Elderly depression

I work in healthcare and the other day I had a patient who has pretty end stage disease that can't be cured but only her symptoms can be treated. When I went to talk to her, she was really depressed and just kept saying she wished she could die and that she was tired of fighting and that she had nothing left to hold on to(no kids, no husband, family all passed away etc). I can't cure her obviously but I wish I could comfort her. How do you best respond when someone says they don't have a reason to hold on to and they want to die? I was at such an awkward loss.

Usually I know this kinda stuff but maybe because of my own personal issues at the moment, I just was speechless. What's a good comforting response to that situation?

Tell her you understand...she knows the end of the journey and just wants to speed it up. My dad was like that the entire last year of his life...and he had a wife, kids and a grandchild. Sometimes people are just done.

Yeah that's really true. I think I said something similar. I mean I understand where she's coming from, I can't blame her, her life seems tough. But sometimes these platitude statements sound so fake to me in my head when I say them. I guess I was genuinely sad for her and felt bad and ended up talking to her for a long time, but I wanna make sure i come across genuine to her too. Lately I struggle so much to express myself properly.

Show empathy instead of sympathy and try to show understanding while validating her feelings.

It is hard being in that situation and feeling like you have nothing to live for anymore. It is also hard watching people go through such stages in life, and if it were me in your position I would look at speaking with a professional myself because some of those feelings can be transferred and affect our psyche.

Sent from my iPhone using Tapatalk

What's a good comforting response to that situation?Usually I know this kinda stuff but maybe because of my own personal issues at the moment, I just was speechless. What's a good comforting response to that situation?

Few of us know what it's like until we ourselves are at that point. Try to just be with her, listen to her if she wants to talk. I suppose you could ask her if she'd like to tell you more about it, what she is feeling or thinking. Let her talk, or let her just sit together with you. Sometimes silence is enough. In doing so you will let her know that she is not alone. (At least while you are there, she is not alone.)

It is hard to deal with situations like these and honesty there will never be a correct response.

All you can do is be there for them.

It is sometimes good to just read the basics again.

Through some of my experiences in pharmacy I have found that nearly all of the elderly people I have encountered in an assisted living facility we receiving antidepressants. Not to say that this happens to all elderly patients everywhere, but definitely close to 100% of the ones I have encountered. I'm sure it's due to a combination of the cognitive decline that occurs in advanced age as well as isolation, though I've always wondered which factor is responsible for it more. If you are involved in the decision-making process you could suggest antidepressants if it can be dosed safely in combination with her disease. That and finding ways to make her less isolated. Maybe there are group activities or outings she can get involved in.

It's a sad scenario but unfortunately, a pretty common one that happens to many people, even those who still have family around. I see it a lot where I work though.

I would just be there for her. Be warm but not doting or placating, which can come across as overbearing. I often tell people "I am very sorry that you are hurting. I am here for you and will do what I can to help." and squeeze their hand.

I also sometimes will offer extra blankets or ask if they would like a little lotion on their bank or arms "to help with the dry air". It's just very calming for those who like it. If they say "well, I wouldn't want to bother you....", I say "I insist, please."

If she wants to talk, about happy or depressing things, just let her. Be there and listen. If she seems to want to talk about something, then by all means, engage and talk to her about that subject. Don't try to steer the conversation, let her do it. Make her as comfortable as you can and ask for her input on little things.

Just being there for her is important. You may not feel like it's a lot but a quiet, understanding presence means the world to many people who are hurting. I can only hope I would receive the same treatment when I am elderly myself.

Think of this: put yourself in her shoes. How would you like to be treated? What would you like people to say to you? Act accordingly.

I also sometimes will offer extra blankets or ask if they would like a little lotion on their bank or arms "to help with the dry air". It's just very calming for those who like it.

This is a very kind way to offer gentle touch. Thanks, Fudgie.

I don't know whether you're talking about an in-patient situation, or one where you have only a fleeting role in her care, but that would alter how much contact and comfort you can give her. I certainly think that when you see the patient more often, you can simply provide that soothing, calm, reassuring presence that gives them a little something to look forward to. I used to work in hospice, and one thing they really appreciated was taking time to read and talk with them, just being with them. In a setting where you cannot take that time to attend to them, it can be hard to afford those kinds of "quality time" opportunities.

I think this very much depends on the individual and how receptive they might be to this input, but I would almost always try to guide them to whatever spiritual or religious support they have relied upon throughout their life. If they were religious, I would talk to them in their own language about what their vision of a higher power would want for their last days on earth, and how to live them. I would try to help guide them towards a more transcendent vision of this life, where material needs are now not the most important thing, and that includes the usual supports people think of. I would validate how important people are as "something to live for", but also emphasize, again in their language, how precious their life is, up to the very end, to their higher power, no matter what their circumstances. (I would also make arrangements for them to speak with their pastor, rabbi, or other religious counselor where possible.)

If they are not religious, the very same existential/spiritual ideas can be offered -- sometimes it's harder if someone has no God or higher power to use to comfort them. But since I am non-religious in my own orientation, and this is what I in fact would reflect upon, what I would tell them -- in this case, your patient -- is that viewed a little differently, this could be a time of deep understanding, understanding that every moment counts, on its own terms. I would ask her if there were small ways she could take every moment as it comes, as a chance to appreciate the little things, like a hot cup of tea or a small blossom outside the window. In other words, these can be moments of letting go -- letting go of whatever ideas she may have about "reasons to live" and finding her own little reasons now. I would add that a lot of people don't appreciate the little things, they are so busy hustling and bustling, and they can do this all their lives and never really live. But she's in a place now where she can spend as much time as she wants finding those little things. She doesn't have to see herself as "fighting" -- she can stop fighting. Instead, she can see herself as just BEING, and letting each moment be its own life to live.

So I would bring empathy and lots of listening, but I would also try to steer her away from the grieving mind, and give her things to think about to help shift her awareness. There is almost no way to console someone about death, but if you can get them to see it as an opportunity to savor life, either as their God's creation or as a creation of the universe, that can redirect the response to the situation.

Even the most unphilosophical people can find something of value in this discussion, if you approach it gingerly and in an individualized way.