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Signs of Depression in Older Adults

Depression is more than just feeling sad from time to time. It’s a serious mental health issue that can be treated. It can cause severe symptoms that affect your entire life including how you think, feel, and handle day-to-day activities such as sleeping and eating.

Depression is a legitimate illness. It’s not something you can just “shake off” one day, and it doesn’t mean that you’re weak or that you lack willpower. It’s important to know the signs of depression in older adults so you can find the treatment you need. 

Types of Depression

According to the National Institute on Aging (NIA), there are several types of depression. The most common types of depression are major depression and persistent depressive disorder.

  • Major depression involves severe symptoms that affect your ability to work, sleep, study, eat, and find joy in life. A person may experience an episode of major depression only once, however, multiple episodes are more common.
  • Persistent depressive disorder is a depressed mood that lasts for two years or more. A person diagnosed with persistent depressive disorder may have episodes of major depression with periods of less severe symptoms in between.

Other forms of depression include Seasonal Affective Disorder (SAD), psychotic depression, and postpartum depression.

Signs and Symptoms of Depression in Older Adults

It might be difficult to recognize depression in older adults because they may show different symptoms than younger adults. For example, sadness is not the main symptom for some older adults. They may have less obvious symptoms of depression like restlessness, or they may not be willing to talk about their feelings. Doctors may be less likely to recognize that you have depression.

Sometimes older people who are depressed feel tired, have trouble sleeping, or seem irritable. Sometimes the attention problems that depression can cause look like Alzheimer’s disease or other brain disorders. Older adults may have medical conditions such as heart disease, stroke, or cancer, which may cause symptoms of depression. Certain medications can also have side effects that contribute to depression.

There are many symptoms associated with depression, and they can vary from person to person. If you have any of the following symptoms for more than two weeks, you may have depression. Symptoms of depression can include: 

  • Persistent sad, anxious, or “empty” mood
  • Feelings of hopelessness, guilt, worthlessness, or helplessness
  • Irritability 
  • Restlessness
  • Loss of interest in activities you once enjoyed
  • Fatigue or a lack of energy
  • Talking or moving slower
  • Difficulty focusing, remembering, and/or making decisions
  • Difficulty sleeping, waking up in the early morning, or oversleeping
  • Unplanned weight gain or loss
  • Suicidal thoughts, suicide attempts, or thoughts of death
  • Aches or pains including headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease with treatment
  • Frequent crying

Depression Risk Factors

Several factors can contribute to depression including: 

Genetic factors: People who have a family history of depression may be more likely to develop it than people whose families do not have a history of the disease.

Personal history: Older adults who had depression when they were younger are more at risk for developing depression later in life than people who did not have the illness earlier in life.

Brain chemistry: People with depression may have different brain chemistry than people who do not have the disease.

Stress: Situations such as the loss of a loved one or a difficult relationship can trigger depression.

Age: Depression can occur because of the changes that happen as you age. For example, some older adults have a condition called ischemia, which means restricted blood flow. With ischemia, the brain may not get the blood it needs to function. A condition called vascular depression can result, which also puts the person at risk for heart attack, stroke, or other hematologic disorders.

Depression can co-occur with other serious medical conditions such as diabetes, cancer, heart disease, and Parkinson’s disease. Depression can make these conditions worse. Sometimes medications taken for these physical illnesses can cause side effects that contribute to depression. Your doctor may be able to help find the best course of treatment with the fewest side effects.

What Caregivers Need to Know About Depression

It can be difficult to detect depression in your loved one. For example, grieving after the loss of a loved one is normal, and it oftentimes doesn’t require professional mental health treatment according to the National Institutes of Health

If you notice that your loved one has signs and symptoms of depression, make an appointment with the doctor. Know what questions to ask your loved one’s doctor and go into your doctor prepared with notes about: 

  • Any symptoms your loved one has even if they unrelated to the reason for your appointment. Write down when their symptoms started, the severity of symptoms, if they’ve occurred before, and the treatment for the symptoms.
  • Key personal information such as any major stresses or recent life changes
  • All medications, vitamins, or other supplements that your loved one takes. Be sure to include the medication’s dosage and the frequency at which your loved one takes them

Caregivers Can Also Experience Depression

It may be easy to forget about yourself when you spend so much time and energy on your loved one. Caregivers can experience depression, too. According to the Family Caregiver Alliance, many people with symptoms of depression don’t think they’re depressed. Caregivers may have unique concerns when it comes to their own depression including:

