You used to be able to talk to Dad about everything. But lately you’ve noticed he seems to have pulled away. He’s making excuses to avoid you and his grandkids, sleeping more, eating less, and he appears to be in a fog. Could it be depression?

Research shows that 10 to 20 percent of elderly patients seen by a primary care physician suffer from depression—and among the homebound, that figure may be as high as 46 percent. Even more concerning: The elderly represent 13 percent of the population but 16 to 20 percent of the nation's suicide rate, with the highest rates in males 80 years and older.

Yet despite these dismal statistics, depression in the elderly is frequently ignored. “Symptoms may be attributed to other diseases or even to aging,” says Rose Madden-Baer, MSN, MSHA, Vice President, Behavioral Health and Special Projects for VNSNY, “and because of the stigma associated with mental illness, older adults are often reluctant to admit they are suffering.” Some seniors may ignore the symptoms, thinking their depressed state is a result of growing older, but depression is not a normal part of aging.

Keep an eye out for these warning signs of depression: 

• persistent sadness or anxiety;
• sleeping too much or too little, awakening frequently; 
• reduced or increased appetite and/or weight loss/gain; 
• loss of interest or pleasure in activities; 
• fatigue, loss of energy, irritability or restlessness; 
• difficulty thinking or concentrating, remembering or making decisions; 
• thoughts of death or suicide, including suicide attempts; 
• feeling inappropriate guilt, hopelessness or worthlessness.

Talking with Your Loved One

If you see any of the warning signs in your parent, approach the subject in a way that won’t make your loved one uncomfortable. Instead of asking Dad if he’s depressed, ask him how he’s feeling or what is bothering him. Give him an opportunity to open up to you, and listen to what he says. Depressed seniors often talk about the physical symptoms of depression first (“I’m not sleeping well,” or “I’m just not hungry.”). Reassure him that with a little help, he can be enjoying life again. Keep in mind he may be holding back because he doesn’t want to create an additional burden for the person who is caring for him.

Get an Assessment

Most importantly, talk to your loved one’s physician and request an assessment. There are many effective ways to treat depression in the elderly, from cognitive behavioral therapy, to the use of some medications, though these must be carefully monitored as the side effects can be more significant in older patients or have harmful interactions with other prescription medications.

“We take this problem very seriously,” says Madden-Baer. VNSNY’s program is showing success treating homebound seniors whose depression was previously undiagnosed, untreated or under-treated. “Patients who would not get out of bed are now fully engaged in their communities and living active lives with dramatically improved quality of life.”