Case Study: Depression, Dementia, and Disability in Elderly

This case study examines an elderly patient, 'X,' a 65-year-old retired teacher, grappling with depression, early-stage dementia, and a walking disability. The study delves into the patient's background, highlighting the loss of her husband, her son's relocation, and her social isolation, which contributed to her depression. The pathophysiology section explores contributing factors like environmental and genetic influences, and relates them to theories of aging. The impact of depression on the patient's physical and mental health is analyzed, referencing literature on the topic. The study proposes a collaborative care model involving a medical doctor, therapist, counselor, and dietician, along with recommendations for exercises and counseling to address the patient's needs. Ethical and legal considerations are also addressed, emphasizing the importance of informed consent to avoid future complications. The assignment provides a detailed overview of depression and care for elderly people.

Running Head: CASE STUDY OF AN ELDERLY PERSON SUFFERING FROM
DEPRESSION
Case study of an elderly person suffering from depression
Name of the student:
Name of the university:
Author note:

1CASE STUDY OF AN ELDERLY PERSON SUFFERING FROM DEPRESSION
Introduction
Depression is a psychological disorder which hampers the physical and mental state
of a person. It hampers the state of mind of an individual. Feeling of hopelessness,
helplessness, sadness is common. In Australia, about one in every eleven individual (8.9%)
have depression (Australian Bureau of Statistics 2019). Depression is more common in
females as compared to the number of males, especially old age women (Ylli, et al., 2016).
The essay focuses on the case study of an individual, who is suffering from depression,
dementia, and walking disability. To prepare a case study, detailed information about the
background of the patient should be collected through interview. Based on the information
obtained from the interview, the care model is prepared to get an effective result. It is caused
by different factors such as environmental factors. It can cause a negative impact on the
mental health of an individual which can be cured by using the care model. The legal and
ethical issue should also be considered to avoid future complication.
Patient’s background
To prepare a care model for any particular individual, it is necessary to have detailed
information related to the patient’s background as well as their present health condition.
Hence here an interview is conducted to gather all the information about the patient. This
case involves a 65-year-old patient named X (pseudonym), who is a retired primary teacher.
She is suffering from depression and also in the initial phase of dementia and tends to forget
things, which is common in old age people. She spent her whole life among children by
teaching them. She enjoys cooking and traveling with her family and friends. She used to be a
fun loving woman, but after the death of her husband her health condition started
deteriorating. Her husband died a few years ago in an accident and now she is left with only
a son, who has also recently moved to another city to develop his career. She is living alone

2CASE STUDY OF AN ELDERLY PERSON SUFFERING FROM DEPRESSION
and has no one with whom she can share her feelings Due to her loneliness, she went into
depression. In addition, she also has dementia, because of which she forgets to take her
medicine and even about her appointment with the consultant, which is making her condition
worse. Digestive issues are common, as she does not follow the diet provided by the general
practitioner and does not eat properly. She cannot walk properly because of her age and have
to take the help of a walking aid. She does not go out much because of her mobility issue and
always remain locked inside her house. She lost her social circle, as she does not talk with
anyone and feels isolated. She has insomnia, which is a symptom of depression and
headaches are also common. She always feels tired and hence, not able to concentrate on her
work. She often has a suicidal thought, as she does not want to live anymore.
Pathophysiology including contributing factors and relation with the theory of aging
Depression is a psychological disorder which is often induced by the physical, mental
and sociological factors of the environment. It affects the daily life of an individual and
people with depression often get suicidal thought and want to end their life. Depression is
common in all age group, but among the people of age 60 and above it is more prevalent,
especially in elder females (Mojtabai, Olfson, & Han, 2016). Contributing factors for
depression is not clear, but the complex interaction between the receptor regulation and the
neurotransmitter is supposed to be one of the reason. Other contributing factors are the
environmental factors, genetic factor, an interaction between the risk factors and ageing.
Financial loss is also considered as an important risk factor. Depression is common in an
individual of age 65 and above. Dementia is one of the other contributing factors to
depression, which is common in old age females (Kuehner, 2017).
Ageing is an unstoppable process and deterioration of health is correlated to ageing.
To understand the process of ageing and to maintain health by getting proper treatment and
cure, theories of aging are introduced. The two most common philosophies of ageing are the

