Treatment for Older Veterans with Depression & Early Stages of DementiaJuly 25, 2019
New Vitae Wellness and Recovery is honored to support those who have served our country through our Veteran Pathways program. We recognize that veterans’ wants and needs in residential and clinical support are specialized, particularly those of older veterans who may also be battling depression or dementia. New Vitae offers person-centered care for older veterans suitable for each individual’s needs, developing individualized recovery plans in partnership with the U.S. Department of Veterans Affairs.
How Many Older Adults Experience Depression?
The National Alliance on Mental Illness states that more than 18 percent of adults over the age of 65 are affected by depression. While in many cases the individual may have experienced symptoms of depression in the past, sometimes these do not appear until later in life. For older veterans, depression can be just as prevalent. Veterans Affairs estimates that one in three veterans shows symptoms of depression. That number is most likely higher, as it does not account for veterans who have not sought out services for depression.
What are symptoms of depression?
Symptoms of depression in older veterans can often be overlooked, as many people associate symptoms with natural aging; this is not the case. Many older veterans are also reluctant to communicate their symptoms or feelings, as they may associate feelings of shame and guilt with depression symptoms. Though depression can be a reaction to chronic illness, pain, and other struggles faced later in life, it is its own diagnosis. Symptoms of depression in older adults can be different from signs in young adulthood. Some of the symptoms in older patients include:
- Reluctance to leave the house or go outside.
- Personality changes.
- Suicidal thoughts or feelings (especially in older men).
- Memory difficulties and confusion.
- Loss of interest in activities.
- Loss of appetite or disinterest in eating.
- Trouble sleeping and irritability.
- Physical aches, pains, and fatigue.
Many of these symptoms are overlooked due to other co-occurring illnesses or chronic pain. Symptoms can often be mistaken for those of arthritis, cancer, heart disease, Parkinson’s disease, stroke, thyroid disease, and especially dementia.
According to Veterans Affairs, depression and dementia in veterans are often linked, and both can affect older veterans’ quality of living. It is estimated that older adults with depression are almost twice as likely to develop dementia as older adults who do not experience depression.
Depression and dementia can result in similar symptoms and can therefore be difficult to distinguish from each other.
Differences in Symptoms of Depression and Dementia
Because of the link between depression and dementia, it can be difficult to determine the differences. Some ways that depression and dementia differ are:
- Mental decline is fast.
- Language and motor skills are normal, but could be slow.
- Memory loss, lack of concentration, or confusion are noticed by patient
- Mental decline is slow.
- Language and motor skills are impaired.
- Confusion, disorientation, and memory loss go largely unnoticed by patient.
Types of Depression
There are four most common types of depression that may be experienced by older veterans:
- Major depression, in which the person experiences an all-consuming dark mood. Any interest in prior activities is lost. Swings in appetite or weight can occur, as well as trouble sleeping. Feelings of worthlessness and thoughts of suicide and death can occur as well.
- Persistent depressive disorder, in which the person experiences a low mood that has lasted persistently for two years but may not be as severe as major depression. Day to day function is continued but is accompanied by low mood. Changes in appetite, weight, sleeping, and feelings of hopelessness and low energy can also occur.
- Bipolar Disorder, in which the person experiences periods of depression, with episodes of what is called mania, or periods of high energy and activity. Symptoms of mania include extremely high self-esteem, grand ideas, decreased sleep, and high pursuit of pleasures such as sex, overspending, and taking high risks that are self-destructive. Mania does not last long and is followed by a period of low depression.
- Seasonal affective disorder, in which the person experiences depression during the winter months, when the days are shorter. This could be related to changes in the body’s natural schedule, sensitivity to light, and differences in how serotonin and melatonin function.
Though these are the most common forms, keep in mind that depression can be a bit different for individuals, especially in older veterans who may have co-occurring illnesses such as dementia, among the others listed previously.
How Can Depression in Older Veterans be Treated?
Treatments for depression in older veterans should be person-centered and specialized for each individual; the common treatments for depression may be utilized in conjunction with each other and with other treatments. The major ways to treat depression in older adults include:
- Psychotherapy, or “talk” therapy, can be a very effective form of treatment for older adults with depression. It works to teach new ways of thinking, behaving, and planning that combat depressive cycles. Difficulties in life, relationships, and past trauma are also topics that are addressed, particularly in older veterans that haven’t communicated things that may be troubling them. Problem-solving methods in cognitive-behavioral therapy can be very effective in improving older veterans’ quality of life. Psychotherapy can be just as effective as medication in treating depression in older adults, but in serious cases, medication, or the combination of both, may be more helpful.
- Medication is another common treatment, in the form of antidepressants. These work to balance the level of neurotransmitters in the brain that control mood. While they can be very effective, older adults who may be on other medications are at higher risk for drug interactions among medications, and there are often side effects to taking such medications. Following a doctor’s directions when taking antidepressants is very important, and medications should not be started or stopped without consulting a doctor. In those with depression and dementia, care should be taken to determine whether possible side effects of antidepressants can affect or worsen symptoms of dementia.