  • Dementia caregivers experience depression at higher rates. People who care for loved ones with dementia are twice as likely to suffer from depression than other caregivers. Dementia caregivers spend more time with their loved ones than other caregivers, and they may experience the following issues:  
    • Employment problems
    • Stress
    • Physical and mental health issues
    • Sleep deprivation
    • Less time to do the things they enjoy
    • Less time with other family members
    • Increased family conflict
  • Women experience depression at higher rates than men: According to the Family Caregiver Alliance, about 12 million women experience major depression each year, which is double the rate of men. Physical factors such as iron, vitamin D, and Omega-3 fatty acid deficiencies along with menopause and thyroid disease can contribute to depression.
  • Men experience depression differently than women. Men are less likely to report feelings of depression to their doctor, and they’re more likely to “self-medicate” with alcohol or other substances.
  • Depression can persist even after you place your loved one in a care facility. It can be stressful to move your loved one into a long-term care facility. Even though you may get some much-needed rest, you may feel guilty or lonely, which may contribute to major depression.

Caregiver Support Services

Some caregivers can receive compensation from their state’s Medicaid program. Benefits and payment amounts vary by state. 

You can also look for online and in-person support groups that focus on the needs of specific caregivers. For example, some support groups are only for dementia caregivers. 

Other caregiver resources include educational materials and respite care, which is when your loved one stays at a hospital or long-term care facility to give you a break. Medicare will cover respite care only if it’s a part of hospice care. 

How to Prevent Depression

According to WebMD, doctors don’t know if it’s possible to “prevent depression altogether.” However, you may be able to keep it from returning if you’ve already had an episode. Some therapists use a treatment called mindfulness-based cognitive therapy (MBCT), which combines cognitive therapy with mindfulness. 

According to the Mayo Clinic, cognitive therapy is a type of psychotherapy that helps the patient change negative thinking patterns that can come with depression. Mindfulness is the “self-regulation of attention with an attitude of curiosity, openness, and acceptance, according to Psychology Today.

Other ways to help prevent depression include changes to your lifestyle and nutrition habits. Even though there’s no guaranteed way to prevent depression, you can: 

  • Find ways to improve your self-esteem and manage stress.
  • Practice healthy eating, sleeping, and exercise habits.
  • Reach out to friends and family during difficult times
  • Get regular medical check-ups and make a doctor’s appointment if you don’t feel right.

Treatment for Depression in Older Adults and Medicare Coverage

Even the most severe depression can be treated, according to NIA. Treatments often include therapy — usually talk therapy — and prescription drugs.

Depression can get a lot worse if you wait to seek help, so it’s important to talk to your doctor as soon as you notice something is wrong.

You can receive Medicare coverage for depression treatment if you are 65 or older, have ALS or ESRD, or have received SSDI for at least 25 months. 

Medicare Part B may cover behavioral health services like psychiatrist or psychologist appointments. Counseling or therapy sessions may be limited because they are only covered under Medicare if your doctor accepts Medicare assignment. Behavioral health services can include:

  • One-on-one and group therapy
  • Substance abuse treatment
  • Occupational therapy
  • Active therapy (art, dance, music therapy)
  • Family counseling
  • Annual depression screening
  • Prescription drugs you cannot administer yourself

Original Medicare will cover these services at 80 percent of the Medicare-approved amount. This means you may pay 20 percent coinsurance after you meet the Part B deductible. For example, if your psychologist bills Medicare for $200, you’ll pay $40.

Other treatments for depression can include antidepressants, which are prescription drugs that can help ease symptoms of depression. Original Medicare does not cover prescription drugs. However, Medicare Part D or certain Medicare Advantage plans do.

Medicare Advantage policies are private insurance plans that can offer additional benefits to help treat and prevent depression such as depression screening, possible reduced therapy costs*, and fitness classes!

Another option for additional Medicare coverage is a Medicare Supplement (Medigap) plan. You cannot have a Medicare Advantage plan and a Medigap plan at the same time, so it’s important to know the difference between the two. Medicare Advantage plans cover additional benefits. Medigap plans cover financial items such as coinsurance and copays**. 

*A Medicare Advantage plan may offer coverage for therapy services. You may still owe a copay.

**You are still responsible for the Medicare Part B premium even if you have a Medicare Advantage or a Medicare Supplement plan.

Get Medicare Mental Health Coverage Today

Whether you need a Medigap plan, a Medicare Advantage plan, and/or a standalone Medicare Part D plan, a licensed agent with Medicare Plan Finder may be able to help. 

