In This Issue

	Late-Life Depression
	If you answer yes to any of these questions, Hurley Elder Care Law can help
	Life Care Planning Goals
	The Nuts and Bolts Guide to VA Benefits

Late-Life Depression

	As people age, they must deal with such issues as the loss of a spouse or close friends, having to move from a long-time family homestead, no longer being able to drive and loss of functional capacity. When any or a combination of these events occur, individuals may experience a great sense of loss. If that sense of loss continues over time, they may be experiencing depression. Depression is widely misunderstood and frequently under diagnosed and under treated. We thought it would be wise to present a short explanation of depression, its symptoms and its treatments.
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To attend our monthly Professionals’ Luncheon please call Louise Morris at 404-843-0121 or email her at lmorris@HurleyECLaw.com

If you answer yes to any of these questions, Hurley Elder Care Law can help.

		Has the elder been diagnosed with a mentally or physically debilitating disorder such as Alzheimer’s, Parkinson’s, ALS, stroke or a decline in functional capacity?
		Is the elder isolated due to the recent death of a spouse, or have family that either lives too far away or is too busy to provide adequate care?
		Is the elder soon to be discharged into a care facility or currently receiving in-home care?
		Does the elder have a variety of healthcare providers and need coordination and advocacy for quality care?
		Does the elder seem unusually concerned about costs of medication and services, indicating he or she may be having financial troubles?
		Does the elder have assets that fall between $50,000 and $400,000 – enough to finance a short stay in a care facility but not enough for an extended stay?
		Does the elder have a spouse whose financial needs must be considered in light of the elder’s medical condition?

Life Care Planning Goals

1. Meeting the elders’ immediate health care and long-term care needs.
2. Making sure the elder/family is making good health care and long-term care decisions.
3. Helping the elder/family sort through the maze of their long-term care options including residential options.
4. Identifying and accessing public benefits and resources to pay for care should the elder meet the qualifying criteria.
5. Help with asset management, including the burden of home ownership and personal property.
6. Providing the entire family the peace of mind that comes from knowing their loved one is monitored by a team that combines legal and financial expertise with specialized knowledge of the elder’s physical, mental and emotional health.
7. Ensuring the highest level of independence the elder can achieve, while ensuring safety.

Late-Life Depression

What is Depression? Depression is a complex but treatable illness and is the most common emotional disorder that occurs in males, females, young and old, and has sadness as a predominant feeling. Depression ranges from mild to moderate to severe. Severe depression can be life threatening and can cause health to fail rapidly. Even mild depression can deepen or persist so it needs treatment as well. Depressed individuals appear to be more susceptible to infection and other illnesses and they take longer to recover. Characteristics of Depression – Generalized feelings of helplessness, hopelessness, pessimism and emptiness characterize a depressed person. Even previously enjoyed activities lose their interest and depressed people have difficulty identifying or describing their feelings. Low self-esteem, low self-confidence and feelings of failure often accompany feelings of being unattractive and unloved. Usually humorless and unresponsive, a severely depressed person feels inappropriate guilt and often cries for no apparent reason. What are Some Myths about Depression? It is erroneously thought that depression is a normal part of aging; that older people cannot benefit from therapy; that older people are resistant to change or that older adults rarely commit suicide. It is also wrongly believed that depressed people lack willpower or are putting on an act and they could control their condition if they just had the right attitude. In fact, older people respond well to short-term psychotherapy and being depressed is as real as a heart attack. It is not a character defect and cannot be wished away. Suicide rates of older adults are the highest of any age group in the United States and any person who talks about suicide is at high risk of doing so. Such talk needs to be taken seriously; the fact is that older people seldom attempt suicide as a means to get attention or as a cry for help. Their attempts are well planned and usually completed. Types of Depression – Major depression is pervasive, interferes with normal social and physical functioning and can be episodic or recurring and may require ongoing medication. It is the “black cloud” hanging over a person’s life. Dysthymia is a low-level depression, lasting two years or longer with symptoms less severe than with major depression and is likely to become chronic. It is the “dim gray cloud” hanging over the person. Bipolar disorder, also known as manic-depression, involves emotions at two extremes. Late onset of bipolar disorder is rare but those who have it continue to need medication as they grow older. What Triggers Depression? To name a few, triggers of depression include: heredity; drugs; biochemical changes in the brain; illness and chronic health problems; stress; loss of independent functioning; loss of socialization; dementia; moving away from the home; chronic pain; changing seasons of the year; and personality issues. What are Signs of Depression? Physical signs of depression include new aches, pains, change in appetite, weight loss or gain, change in sleep patterns and fatigue or lack of energy. Emotional signs of depression are pervasive sadness, anxiety, lack of feeling, decreased pleasure, crying for no apparent reason and indifference. Thought pattern changes include inability to concentrate, slowed or disorganized thinking, forgetfulness, inability to make decisions and recurrent thoughts of death or suicide. Changes in behavior include loss of interest in previously enjoyed activities as well as neglect of personal appearance, hygiene and the home. Additional behavioral changes such as increased irritability, hostility, pacing, restlessness, increased use of alcohol or drugs, withdrawal from people and activities, suicide attempts or talking about suicide. Other changes are giving away possessions and putting closure on relationships and tasks. It must be noted that no single sign identifies depression because it involves a cluster of symptoms, often masked by physical illness. Depression can mimic physical illness and often physical illness and depression coexist. Treatments for Depression – The three basic types of treatment are medication therapy, psychotherapy and electroconvulsive therapy. The earlier a depressed person receives help, the sooner the symptoms will be alleviated and the quicker the recovery. Often it takes more than one try to find the treatment that works best. Herbal treatments have become popular, but should be talked about with the elderly persons physician first since they can interact with prescribed medication. How Others Can Help – Encouraging a seemingly depressed person to get a medical evaluation is the first step. Since they are depressed they may need you to actively make an appointment for them. Go with them to the doctor and make sure that they are screened for depression. Denial, confusion, and forgetfulness will make helping them more difficult but intervening may improve their quality of life or even save their life. In Atlanta, we have a very good resource for dealing with late life depression issues: The Fuqua Center for Late-Life Depression at Emory University; 1841 Clifton Road NE, 4th Floor Atlanta, GA 30329 Phone: (404) 728-6302 Toll Free:1-877-498-0096. www.emoryhealthcare.org/departments/fuqua/ Source Schmall, Vicki L., & Bowman, Sally, 2004, Depression in later life: Recognition and treatment, Pacific Northwest Extension Publication, Oregon State University.