Jan L. Warner & Jan Collins

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How can we help ease Dad's depression?

http://www.NewsAndOpinion.com | Q: My father, a widower in his early 70s, has been diagnosed with early Alzheimer's or dementia (I'm not sure which). Regardless, Dad began losing his memory and interest in life after Mom died 18 months ago. They were very close.

My wife and I talked him into moving into an assisted-living facility on a "trial basis," as he had let his grooming go and would not eat regularly at home. However, he can still dress himself, bathe (when reminded) and seems to make sense when he wants to. But he is miserable there, refuses to become involved with the other residents, and stays in his room most of the time in the dark. My wife and I visit several times each week, but this doesn't seem to be enough.

His longtime family doctor saw him briefly, heard the symptoms we described, and prescribed Aricept (prescribed to patients with Alzheimer's) and an anti-depressant for him. But Dad still seems to be lonely. We're unsure what to do and are even considering hiring a companion for Dad so that he has company when my wife and I aren't there. Can you help point us in the right direction?

A: It appears that your father was in good shape until your mother died, which was when his present symptoms began. While we certainly don't pretend to be medical experts, it's possible that your father may be more depressed than demented. In fact, severely depressed individuals often have many of the same symptoms as dementia. For this reason, physicians shouldn't exclude depression in their patients before giving a diagnosis of dementia or Alzheimer's.

Some of the questions doctors ask to rule out depression deal with abnormal sleeping habits, loss of weight or bouts of sadness. During these examinations, those who are depressed may well discuss their symptoms and loss of memory, while those with dementia or Alzheimer's are more apt to be unaware of their loss of memory or, if they are aware, try to hide these lapses. When depression contributes to a person's mental downturn, it should be treated immediately.

Further, because many seniors take a number of medications — sometimes from several unrelated physicians — a doctor should ensure that the medical history includes an investigation into the drugs a person may be taking that could cause cognitive deficiencies or have an effect on the central nervous system. In addition to prescriptions for heart ailments, diabetes, ulcers, hypertension, certain painkillers and various psychiatric medications, doctors should also consider the potential effects of such over-the-counter medications as anti-inflammatory drugs, cold medications, diuretics, vitamins, herbs and supplements.

Because of inappropriate diagnoses, dementia may be unjustly fingered as the culprit when depression or, possibly, medications are the true problem. That is why geriatricians, who specialize in treating older adults, are so necessary in treating today's seniors.

Individuals are known to live more productive and happier lives for a longer time when placed in the least restrictive environment possible. While assisted living is only slightly more confining than independent living, it is a quantum leap given the lifestyle your father enjoyed at home with your mother. We suggest that you secure an independent assessment from a geriatrician or internist who is knowledgeable about these issues before you take any more steps that will cause further diminution of your father's mental status and lifestyle.

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JAN L. WARNER received his A.B. and J.D. degrees from the University of South Carolina and earned a Master of Legal Letters (L.L.M.) in Taxation from the Emory University School of Law in Atlanta, Georgia. He is a frequent lecturer at legal education and public information programs throughout the United States. His articles have been published in national and state legal publications. Jan Collins began co-authoring Flying SoloŽ in 1989. She has more than 27 years of experience as a journalist, writer, and editor. To comment or ask a question, please click here.