associated with emergence of a variety of medical complications, including dementia, arthritis, cancer and hypertension that make the lives of the elderly more miserable. For instance, America Psychological Association (n.d.) points out that prevalence of chronic medical complications like cancer and Alzheimer increase with increase in age. For example, more than half of new cancer cases diagnosed in United States involve people above 65 years old. This is also true for Alzheimer disease and diabetes. A combination of the losses, mentioned above, and emergence numerous medical complications have been cited as some of the key factors responsible for high levels of depression witnessed among the elderly in private and nursing homes across the United States and other parts of the world (Alexander, LaRosa, Bader, & Garfield, 2009) The situation is worsened when the elderly is in a nursing home. There are also some research findings indicating some role of the body changes that take place during aging in development of depression. For example, low blood and nervous system folate levels may play an important role in development of depression, dementia and other forms of mental impairments among the elderly. A combination of debilitating illnesses and losses means that the elderly requires a 24 hours care from other individuals, be it their family and caregivers in their homes or in the elderly nursing homes.
The complex nature of the situation confronting the elderly in private and nursing homes requires more than just providing the basic care for these individuals. Care for the elderly requires a holistic care; spiritual, emotional, psychological, medical and physical care. This is due to the understanding that depression and other complications facing the elderly results from an array of factors that must be taken into consideration to reverse the situation or prevent recurrence of depression and its associated consequences like eating disorders, suicidal thoughts, insomnia, geriatric anorexia and obesity among others. It is often difficult to provide this kind of care from private or residential homes. The holistic care requires a specialized facility and specialized individuals. This is where nursing homes and nurses come in as the best places and individuals suited for this kind of care. This does not mean that nursing homes are devoid of negative effects on the elderly; in fact, research has shown that old people in nursing homes experience higher levels of depression and exhibit high mortality and morbidity rates compared to their counterparts in private homes. The high morbidity and mortality rates have been blamed on high levels of depression among the elderly in these facilities (Chew-Graham, Baldwin, & Alistair, 2008). This means that the main focus of nursing intervention in nursing homes for the elderly should be to prevention or reduction of depression levels among their clients. In order to realize this, nurses should focus their energies and special skills in taking care of the factors responsible for high depression levels as indicated earlier.
Some of the nursing interventions that have been shown to be effective in reducing or preventing depression among the elderly in nursing homes include exercise therapy, nutritional therapy, counselling therapy and cognitive behavioural therapy among other nursing interventions.
Exercise therapy has been shown to be one of the most effective nursing interventions in compacting depression among the elderly in nursing and private homes. Nurses should not only encourage the elderly to take part in physical exercises, but should also let them understand the importance of physical exercise in their mental and physical wellbeing (Cox, 2007). Nurses must also facilitate the participation of the elderly population in nursing in physical exercises by establishing group exercise programs and encouraging the elderly to take part in them. This is due to the fact aging adults do not consider as an important part of their lives and may be unwilling to take part in any physical exercises due to a variety of medical complications like arthritis (Mauk, 2010).
Counselling therapy has also been shown to be effective in reducing depression among the elderly in nursing homes. Miller (2008) defines nursing counselling as “the employment of an interactive helping process focusing on the problems, needs or feeling of the client to support or enhance interpersonal relationships, support coping, as well as, problem solving.” Ingram (2009) argues that some of the responsibilities of the nurse in counselling the elderly include encouraging the elderly under their care to express their feelings, demonstrating warmth, genuineness and empathy to the patients, establishment of a therapeutic relationship with the depressed elderly under their care, as well as, helping these individuals identify their strengths and reinforce them appropriately among others…”
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