3CASE STUDY OF AN ELDERLY PERSON SUFFERING FROM DEPRESSION
programmed theory and the damage of error theory. The programmed theory consists of three
subcategories, endocrine theory, programmed longevity and immunological theory.
Programmed longevity explains that the ageing is the consequence of swapping on and off
some genetic factor in a sequence. An endocrine theory states the reason of aging is the
complexity of hormones and the immunological theory describes the immune system is
responsible for ageing, as due to the programmed decline of immune system vulnerability to
contagious diseases increases (Avogaro, & de Kreutzenberg, 2017). Another theory of aging,
the damage and error theory is classified into four subcategories. Wear and tear therapy states
that wearing of cells and tissue results in ageing. Cross-linking theory suggests that the
damaging of cells by the accumulation of cross-linking polymers results in ageing. According
to the rate of living theory, the oxygen basal rate of an organism is correlated to the life span
of an individual, greater the oxygen basal rate the shorter is their life span. Lastly, according
to the free radical theory, macromolecules and superoxide damage the cell resulting in ageing
(Gladyshev, 2016). There are some other theories of ageing based on sociological
perspectives such as activity theory, disengagement theory, and conflict theory. According to
disengagement theory, people should disengage older people from the important role of
society and they should be engaged in those activities only, which are appropriate for them
physically and mentally. This ageing theory is considered as functionalist of the process of
ageing (DeLiema & Bengtson, 2017). Another theory, activity theory states that, if older
people continue to be active, they provide benefit to society as well to themselves. This
philosophy is considered as an interactionist description of the process of ageing. Hence,
individuals of age 65 and above should be more active should not sit at one place for a longer
period of time (Cox, 2015). According to a recommendation by the government, old age
individual should engage in more physical activity and if they stop doing anything and
always remain sitting at one place, it can hamper their health physically and mentally.

4CASE STUDY OF AN ELDERLY PERSON SUFFERING FROM DEPRESSION
(Gov.uk. 2019). Lastly, conflict theory states that older people have to suffer more because of
gender discrimination, age-based inequality and race and social prejudice (Klimczuk, 2017).
As ageing is considered as one of the major contributing factors for depression,
especially in case of old age females. The patient is also suffering from dementia, which is
common in an individual suffering from depression. The risk factor involved in depression in
case of a patient is her loneliness. She feels isolated, as she has no one with whom she can
share her feelings with. According to activity theory of ageing, old age women should engage
in physical activity more often and in the case of patient X, she cannot move much because of
her walking disability, which can be considered as a contributing factor for her mental and
physical illness. Another contributing factor is that at this age also, she has to manage
everything alone, which is hampering her health as stated by disengagement theory
(Jørgensen, et al., 2016).
Impact of the disease based on literature analysis
Depression poses a negative impact on the physical and mental health of an
individual, either on a young adult, older adult or old age individual, but in case of old age
individual, it can have a more serious effect. Expression of depression is extensive in the case
of old age females. One of the common symptoms is feeling of tiredness all day without even
doing anything which is observed in the case of patient X. It can cause a loss of interest in the
intimacy with the partners. It can give rise to more severe and chronic illness such as
dementia (Haenisch, et al., 2015). If the treatment for depression is not done properly it can
prove fatal, as people with depression often have suicidal thought and can end their life,
which is attempted for several times by the patient (Verma, et al., 2017). People suffering
from depression either sleep too much or too less. Hence it is dangerous in both cases. In the
case of patient X, she sleeps too little and is suffering from insomnia. Elder adults suffering
from depression always goes through unexplained pains which they cannot explain to

