December 08, 2010

Older Adult Depression During the Holidays

According to Mental Health America, more than two million of the 34 million Americans age 65 and older suffer from some form of depression - and during the holidays this number climbs. For many Americans, the holiday season is a time of good cheer, family celebrations, and socialization with friends. Yet for some people, particularly the elderly, it's a time of loneliness, reflections of the past and anxiety about the future. During the holidays, older adults may feel more acutely the absence of loved ones, the distance of family members, and the passing of time. Traditions and reunions that were once observed may no longer be possible which may result in an absence of holiday meaning and significance for the elderly individual. Some major factors contributing to holiday depres-sion in the elderly include:

. Being alone or separated from loved ones,
. Loss of independence,
. Financial limitations,
. Failing eyesight (inability to read or write personal holiday correspondence),
. Loss of mobility and/or the inability to attend religious services.

Although sadness and grief are a normal part of life, depression is not a normal part of growing older. Depression is an illness which can be prevented and treated. Some of the warning signs of late-life depression include:

. Persistent sadness
. Lack of energy or interest in things that were once enjoyable
. Withdrawal from regular social activities
. Feelings of worthlessness or helplessness
. Frequent tearfulness
. Slowed thinking or response
. Excessive worry about health or finances
. Weight changes
. Pacing and fidgeting
. Changes in sleep patterns
. Inability to concentrate
. Staring off into space or at the television for prolonged periods of time

For many older adults there may be stigma attached to asking for help and they may have trouble discussing depression or mental illness. Understand that open communication is needed and that it may take more than one conversation to get the individual to agree to get help. If necessary, offer to call the individual's doctor or clergy and accompany the senior to an appointment. It is important to let the older adult know that depression is not part of growing old, that it is treatable, and that their lives can be better.

The National Registry for Evidence-based Programs and Practices

An Introduction

The Substance Abuse and Mental Health Services Administration (SAMHSA) developed the National Registry of Effective Prevention Programs in 1998 to better facilitate effective identification and dissemination of prevention programs targeting substance abuse. The newly revamped system, now the National Registry of Evidence-based Programs and Practices (NREPP), has expanded to include programs and practices for preventing and/or treating mental health and substance use disorders.

NREPP seeks to bridge the science to service gap by providing easily accessible information on the best practices and programs.

Without the identification, broad dissemination, and implementation of evidence-based practices (EBPs) for older adults, this vulnerable population faces delivery of services that are unsystematic and possibly ineffective or harmful. Delivery of effective and reliable services to older adults can decrease the disabilities and impairments associated with mental health problems and substance abuse in late life, while increasing the quality of life for this rapidly growing population.

Inclusion within NREPP is highly valued and potentially advantageous. SAMHSA and many other Federal and State agencies are increasingly awarding grants to programs that utilize EBPs. Because of NREPP's strong adherence to promoting EBPs, it serves as a rich resource for states, communities, public and private researchers and specific programs seeking to implement or promote specific evidence-based mental health and substance abuse prevention and treatment services for older adults.

The TAC is positioned to assist interested programs, practitioners, and researchers to learn more about NREPP and help determine whether they would be solid candidates for NREPP consideration. Programs targeted for the NREPP process are thoroughly evaluated, focusing on program outcomes. As a preliminary step prior to NREPP submission, the TAC analyzes program strengths and gaps to determine if the program is suitable for NREPP review, i.e., has sufficient supporting evidence for submission. If a program is found to be in need of further technical assistance in order to get NREPP-ready, TAC staff is available to work with program staff regarding gaps and ways to address these issues. For those programs ready for submission, the TAC will package their materials and submit them for review and evaluation by three independent NREPP reviewers on the basis of scientific merit and utility.

Programs reviewed by NREPP are placed into one of five categories: (5) Effective Program or Practice, (4) Conditionally Effective Program or Practice, (3) Emerging Program or Practice, (2) Program or Practice of Interest and (1) Insufficient Current Support.

Recently, the TAC highlighted the NREPP process in a poster presentation at the 3rd National Prevention Summit held in Washington, DC. We look forward to the further identification of and coordination with potential NREPP programs. If you are aware of a successful program serving older adults, please contact us at or 1-888-281-8010 and provide the program name, along with contact information. In addition to the identification of programs and support throughout the NREPP process, TAC staff receives frequent requests regarding evidence-based practices and programs. While NREPP itself is unable to focus on knowledge dissemination, the TAC can assist with disseminating successful programs and practices and promote the use of recognized evidence-based activities.
LCSW and Social Worker Continuing Education

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