Our agents are highly trained and they can help you assess your needs. Your agent can see what plans are available in your area and help you determine what’s right for you. Call 844-431-1832 or contact us here to set up a no-cost, no-obligation appointment.

9 Questions a Caregiver Should Ask Their Parent’s Doctor

Being a caregiver can be fulfilling and joyful, but it can also be a lot of work. You may not know where to find information about your parent’s health condition or treatment plan. Luckily, your parent’s doctor can be a valuable resource who you can –– and should –– rely on for answers. Here are nine questions a caregiver should ask their parent or loved one’s doctor:

1. What can you tell me about my caregiving situation?

Doctor and Patient Discussing Treatment Plan - Medicare Plan Finder

Every caregiver’s situation is different. Your loved one may have different medical, nutritional, or assistive needs, and your doctor can tell you the best place to start with meeting your loved one’s healthcare needs. 

For example, your parent may need non-emergency medical transportation to their various appointments, and they might need special care. Your parent’s doctor may be able to provide contact information for medical transportation services, or even schedule rides to the office. You might not have considered that your loved one may need an EMT-certified driver, especially with rideshare apps like Uber and Lyft offering rides to doctor’s appointments.

When you ask your parent’s healthcare provider about your unique situation, the physician can discuss the individual needs your parent has. Your loved one’s doctor should feel like a partner in providing the best quality care. Your doctor may even tell you ways to take care of yourself, because it can be easy to forget your own needs when you’re so focused on someone else’s.

2. Can you help me connect with other caregivers in similar situations to me?

It can be easy to feel like you’re on your own as a caregiver. An important question a caregiver should ask is what type of non-medical support they might need. Your parents’ provider may recommend resources such as caregiver support groups and online forums. It’s valuable to connect with other people in similar situations. 

When you feel like you have emotional support, you’re able to take better care of your parent. It can be easy to feel frustrated or overwhelmed as a caregiver. A support group can give you ideas to cope, tips for providing better care, and/or just lend an empathetic ear. Your parent’s doctor can give you ideas about how to build a support system.

3. What can I do to build confidence in my caregiving activities and skills?

Your parent’s doctor should talk about your parent’s treatment plan and care needs with you. You should feel confident in your abilities to properly administer medications or help with physical therapy. If you’re unsure of how to do something the doctor recommends, ask them to explain the task further.

Ask if there are any shortcuts, tips, or tricks you need to know about. Find out if you can practice complex tasks so you can help effectively. Some tasks may be dangerous to perform on your own, and you may need to find outside assistance. Find out if you need to look into home health care services or if you can perform the tasks on your own.

Medicare Caregiver Support

4. Can you help me arrange respite care when I need a break?

Providing 24-hour care can be rewarding, but also exhausting. Sometimes you need to take a break. “Respite care” is when your loved one stays at a hospital or other care facility so you can get some much-needed rest. It may give you peace of mind to know that your parent is staying at a facility with qualified professionals. 

Your loved one’s healthcare provider can point you in the right direction for finding respite care services. 

5. What do I need to know about my parent’s diagnosis?

Every health condition or disease may have different need-to-know information. For example, your doctor may tell you to avoid fatty cuts of beef if your loved one has high cholesterol. 

Your parent’s provider should tell you how and when to administer medications, how often you need to make follow-up appointments, and what symptoms to watch out for. The healthcare provider should help you provide the best possible care for your loved one, and that includes knowing the ins and outs of your parent’s health.

6. How will you coordinate with my loved one’s other healthcare providers?

Some diagnoses mean that your parent requires a care team. For example, your loved one might have a gerontologist, a physical therapist, and a neurologist. Ask how the team will coordinate your loved one’s care and keep you in the loop. 

For example, some healthcare facilities feature apps to contact care team members if you have questions or need to refill prescriptions. Health facility apps can also include post-appointment notes  so you can access any information you need. 

7. I found this information on the internet. Is it accurate?

Looking up Medical Information on the Internet - Medicare Plan Finder

Google has a wealth of information about any disease you can think of. Sources such as WebMD and the Mayo Clinic offer information about symptoms, causes, risk factors, and treatments for a seemingly infinite number of health conditions. 

Even though the internet has more information that you could ever need, the information can pose a problem for doctors and patients. 

