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Stress can lead to depression. While many aging Americans look forward to a happy and healthy retirement, many seniors face a disproportionate amount of stressors. Losing loved ones, feeling useless and unproductive after years on the job, loss or decline in physical senses, chronic illness, and the financial pressure of mounting medical bills can, and often do, lead to depression among seniors even if there has been no prior history of mental illness. Says Kathleen Buckwalter, PhD, RN, professor of gerontological nursing with the University of Iowa, “The elderly are less likely to cope with loss as well as young people because of the added years of meaning behind it, and the fewer years with which to move on.”

Aging experts agree it is important that adult children and other family members learn to tell the difference between the signs and symptoms of senior depression from ordinary feelings of melancholy.

Signs of Senior Depression

According to Joel E. Streim, MD, a professor of geriatric psychiatry with the University of Pennsylvania, “If your parent is not eating for more than a few days, or loses interest in activities that used to give him or her pleasure for longer than two weeks, it could be depression.” Other signs of depression include:

• Feelings of persistent sadness, anxiety or feeling “empty”
• Pessimistic feelings, hopelessness
• Low self-esteem, persistent guilt or feelings of worthlessness
• High irritability, restlessness, aggressive behavior
• Chronic fatigue and lack of energy
• Memory loss, difficulty concentrating, indecisiveness
• Disruption of sleep patterns
• Suicidal thinking, suicide attempts
• Pains, cramps, headaches with unknown cause that do not cease even with treatment

Looking at the above list you can see that many of these may also just be signs of aging so it becomes particularly difficult to spot early signs of depression in the elderly. Dr. Streim also reminds us that depressed seniors do not always look depressed or express depression the same way younger folks do. An elderly parent may not tell you outright that they are “sad” or “feeling lonely” because they’re afraid of being a burden on the family, but “they may show signs of distress by wringing their hands excessively, getting agitated or irritable, or having difficulty sitting still.”

Dr. Streim also points out that it is important that adult children dealing with a depressed parent recognize that depression is an illness, not laziness. Adult children should be aware of the disability that depression can cause and should avoid making depressed parents feel worse by telling them to “just get over it” or to “pull themselves up by the bootstraps.”

Treatment for Depression in Seniors

The most commonly used treatments for depression in the elderly are psychotherapy and antidepressant medication, or a combination of both methodologies. Prescribing antidepressants for seniors with depressions can be a little tricky because of changes in the way the aging body metabolizes drugs, and the interactions with other medications they may be taking. Therefore, an aging parent with mild or moderate depression may benefit from talk therapy and should be encouraged to try that first. For severe or incapacitating depression, medication is generally recommended in addition to psychotherapy. However, make sure that you and the treating physicians are all well aware of any medications that have been prescribed for your parent, and monitor the dosages carefully. Often due to confidentiality restrictions, a psychiatrist may not be required to share prescription information with family members unless the patient has given permission, so make sure your loved one has done so.

Source: Parent Giving

Years ago doctors were mainly concerned about vitamin D deficiency in children. Foods were fortified with vitamin D to prevent the bone disease called rickets. Now we know that rickets was only the tip of the iceberg and that seniors are also at high risk for vitamin D deficiency. According to a recent study in the journal Age and Ageing, vitamin D deficiency may contribute to osteoporosis, muscle weakness, hip fractures, diabetes, cancer, heart disease, arthritis and poor general health in seniors.

Sources of Vitamin D

Vitamin D is not common in many foods, but it is very important for helping your body absorb the calcium you need to build bone strength. Vitamin D also helps you fight off many diseases and is important for proper nerve function. Sources of vitamin D include:

• Food. There are few foods that contain vitamin D naturally. The best foods for vitamin D are cod liver oil, salmon, mackerel, tuna, beef liver, cheese and egg yolks.
• Vitamin D fortified foods. Since it is difficult to get enough vitamin D naturally, many foods have vitamin D added to them. These foods supply most of the vitamin D in the American diet. Milk, breakfast cereals, and juice drinks are commonly fortified with vitamin D.
• Sunlight. For most people exposure to sunlight is the most important source of vitamin D. Sunlight converts cholesterol to vitamin D in the body.
• Vitamin D supplement. Between 2005 and 2006 the National Health and Nutrition Examination Survey found that only about one-third of Americans were getting enough vitamin D in their diet. A recent study published in the Archives of Internal Medicine suggests that older adults can reduce their risk of bone fractures by taking an oral supplement of vitamin D every day.

Why Are Seniors at Risk?

People over age 50 have an increased risk of vitamin D deficiency and the risk increases with age. As people age they lose some of their ability to synthesize vitamin D from sunlight. Vitamin D also needs to be activated in the kidney before it can be used by the body and this function also decreases with age. Finally, elderly people who are homebound are less likely to get outdoor exercise and activity. Researchers have suggested that it takes up to 30 minutes of sun exposure twice a week to make a sufficient amount of vitamin D from sunlight.

How Much Vitamin D Do You Need?

You need more vitamin D as you get older. According to the Food and Nutrition Board at the Institute of Medicine of The National Academies, an adequate intake of vitamin D up until age 50 is 200 International Units (IU) for both men and women. Between age 50 and 70 the adequate daily intake is 400 IU for men and women. After age 70 the adequate intake is 600 IU for men and women.

