Geriaterics need to be given tenable cushions and healthcare facilities so that they may not feel let down and despondent at the end of the day

Geriatric depression is a term used to define mental & emotional disorder affecting older adults.Feeling of sadness and occasional ‘’Blue”moods are normal.We all feel sad &disappointed but a perpetual depression is not considered a part of normal ageing process.It may be a sign of a mental disorder that effects us during old-age and may remain undiagnosed as the family members consider this as a behavioural symptom of getting old. However this must not be neglected as the symptoms may deteriorate rapidly and may cause severe depression and anxiety.This condition may lead to death _ anxiety.Ouer body,including brain, the master organ , degenerates as we grow old.According to medical research , ageing occurs due to the oxidative damage to the mitochondria, cell-death, u-v radiation, pollution etc.Ageing is among the greatest known riskfactors for most human diseases; of the roughly 1500000people who dieeach day across the globe,about two thirds die from age –related causes.The thought of death sometimes is very intimidating , especially post retirement ,when a person feels isolated after death of spouse or close friends of the same age group.The fear of death aggravates the death – anxiety.The bodily process like respiration , digestion,circulation etc grow weak as we age and even minor ailment like fever may trigger a fearof death.As per the medical research,the decline of neurotransmitters-Dopamine,serotonin and norepinephrine cause depression in old-age.The genetics,socio-economic conditions , family environment and history of substance abuse play a significant role in the causation of depression in the elderly.
High Blood Pressure
 Diet low in salt
 Decrease fat intake
 Exercise as recommended by physician.

EARLY WARNING SIGNS OF GERIATRIC DEPRESSION
Persistent feeling of sadness,hopelessness,inappropriate guilt and /or feeling of worthlessness.Neglecting self-care , hygiene and clothing.Feeling of anxiety.Loss of interest in life.Loss of interest in enjoyable activities.Loss of confidence & motivation .vague complaints of pain or malaise.Loss in recent memory-forgetfulness,misplacing objects or items.Apathy-Loss of emotional expressiveness.Excessive Lethargy-sleeping in the day.Increased usage of alcohol,tobacco or prescription drugs.Problem falling asleep – Insomnia .Restlessness.Perpetual sadness-Change in appetite-Less or even more than usual diet.Loss of interest in socializing or hobbies.Social.Fixation on death –suicidal thoughts of suicide.Slowed movement or speech.
CHRONIC ILLNESSES –DIRECT ROLE IN CAUSING DEPRESSION
Some illnesses cause changes in the brain and may have a direct role in causing depression: Stroke ,Parkinson`s , Dementia , Infections,Malignancies,Endocrine dysregulation.

RISK FACTORS-DEPRESSION CAUSING/COMPLICATING ILLNESS
Older Adults with depression have increased incidence of : Cardiovascular disease,Diabetes,Stroke,Dementia,Osteoporosis.

MYTHS
• Elderly people are incompetent and incapable of making decisions or handling their own affairs.
• All elderly people live in poverty.
Changes may cause the elderly to experience

DYSPNEA
 Breathing increases in rate.
 Difficulty coughing up secretions.
 Increase susceptibility to infections such as : cold or pneumonia.
 Bronchioles lose elasticity.
Senses of taste , smell,vision &hearing are diminished

MANAGING GERIATRIC DEPRESSION,ANXIETY & SUICIDAL THOUGHT

It is very important to identify the early warning signs of depression and death anxiety in the elderly at the community level.Our social system is such that post-retirement most of the people suffer from a feeling of worthlessness.Depressionand inability to cope up with stress happens to be the chief cause of suicides in india.Elders sometimes take multiple medications and this puts them at a high risk.Side-effects of certain medications may cause depression in the elderly and the same should be reported to the physician so that the same can be addressesd at an early stage.Secondly ,tobacco consumption along with alcohol and substance abuse (ganga,bhang,opium etc)is significantly high in rural india.Old –age is marked by mild cognitive decline which gets aggravated due to the substance abuse.We must lead an active healthy life and exercise moderately to keep fit in old age.If we pursue a new hobby then it relieves the stressas well as newcells in the brain get generated.Diet,proper nutrition,proper sleep wake cycle along with exercise are a must for having good physical and mental health.People living on the hills and cold area often suffer from mood disorders like seasonal Affective Disorder ( S.A.D.). Spending time in the sunlight boosts serotonin levels which improves our mood and increases our resilience to fight with depression which is caused by seasonal affective disorder ( SAD).

• Care management is evolving and every organization is different.
• Ask your potential provider about the range of their services.
• Think about what would make a difference in your life and see if the provider can support that.

By:-ASHFAQ AHMAD LONE
TANGDAR KARNAH
Ashfaqanu786@gmail.com