For example, your loved one could fall and bruise their knee. You Google “knee pain,” and read the first web page you see from WebMD. The article you read could have you thinking that your loved one needs a full knee replacement, but all they really need is an ice pack and some over-the-counter pain medications

Your parent’s doctor will be able to help determine what’s really going on and sort out the facts from the fiction. 

8. Should I be concerned about these new symptoms I’m observing?

If your parent has a degenerative health condition or they have new symptoms, ask the doctor if you should be concerned. Your loved one’s healthcare provider will let you know if they need to see your loved one or if you notice something normal. Your parent’s doctor should be available to answer your questions in a timely manner.

9. How will I know when it’s time to look into hospice care?

At some point, your loved one may need to switch from curative (to find a cure) care to palliative (to provide comfort) care. Your parent may be eligible for hospice care if curative care will not work and palliative care is the only option. 

Ask your doctor to let you know when it’s time to start palliative care only, and if they know of any resources to find hospice care. 

Find Medicare Caregiver Resources

As a caregiver, you’ve got a lot on your plate. Use this list of questions a caregiver should ask their loved one’s doctor can be a valuable source of information if you ask the right questions. 

Another valuable resource is your parent’s health insurance plan. If you have durable power of attorney, you can make Medicare decisions for your loved one. A licensed agent with Medicare Plan Finder may be able to help you find a Medicare Supplement or Medicare Advantage plan that suits your healthcare needs and fits your budget. Call 1-844-431-1832 or contact us here to schedule a no-cost, no-obligation appointment today.

11 Crucial Tips for Taking Care of Elderly Parents at Home

Taking care of an elderly parent at home may be the most important thing you ever do, but it can be easy to get bogged down with the day-to-day struggles you may encounter.

You can help minimize your physical and financial stress that can come with caring for aging parents with some planning and resources. Follow these 11 tips to set yourself up for caregiving success.

1. Monitor Medications

One vital part of caregiving is making sure your parent receives his or her medications on time. Many pharmacies have apps that allow you to set up automatic refills for qualifying prescriptions, and you can even have prescriptions mailed directly to you.

It’s important to find a health insurance plan that will help pay for all of your parent’s medical needs. Medicare is a fantastic resource for paying medical expenses, but Original Medicare may not cover all of the services your loved one needs, such as prescription drugs.

You may have to look into private insurance policies called Medicare Supplements or Medicare Advantage plans to cover additional services and ensure that your parent’s insurance meets his or her needs.

If you need help paying for your parent’s medications, Medicare Part D or certain Medicare Advantage plans offer prescription drug coverage. There may be many plan options out there for you, and asking a qualified professional for help finding the right one may make the difference in your loved one receiving the right care.

Contact Us | Medicare Plan Finder

2. Find Assistive Devices to Help Make Life Easier

As your parent ages, he or she may have difficulty performing actions such as bathing, standing up, or walking, and you may consider using assistive devices or Durable Medical Equipment (DME) to help make life easier. Assistive devices for the elderly range in supportive functions from fall prevention and mobility (canes, walkers, wheelchairs) to helping button shirts or clean.

Medicare Part B will help cover DME if your doctor prescribes the devices. You may owe deductibles or coinsurance. Some items such as wheelchair ramps and handrails may not be considered DME, but some Medicare Advantage plans cover those home modifications.

3. Hire Outside Help if Necessary

At some point, your parent may require more help than you can provide. You may have to enlist the help of skilled nurses or other healthcare professionals to perform the required level of care. If you don’t know where to start looking, your parent’s doctor may recommend a home healthcare service, or Medicare has a registry where you can find agencies in your area.

If it’s extremely difficult for your parent to leave the house, Medicare will cover intermittent skilled nursing services, meaning that the skilled professional doesn’t visit your parent every day or for extended periods of time.

Some parents will need long-term care, and Medicare will not cover those services. You can, however, purchase long-term care insurance to help pay for expenses such as a full-time nurse.

4. Make Sure Your Loved one Stays Active

Healthy Seniors Lifting Dumbbells | Medicare Plan Finder
Healthy Seniors Lifting Dumbbells | Medicare Plan Finder

An active lifestyle that includes regular exercise may help prevent chronic diseases. Resistance training combined with cardiovascular exercise can help manage symptoms of osteoporosis, diabetes and chronic hypertension. Go on walks with your parent, go to the pool or look for fitness classes geared toward seniors such as Silver & Fit® or SilverSneakers® in your area. Certain Medicare Advantage plans cover fitness classes.