“The clinical manifestations of suboptimal vitamin D levels has a significant physical, psychological and financial impact on older people and society as a whole,” —Age and Ageing

Because seniors are at greater risk for vitamin D deficiency, there have been many recent studies to determine if vitamin D supplements are useful in preventing falls and fractures. Some studies have found that a supplement of 400 IU daily is adequate and effective for reducing falls and fractures in seniors. Other studies suggest that the best dose for fracture reduction is 800 IU daily, and still others have found that a dose of 800 to 1000 IU daily is best.

It is possible to take too much vitamin D supplement. Symptoms of vitamin D toxicity include nausea, vomiting and weakness. Too much vitamin D can cause your calcium level to increase and lead to mental confusion and heart arrhythmias. Too much sun exposure does not lead to too much vitamin D (though there are skin cancer risks to consider). To be in danger of overdosing on a vitamin D supplement you would need to take well over 2,000 IU daily.

Ideas for Caregivers

If you are a caregiver for a senior, here are some things you should know about vitamin D deficiency and supplements:

• Older people who do not take vitamin D supplements are at higher risk for vitamin D deficiency.
• Not all seniors have the same risk. Women are at higher risk than men. Seniors with darker complexions don’t produce vitamin D from sunlight as well as light-skinned seniors.
• Sunlight may not be enough. If you live in the northern part of the America, above a line drawn between Boston and the top of California, there is not enough sunlight to produce vitamin D from November through February. Skin needs to be uncovered (no sunscreen either) to absorb the sun’s rays and sitting inside next to a window doesn’t work.
• Some medications, like steroids, some weight-loss drugs, some cholesterol-lowering drugs and some drugs used to control seizures, can interfere with vitamin D supplements.
• A senior’s sex, age, diet, sun exposure and medical history all need to be considered when deciding on vitamin D supplements. Talk to your health care provider about the possibility of vitamin D deficiency and best dose for vitamin D supplements.

Source: Parent Giving

Studies have shown that we tend to cut back on eating as we age, though clearly every individual has a different appetites, body types, metabolisms, nutritional needs and health challenges. The best advice for maintaining cardiovascular health is to get plenty of exercise and eat a balanced diet made up of small portions lacking in salt, processed sugars and saturated fats, yet high in the right vitamins, proteins, healthy fats like the ones found in fish and lots of fresh veggies and fruits. In fact, when it comes to eating the best we can, farm fresh produce, meats, whole grains and other non-processed foods are optimal. Eating organically also keeps us from ingesting unnecessary and potentially harmful things like fertilizers, animal hormones or antibiotics and other types of chemicals.

Cutting back on calories isn’t for everyone, though, and not just because we love our sweets. If you or an elderly person in your life has trouble swallowing or takes medications that decrease appetite, getting the proper amount of healthy calories can be a challenge. Being able to swallow food without the fear of choking or having food “stuck in your throat” is very important, as having a fear of eating can develop into an eating disorder and compound already challenging medical issues. Food thickeners and purees help eating to become a pleasurable experience again for those living with a swallowing disorder.

Loss of appetite can contribute to frailty and lack of energy. Liquid protein and vitamin supplements make getting necessary nutrients an easier feat to accomplish. Boost VHC nutritional drinks provide 530 calories per serving to support weight gain and maintenance goals. Each Boost VHC contains high protein calories to develop lean muscle mass while keeping on weight. There are other choices for ensuring proper enteral (tube feeding) nutrition as well, we feature a variety of choices here on our website.

Here’s some great news: dark chocolate has been shown to have benefits like boosting your mood and thus reducing stress (less stress = healthier heart), however, it was also reported by researchers in the open access journal BMC Medicine that the flavanol compounds in chocolate, “promotes vasodilation and consequently may lower blood pressure.” This doesn’t mean you should polish off that box of Valentine’s Day chocolates in a single sitting, though it is a special occasion and hence possible exception Just keep in mind that chocolate is also high in fat and sugars, so around an ounce of the dark stuff is a heart healthy dose.

Another nice discovery revolves around the benefits of red wine. Two glasses at the end of the day (moderation is key) have been shown to improve heart health through its antioxidant polyphenol, which may assist in protecting the lining of blood vessels found in your heart. Another ingredient, resveratrol might help to prevent blood clots. Cheers to your heart!

Drinking soda, however, is a big no-no. It’s very high in sugar and empty calories and has been linked to diabetes and cardiovascular problems in a big way. Calories without nutritional value can lead to weight gain. Our bodies simply think of them as “extra,” literally sending them “straight to our hips.”

The long and short of it is to make sure the right calories in the right amounts are being consumed, to cut down on sodium, fat and sugar and to exercise at the level that you or the person you care for is able. Unfortunately, this means cutting down or out many of our favorite foods: cheeseburgers, french fries, chips, high fat/salty breakfasts like bacon, eggs, fried potatoes and butter toast or sugary ones like pancakes with syrup or compote and whipped cream—not to mention dessert. But with the dark chocolate backup, seasonal fruits, a glass or two of cabernet sauvignon and nutritious desserts like Boost pudding—a great option, as it has seven grams of protein per serving and comes in the yummy, classic flavors of vanilla, chocolate and butterscotch—we can keep our hearts and bodies in good shape, while still enjoying the finer things in life.

Source: Parent Giving