Significant Health Care Issue - Research Paper Example

? Significant health care issue: lack of screening for depression in older adults Introduction The long term impact of depression is an important concern at all the ages but it is particularly harmful in the elderly age. The signs and symptoms are usually unnoticed by the patient or not even recognized by the medical practitioner. Depression can result in difficulties in the healing procedures and keep the sufferer from rehabilitation (Unutzer et al, 2009). The condition can be preexisting that probably intensify with the passage of time or may be new in origin. For some people it is not a new thing to have depression in the old age but still it can not justify the acceptance of the problem. Different studies have shown that depression should be recognized as crucial issue by the practitioners. The major signs and symptoms of depression are losing interest, loss or change in the appetite, lack of interest in daily activities, change in sleep patterns. In a depressed state one may also feel low levels of energy and feeling of exertion even after having rest. If depression is not treated in a proper way it can result in physical sickness, isolation or in worst cases may lead a person to commit suicide (Styron, 1990). By dealing with the hurdles and utilizing a straightforward 20 questions Geriatric Depression Scale, diagnosis and cure can be performed with ease. The reports by NIH show that the symptoms of depression are represented by about 15 to 20% of the people who are over 60 to 65 years in age. Major and minor depression varies in rates from 5% to 30% from primary to long term setting. It has been shown that only 15 % of the old people receive the proper treatment for depression according to American Psychiatric Association (2002). The mortality rates in the old aged people due to depression are much higher as compared to the ones who are not suffering from it. The barriers for depression diagnosis by the patients and the practitioner are given as follows: By The Patient: • Issues regarding perceptions or disgrace associated with psychological sickness • Fear about condemnation by relatives • Economic concerns related to expenditure of treatment • Information and aptitude to identify symptoms of depression • Anxiety concerned with other therapeutic occurrences like chronic sickness The Practitioner • Unwillingness to pay attention • Conviction that depression is a usual factor of growing old • Non- familiarity or identification of symptoms • Other medical situation is given priority Predominance of Elder Depression It has been found by extensive research that almost 25 to 30% of the elderly population shows symptoms of depression in one way or the other. The prevalence of depression in older women is two times more as compared to men of the same age. The depression in late life can lead to serious complications leading towards increased mortality and morbidity, higher costs of health care and prolonged stay at the hospitals. It has been estimated that 65% of older people having some mental problem want unmet psychological health services (Huisani, 2004). As the American people have longer life span, the disease and disability can not be avoided with the advancing age. It has been estimated that 55% or people at age 65 or older have some sort of disability and 35% are having severe disabilities. Therefore more than seven million elderly persons need some sort of help in order to perform daily activities of life like bathing, eating, cooking, travelling etc. All the above problems increase to further extent when the person moves to the age of 80+. Consequently, almost 20% of the US adults are engaged in providing extraordinary care to their elderly relatives especially parents. These adults are at the same time involved in the brought up of their own children and also do jobs outside their home. So they are having a sort of double burden on them. Theoretically "Individuals involved in providing care to aging relatives and raising kids simultaneously at are known as the sandwich cohort" (Dixon, 2003). Quality of life issues Depression is associated with some sort of disability. It has also been proved in one study that in old age depression is a risk feature for disability (Lenze, 2001). Activity is restrained due to impairment which results in decreased social interactions and decreases the sense of importance of a particular person in the society. The depression and disability thus leads towards boycott from the society. The person becomes dependant for his basic needs like eating, drinking, bathing, walking, dressing, toileting etc. Although most of them are physical activities yet are mandatory to maintain the mental balance. These underlying factors are all important to consider because during the treatment of depression, improvement in physical health has also been observed. It has been reported in many studies that due to depression different chemicals are released in the body which are harmful for the physical functions. Lenze (2001) reported that the quality of life is influenced by depression. The life quality in the last years should be like that of the initial years. Vision impairment is also connected with depression. The sense of sight is regarded the most vital among the 5 senses. “In a trial of 2,000 old people with rigorous sight issues, the subjects who were less socialized and depressed had the highest mortality rate. In them the visual disorders and the depression were not treated correctly which ultimately lead to their death” (Styron, 1990). A familiar response to visualization failure is despair and depression. The individual suffers from lack of self esteem and self sufficiency. In extreme cases the individual may commit suicide. It has been estimated that 45% of persons having depression also suffer from a condition called dementia (loss of memory). Sometime depression is incorrectly taken as dementia and not treated, but depression is frequently associated with loss of memory. If an aged individual is suffering from despair it should definitely be treated regardless of other prevalent predicaments (Moris, 2004). Complications from Condition An important cofactor for the heart diseases is depression in addition to high cholesterol levels and hypertension. In the last 20 years it has been proved that depression is directly associated with heart problems. Both are chronic, one is going to cause the other (Blazer, 2003). Other complications which arise from depression are: alcohol misuse material abuse nervousness job troubles relatives clashes relationship complexity societal segregation obesity suicide The cost of services Many countries do not have the facility of universal health care. A study carried by NAMI shows that the treatment cost for depression in the United Stated is 3 times greater as compared to other parts of the world. The annual costs for medication are about $4300 per person for the ones