5. Find Proper Nutrition for Your Loved One

Ensuring that your parent eats properly can be time-consuming. You may be responsible for grocery shopping, meal preparation, and making sure your loved one eats at the right times throughout the day. Not only that, but your parent’s doctor or dietitian may recommend that your parent eats a certain number of calories or that your parent’s diet focuses on lean protein sources, fruits, and vegetables.

You can cut down on the time it takes for meal preparation by preparing meals for a few days in advance and putting them in single-serving containers. Look for recipes with simple cooking methods such as using a slow cooker or one-pan meals.

Some Medicare Advantage plans even cover meal delivery, which would dramatically cut down on the time you spend worrying about your parent’s nutrition.

6. Create a Schedule

Creating a schedule and sticking to it is extremely important when taking care of elderly parents at home. You’ve got a lot to do for yourself and your loved one, and if you don’t establish a routine for house cleaning, running errands, or bathing, then those things may not get done.

Take some time every week and make a list of everything you and your parent need to accomplish. Create a calendar that includes all of the events for the week because seeing doctor’s appointments, meal delivery times, etc. will help you coordinate everything your parent needs and also let you schedule some time for yourself.

7. Take Time to Care for Yourself, Too

Smiling Woman in Meditative Pose | Medicare Plan Finder
Smiling Woman in Meditative Pose | Medicare Plan Finder

It can be easy to forget about self-care when you’re so involved with your loved one, but taking some time for yourself is extremely important.

Find some time to relax. Take bubble baths, meditate, or do anything else that makes you happy. The important thing is that you feel refreshed and recharged when you go back to your parent.

Be active. Exercise is not only beneficial for your physical health, but also your mental health. The vast majority of people who exercise regularly report lower stress levels than sedentary individuals. Consider doing yoga, jogging, cycling or joining the gym where your parent takes fitness classes.

8. Find a Support System

Self-care may look like finding a support group or therapist so you can talk about how you feel. Your job as a caregiver may be overwhelming if you feel like you’re alone. If you can openly talk about what’s going on and get information on how to cope, you can provide better care because you’ll have better emotional health.

Sometimes you may just need a break, but you’re unable to leave your loved one alone.

Ask other family members to step in when you need some time off or it could be time to consider finding respite care services, which allow you to rest. Respite care may mean that your parent stays in a hospital temporarily or goes to adult day care.

Medicare will only cover respite care if it’s part of hospice, but the NFCSP or National Association of Area Agencies on Aging (N4A) can help you find respite services in your area that may be in your budget.

9. Know Your Rights

You have rights as a caregiver. The Family Medical Leave Act (FMLA) allows employees who meet certain requirements to take up to 12 weeks per year off to care for qualifying immediate family members.

If your employer has 50 or more employees, you must be allowed to return to your original position or its equivalent when you return to work.

If your employer fires you or demotes you, or refuses to grant leave, you may have a case against your employer for FMLA violations and workplace discrimination.

Talk to an employment lawyer or to your to the Department of Labor if you think your rights have been violated.

10. Obtain Power of Attorney to Make Important Decisions

Caregiver Helping Parent With Power of Attorney Paperwork | Medicare Plan Finder
Caregiver Helping Parent With Power of Attorney Paperwork | Medicare Plan Finder

In order for Medicare to allow you make decisions for your parent, you must first have the right kind of power of attorney (POA). There are many different types of POA, but a Durable Power of Attorney is the only kind Medicare will accept, and it’s the most beneficial for taking care of elderly parents at home. A Durable Power of Attorney will allow you to make medical decisions for your parent before he or she becomes incapacitated.

11. Find Government Assistance for Caregivers of Elderly Parents

Taking care of elderly parents at home can be a full-time job. You may be able to find government assistance for caregivers of elderly parents and receive payment for your hard work. Medicare will not pay for you to provide caregiver services, however, Medicaid will in some states.

It may feel like you’re all alone, but there are some federal resources that can help ease your stress. The National Family Caregiver Support Program (NFCSP) provides a wealth of resources to caregivers information on where to find support groups, educational materials for specific conditions and contact information for advocacy organizations. You’ll be a better caregiver if you use the government resources available to you.

We Can Help You and Your Loved One Find Coverage for Home Care Services

The right insurance plan can help cover the cost of at-home care services. If you have power of attorney, a highly-trained licensed agent with Medicare Plan Finder may be able to help you find a plan that fits your budget and lifestyle needs. Call 844-431-1832 or contact us here to learn more.

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