5CASE STUDY OF AN ELDERLY PERSON SUFFERING FROM DEPRESSION
anyone. Along with that, they lack the motivation in their life to do anything and always feel
useless. They lost their self-worth and want to end their life. In some cases, the patient started
relying on alcohol and drugs to reduce their pain. People with depression often have a
memory problem, dementia in case of patient X. due to dementia, she tends to forget taking
their medicine properly which is damaging her health condition more. Depression is making
her neglecting her personal care, such as skipping meals, neglecting general hygiene and
forgetting medicines. In addition, the patient also has a mobility issue, which is making her
more depressed as she cannot go wherever she wants to go and always remain in locked in
her house (Vidán, et al., 2016).
Model of care and recommendation of strategies and resources
Depression is a mental disorder, which if not treated properly can lead to more severe
results. Hence, in order to treat the disease, an appropriate care plan is needed to provide an
effective result. In the case of a patient suffering from anxiety or depression, the collaborative
care model is proved to be effective. Collaborative care model is an innovative care model
designed mainly for patient suffering for depression and symptoms of depression, such as
anxiety and dementia. In a collaborative care model, a number of professionals are involved,
such as therapist, psychiatrist, counsellor, dietician and medical doctor (Solberg, et al., 2015).
In the case of patient X also, the collaborative model is used. Regular check-ups are
appointed with a medical doctor. She is also suffering from walking disability which is one of
the contributing factors to her depression. Hence, several exercises an appointment with a
therapist is suggested (Pearson, Dieberg, & Smart, 2015). Due to depression, she lost her self-
worth, hence regular counseling session is conducted. The counsellor should induce a sense
of self-worth within them. A sense of self-respect should be introduced in them by a regular
counselling session. She is also suffering from the digestive issue because she skips her
meals. Hence, a dietician is required to suggest the amount of appropriate vitamin, mineral

6CASE STUDY OF AN ELDERLY PERSON SUFFERING FROM DEPRESSION
and other micronutrients in the diet as an adequate amount of vitamin, mineral and other
micronutrients should be present in the diet of an older individual (Jacka, et al., 2017). She
neglects her personal care, personal hygiene, medicines and meals, for which a nurse is
should be appointed which can take care of her. It is important to consult a psychiatrist to
know the exact mental condition for a patient suffering from depression (Busch, Rudden, &
Shapiro, 2016). Hence to get an effective result, the collaborative model is followed properly.
Legal and ethical issue
Every day patient’s family, friends and health care professionals have to face legal
and ethical issue regarding medical treatments. In order to avoid any future complication,
legal and ethical issues are considered before hands. To deal with the legal and ethical issue,
consent form from the patient and organization is collected. People suffering from depression
and mental disorder often experience discrimination and bullying. Hence to prevent such
situation, privacy during the treatment should be maintained. In addition during the treatment
of a patient suffering from depression, sometimes the condition got worse and in some cases,
the patient ends their life. In such a situation to avoid any legal complication, medical doctors
collect consent form from the individual (Quill, et al., 2018).
Conclusion
From the above essay, it can be concluded that depression is a serious mental disorder
which needs proper treatment and care. Pathophysiology of the depression includes ageing,
genetic effect, and interaction with the risk factors. It can cause a negative impact on the
mental as well as physical health of the individual. It can various effects such as, sleeping
disorder, loss of self-worth and self- respect, skipping meals and dementia. The effect of the
disease can be minimized and avoided by the use of a collaborative care model. This model
can be implemented by the collaboration of different health professional such as dietician,

7CASE STUDY OF AN ELDERLY PERSON SUFFERING FROM DEPRESSION
therapist, counsellor and medical doctors. Several legal and ethical issues are also associated
which should be considered beforehand to avoid future complication.

8CASE STUDY OF AN ELDERLY PERSON SUFFERING FROM DEPRESSION
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