You have been visiting Mrs. Smith for two home care certification periods. Over the last few weeks, you've noticed that she doesn't seem to be talking as much, eating regularly, or even going outside of the apartment to see her friends. You ask her if something is bothering her, and she quietly responds, "Honey, I'm old and don't feel like doing much anymore. Being sad and lonely is just part of growing old."
Sound familiar? Whether Mrs. Smith is your patient or your family member, you've probably seen a slow decline in happiness for the seniors in your life. The CDC estimates that somewhere between 1% and 13% of seniors struggle with depression.
But, what can you do? As long as Mrs. Smith is doing basic self-care activities and is safe at home, is there really anything you can do?
Here are a few simple things you can do to help increase the quality of life of your senior patients.
Know How to Spot Depression
Older adults might have to deal with retirement, the death of loved ones, chronic health problems, or other stressful events. But, depression doesn't have to be the new normal.
Here are a few things to assess for:
Loss of interest in hobbies or activities they once enjoyed
Feelings of worthlessness, hopelessness, or pessimism
Difficulty concentrating or making decisions
Decreased appetite or unintentional weight loss
Reports of always feeling sad, empty, or anxious
Lack of energy, extreme fatigue
Interrupted sleep patterns - early morning waking, oversleeping, or difficulty sleeping
Increase in complaints of pain, cramps, or stomach problems with no physical cause
Thoughts or verbalization of death or suicide
If you recognize these signs of depression in your senior patient, call the doctor right away to report the symptoms. They will need further screening to determine what is causing the symptoms. They may also need antidepressants, counseling, or therapy.
Include Them in Activities
As nurses, we often get so caught up in doing our assessments and getting to the next patient that we forget the little things. If you notice a patient not engaging like they use to, try to think of something they enjoy doing and join them during the activity. A few ideas include:
Helping them write a letter to a child or grandchild they may be missing
Fold a load of laundry
Make a grocery list
Pack your lunch and eat with them once a week
These may seem like small, menial tasks, but getting them to engage in a normal activity of daily living helps give them purpose and hope for tomorrow.
Provide Brain Games
Some older folks love to do crossword puzzles, word searches, or other brain activities. And, these are not just fun games, they help to keep your mind sharp and focused.
But, normal vision declines may make it difficult to see standard print. Try to find them large-print versions of these activities to keep their minds sharp and challenged.
Individualize their Care Plan
OASIS can be a pain, but it really does give you the opportunity to cover all the bases of the patient's care. If you have to complete this lengthy assessment - you might as well use it to your advantage, right?
Create your goals and interventions to be meaningful. I remember having a patient that had plateaued in her functional abilities, and no matter what the physical therapist and I tried, she was not interested in ambulating.
During a Recertification assessment, I started talking to her about her goals. I was to the point that if she didn't improve, I would have to discharge her from care. While we talked, she told me how much she missed walking out to get her mail each day as this gave her a chance to chat with the neighbors and feel the sunshine on her skin.
After the assessment, I collaborated with the Physical Therapist to create goals and interventions that would get her back to doing what she enjoyed. And, would you know that once we engaged with her on this specific goal, she began to work hard to achieve it? I learned a simple lesson that day - goals must be individualized and meaningful to make them achievable. When she finally made it to the mailbox, we celebrated!
Listen to Their Wishes
As we age, making hard decisions just seems like it's part of life. But, even after our senior patients have made their choices, they need to be heard and respected. Sometimes these decisions can be difficult for the family to accept. So, it's your role as the home care nurse to listen to what the patient wants, facilitate any documents that need to be created, and help the family understand and respect the decisions that are made.
Tell Them What They Mean to You
Nothing helps boost the spirits of anyone from age 2-100 quite like being told you're appreciated, loved, needed, and respected. Never underestimate the importance and power of your words, smile, or gentle touch to let your patients know you enjoy your time with them.
Do you have other thoughts about easy ways to increase the quality of life in your senior patients?