- Deep Transcranial Magnetic Stimulation (dTMS) uses electromagnetic fields in order to stimulate the brain and help with depression symptoms. For 4-5 weeks, patients receive 20 minutes of TMS each day. The therapy, which uses coils strategically placed around a patient’s head, targets specific regions of the brain. This therapy takes place in a comfortable atmosphere and provides a safe method for helping alleviate depression. Additionally, TMS allows patients an alternative to medicative therapy.
While these treatments are all specific ways to treat depression and dementia in older veterans, there are also other changes that can affect quality of life and recovery outcomes. Healthy lifestyle habits are a solid foundation for the above treatments to work. These include healthy eating, exercise, participation in engaging activities, and taking part in healthy socializing opportunities. Consistency in diet, exercise, and socializing can be difficult to maintain for an older individual without help; residential and clinical services encourage older veterans to continue to improve their health and participate in daily activities.
New Vitae = New Life
Older veterans with depression and dementia deserve the support they need to improve their quality of living and receive proper housing and clinical care that is tailored to their unique needs and wants. Offering personalized care for individuals and their families encourages veterans to adopt and continue clinical services and supports. New Vitae specializes in residential and clinical services for older veterans with depression as well as those with early stages of dementia, to provide person-centered care for each individual.
New Vitae provides many support options for older veterans and their families to consider. Specialized plans are created for individuals with the Department of Veterans Affairs. Those who want to be treated through their local VA office can do so while receiving residential support through New Vitae with the housing option. Older veterans can also choose the Blended option, which provides both residential services and clinical services. With this option, veterans are provided a more intuitive, seamless service, as appointments, communication, and contact with staff are more consistent. There are clinical options for older veterans through our Blended option as well, including:
- Medication management services.
- Individual and group therapy.
- Nutrition assistance.
Individual plans can be further specialized relevant to the needs and wants of veterans who receive our services. Visit our Admissions page to learn more.
Residential Services at New Vitae
New Vitae offers various residential supports that promote healthy behaviors and wellness plans unique to each individual. Veterans receiving residential supports are assisted in developing and maintaining skills for independent living, including personal care, interacting in effective social situations, achieving personal vocational and educational goals, and working on physical health. Staff is available 24/7 to assist with safe living practices and crisis response. Individuals can take advantage of residential community activities, such as art classes, horseback riding, cultural and personal endeavors, and recovery skill building activities. For older veterans with depression and the early stages of dementia, the availability of these programs and opportunity to take part in them play a vital role in building a healthy foundation for treatment and recovery.
Life at New Vitae for Older Veterans
Life at New Vitae means receiving and participating in person-centered supports. This recovery model centers around specialized and personal care, and a goal path for one’s life. Person-centered support focuses on recovery goals and life planning for older veterans with depression and the early stages of dementia. These services work to strengthen the skills, talents, relationships, and abilities that older veterans possess, so that they may develop their own wellness tools. Staff supports veterans in breaking down big life goals into smaller steps and making long-term changes in their daily lives. Every veteran has specific needs and wants as an individual; New Vitae works to understand each veteran’s story and needs, and to create a wellness plan collaboratively.
Support Options Beyond Depression
There are several additional support options available to older veterans who also experience anxiety, mood disorders, addiction, post-traumatic stress disorder, and brain injury, in addition to depression and dementia. Some of these supports include:
- Medication education and administration services.
- Licensed addictions counseling.
- 12-step meetings.
- Recreational activities.
- Volunteer opportunities.
- Prevocational and community employment.
In addition to these lifestyle support services New Vitae offers further recovery plan customization with GeneSight and Alpha Stim. For older veterans who require medication to treat depression and dementia, GeneSight can use a sample of an individual’s DNA to determine the best antidepressant and antipsychotic medications for that individual, which doctors use to determine personalized treatment courses. Alpha Stim machines utilize electroconvulsive therapy (ECT) to reduce symptoms of depression, anxiety, and insomnia in individuals who participate. To learn more about these additional support services for older veterans, visit our Person-Centered Supports page, as well as our Veteran Community page.
Where Can I Visit New Vitae?
New Vitae has several locations, each of which provides specialized, holistic, person-centered care for older veterans. We offer residential health treatment in Bucks County and Lehigh County in Pennsylvania, between Philadelphia and New York City. We provide specialized care for older veterans and their families seeking depression treatment in Bucks and Lehigh Counties, as well as the surrounding NY, NJ, and PA areas.
In treating older veterans with depression and the early stages of dementia, New Vitae is proud to offer person-centered residential and clinical services that are specialized for individual needs and wants. We work with patients to create and achieve goals, to strengthen skills, and to create the quality of life that each veteran deserves. To find out more about New Vitae Recovery and Wellness Center and the services we offer, contact us online or by phone today.
Among her dental, medical, and psychiatric needs, (my daughter's) care has been timely, appropriate, and excellent.- Merritt C. (family member and physician)