Bio-Psychosocial Factors of Depression in Older Adults in Aged Care Facilities

Running head: MENTAL HEALTH ESSAY
MENTAL HEALTH ESSAY
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1MENTAL HEALTH ESSAY
Introduction
Depression is a common phenomenon occurring the older adults especially in the aged
residential facility settings. This is often recognized a slate-life depression. Depression impacts
the older adults differently from the younger adults. This depression leads to increase in the risk
factors of these older adults. It has been estimated that about 13.5% of older adults who are in
need of home healthcare experience major signs of depression (Edwards, McDonnell & Merl,
2013). A wide variety of factors are associated which are seen as the signs of depression such as
medical illness, disability along with the side effects from medication. In addition to the
progressive sensory loss, sleep disturbances, a history of falls, social isolation, and personal
losses, contribute to the increase in the risk of depression in older adults (Brownie & Nancarrow,
2013). Often these patients fail to identify the symptoms of depression. The nurses play a
predominate role in most of the care settings. The nurses are trained to identify as well as care
for depression in these older adults. This paper aims to identify the bio psychological factors of
depression presented in the given case study. In addition, the paper discusses the nursing care
management and the interventions that are required to provide effective care to these aged
individuals suffering from depression. The paper also illustrates the ethical implications
associated with the treatment of depression in such individuals.
Identify and discuss bio psychosocial factors
Several studies have shown that depression is quite common in the aged especially in
then one belonging to the residential aged care settings (Van Malderen, Mets & Gorus, 2013).
This is often seen to be late-life depression, where more than 14 to 26 % of the individuals suffer
from it (Schure, Odden & Goins, 2013)). In this case study, a similar setting is found where the

2MENTAL HEALTH ESSAY
patient Amy, is a 75 years old woman and currently lives in a retirement village, after the death
of her husband. As evident from some of the papers that depression often begins in these older
adults after being diagnosed from at two of the serious physical illnesses. Similarly Amy was
first diagnosed with depression 10 years ago, after she was came to know that she was suffering
from diabetes and hypertension. This is due to the fact that composites measures of the physical
illnesses are often associated with the increase of the risk of the symptomatology of depression
(Steptoe, Deaton & Stone, 2015). A study by Jeste et al., (2013), suggested that depression was
strongly associated with the declines of disability and function in the late life of an older adult,
and this disability often is directly proportional to depression. The case study informs that after
the loss of her husband, the patient has suffered from heightened amount of depression. She
lacked sleep and urge to eat anything along with feeling socially isolated as she felt she had no
one to talk to. This bio psychological factor is quite prominent in such cases of depression as
after the physical death of someone who had a very close relationship with the individual, it
results in elevated levels of depression score in such aged individuals. After Amy was transferred
to the retirement village, she managed her daily tasks on her own which included managing her
medication however sometimes she forgot to take them. This is also a bio psychological factor
associated with ageing, which needs to be understood. The older people receive a sense of
competence when they are able to master their day-to-day environment in terms of self-
acceptance, purpose in life, autonomy or self-reliance (Beerens et al., 2013). However in this
case Amy lacked such competence as she was unable to manage her medications on her own.
This sense of failure was one of the bio psychological factors that added to her depressive state.
Many theorists are of the view that depression is associated with a lower level of mastery and

3MENTAL HEALTH ESSAY
that older adults in residential facilities settings often possess lowered levels of autonomy and
self-acceptance along with no purpose in life or perceived personal growth (Tiong et al., 2013).
Social relationships too plays a prominent part in such cases. Amy has two daughters
who try to visit her every month. However Amy feels that she is a burden for them and believes
that of she died, it would be easier for her daughters. This is another bio psychological factor that
is adds to depression due to the lack of a social support group. Marital status also plays a big role
as a factor, where researchers suggested that depression is often high in the older adults if they
are widowed or are separated and divorced (Butcher, Mineka & Hooley, 2013). Apart from this
the feeling of hopelessness adds up to the complexity of the situation in such patients. Amy too
faced these problems. She expressed feelings of worthlessness, not wanting to get out of bed.
Due to these problems she lacked sleep and resulted in an appetite loss, ending up losing six
kilograms of weight. Thus the key bio psychological factors identified from the case study were
self-rated depressive symptomatology along with established chronic illness (Ryff, 2014).
Additionally factors like self-acceptance, autonomy, environmental mastery, perceptions of
social support, purpose in life, and personal growth played a major role. Lastly another factor
cannot be overlooked which was the hereditary factor. Amy’s mother too had suffered from
depression, which eventually led to her death.
Describe and discuss nursing management or interventions
As already mentioned, depression is common in patients in the older homes, which often
increases their risk of adverse outcomes. For such cases the nurses play a pivotal role in order to
manage depression effectively in the older patients. With the use of the Collaborative Care
models, the nurses are able to play the role of the Depression Care Manager. This enables them
to work with the primary care clinicians along with the psychiatric specialists so that the patients