who have some sort of restricted access. For the ones who have good health insurances it is about $1500. So it can be estimated that the problem is very costly to treat and in fact the disease treatment costs itself add to the problem, as the depressed person will feel more stressed when he comes to know about the treatment expenses. The depression screening can demand three types of expenditures which can be: Direct expenditure i.e. health check operating cost for the analysis and cure of depression. Indirect expenditures i.e. the ones connected with an individual’s failure to execute well at their likely ability e.g. missing output due to non-attendance, early death and loss of salary. Intangible expenses e.g. ache, poverty, strain and decreased quality of living, attitude of relatives and in older age the attitude of children etc (Watson & Pignone, 2003). Burden to society The individuals who are suffering from depression have reported to have poor functioning at their jobs and also suffer from relationship problems. As the symptoms of disease increase the psychosocial problems also enhance. Likewise when the despair subsides, the affected individual’s psychosocial wellbeing, job show and associations come back to regular levels. Depression results in serious financial consequences comparable to that of physical sickness. The patients who have depression problem utilize more health care services; they take more sickness leaves from the job unlike normal people. The high number of leaves cause loss in income and the expenditure burden increases. In general, production sufferers are probable to report for 80% of the whole expenses of psychological problems, with a middling of 2,720 Euros for each individual per annum in the Netherlands only. Of the distinctive psychological disorders, dysthymia results in the maximum expenditure (Huisani et al, 2004). Challenges and assets of elderly population In old age, the physical ability of the person is reduced to a very significant level. Even walking becomes difficult. To cross the road becomes an impossible task in the absence of help or support. At many occasions we see old people standing beside the road and trying to cross it but nobody bothers to hold their hand or stop his car so that the elder person can cross the road. This is a very negative attitude. This not only makes their life difficult but also makes them feel helpless as they experience stress in such conditions. These small aspects when taken together lead to depression. The old people once were young and were a very active part of the society and at the present they reimburse the cost of their previous disregard of the elderly. They themselves are ignored and unacknowledged. Nowadays the family unit is breaching away as youth moves extensively in hunt for improved jobs. As a result the old people are left unaided and ignored. Sometimes the children do not want them at all. Only the luckier ones have their children staying with them. But most of them have to pass the rest of their lives in old houses or in their own vacant home. The memories of good times cause severe depression in them (Huisani et al, 2004). Ignorance by the children is a very common problem in our society. It is what the older people fear a lot i.e. being not cared of or helped in the time of need. There are many other problems which the elderly people face but none is as severe as the negligence and damn caring attitude of their own children. The children have no time to spend with parents and parents feel ignored due to this lack of attention. The young people consider the old ones as additional burden to their existing responsibilities. Even the cartoons and the movies portray them as negative characters of the society. They have a shared pulling out from the general public and their world gets squeezed. They do not intend to visit out in the locality and prefer to stay at home. Families also feel very hectic to visit them. The elder ones have a lesser amount of enthusiasm for self-care and as a result they end up losing weight, feel anxiety and consider themselves being a trouble to their loved ones which is really poignant. The major asset of the elderly people is their memories and experience. Even in the times of sadness their good memories makes them smile (Watson & Pignone, 2003). Diagnosing Depression in Older People Depression is diagnosed when the older person for a two week time, shows 5 or more of the given below signs: Two main symptoms being: depressed temper lack of interest. The additional varied symptoms comprise of: significant loss or gain in appetite sleeplessness loss of power feelings of improper guiltiness diminished capability to create decisions repeated thoughts of fatality fatigue on waking becoming touchy for no reason irritability Conclusion Depression is a major health issue in our society especially in the elderly people. The causes of it are varied and it leads to complicated situations like fear, anxiety, lack of sleep, heart diseases etc and in severe cases the outcome could be in the form of suicide. Counseling can be helpful in this illness as it is not some physical ailment, it a psychological one. The problem is most prevalent in the elderly people because of negligence from their own children as they feel themselves as a burden on the society. The condition can be improved by proper screening and earlier diagnosis of the problem so that the severe consequences could be avoided. Biblography: American Psychiatric Association. (2002). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revised. Washington, p. 356-419. Blazer, D. (2003). Depression in Late Life: review and Commentary. The Journals of Gerontology, Washington , 58A, 3, 249. Dixon , C., Michael, R., & Rollins, C. (2003). Contemporary Issues Facing Aging Americans: Implications for Rehabilitation and Mental Health Counseling. Journal of Rehabilitation, Alexandria , 69 (2), pp. 5. Huisani, B., Cummings, S., Kilbourne, B., & Roback, H. (2004). Group Therapy for Depressed Elderly Women. International Journal of Group Psychotherapy, New York , 54 (3), pp. 295. Lenze, E., Rogers, J., Martire, L., Mulsant, B., et al. (2001). The Association of Late-Life Depression and Anxiety with Physical Disability. The American Journal of Geriatric Psychiatry, Washington , 9 (2), pp. 113-136. Moris, V. (2004). How to Care for Aging Parents, New Edition. New York : Workman Publishing, p.280-289. Styron, W. (1990). Darkness Visible: A Memoir of Madness. New York: Random House, p. 7 - 33. Unutzer, J., Schoenbaum, M., Katon, W.J., Fan, M., Pincus, H.A, Hogan, D., Taylor, J. (2009). Healthcare costs associated with depression in medically ill fee-for service Medicare participants, The American Journal of Geriatric Psychiatry, Washington, 57, pp. 506-510. Watson, L. C., & Pignone, M. P. (2003). Screening accuracy for late-life depression in primary care: a systematic review. The Journal of Family Practice, 53(12), 956–96 Read More