Project #58656 - Depression in Institutionalized Elderly: A Research Proposal

I need help wih a revision of a paper: the paper is complete just nee someone to make the necceasary corrections. My Budget is 40-65
















Depression in Institutionalized Elderly: A Research Proposal








Coretta Casley














Elderly Institutions have been made the home of almost everyone above 65 years of age and undergoing severe depression status that could lead to mental illness if, not checked. The primary aim of such institutions is to provide general care that integrates recreational activities, treatment plans as well as the social construction ties. While most people agree that, depression is an elderly disease the scope behind its implication is rather different. Its impact is usually felt at a later stage in life, but it is based on experiences gathered over the years. These experiences often form an emotional attachment to a person’s being, and once their value is threatened by seclusion or change in behavior, depression is awakened. Although purely a medical condition, depression is viewed in the society as a personal flaw and thus leads to stigmatization. Elderly institutions try to mitigate the problem, but the solution requires complex interrelation issues brought together to function as a single unit. Family ties, environmental capacities, and professional help all provide a solution to the problem as long as they work in harmony to help the elderly suffering from depression. The increasing elderly depression statistics suggest the importance of dealing with depression and how it impacts the well-being of its victims, as well as the general society.














Institutionalized elderly have to deal with loneliness and isolation from their family, friends and environment thus leading to depression. The diagnosis is common in every age group but to the elderly who have been institutionalized it’s the most challenging factor. They have to become accustomed to new surroundings that test their limits due to growing environmental pressures. Depression has become a common diagnosis in such institutions such that it could be considered a disease of old age. The threat of being diagnosed with depression is prevalent in such institutions due to lack of social and family support.


When a person who was at the comfort of family and extended family support is transported to a facility where all colleagues are old and rejected from their comfort zone, there is bound to be increased challenges. The demands of such institutions are usually high for the elderly to face on their own. Also, they don’t have the moral support from caring individuals such as their children leading to a more pressing situation. At this present age, institutions for the elderly have gained much attention from young parents who see their aging parents as a nursing home. An institution to them is a place where they could offload their troubles, and be able to live at peace without the challenge of caring for their elderly parents.The research I this paper aims at analyzing how depression has become prevalent in elderly institutions as well as the factors that lead to the situation.


Problem Statement


Depression in elderly institutions has grown tremendously and is the most prevalent diagnosis there is. The rationale behind this challenge has been researched in depth, but the situation is worsening as every single day passes. The elderly keep on suffering from the lack of social and moral support from extended family and friends while institutions keep on increasing. The situation has become worse as more institutions are being established to care for the elderly without taking full consideration of the scope of the problem. Their purpose for establishment could only be justified by the commercial gain they are making rather than a social good or impact they bring to the community. New strategies have to be established to ensure that such institutions have the clients’best interest at heart. Also, family members have to be made aware of their support and how much it counts towards the general improvement of their elderly relatives. Hence, the situation calls for both parties to work harmoniously to ensure that the elderly feel comfortable and appreciated even though they are in such institutions.




The main goals of the research paper are:


·Identifying the rationale behind depression in elderly institutions


·Role of family members to their elderly relatives


·Role of elderly institutions


·Identifying support tools for such institutions


Literature Review


Rationale behind Depression in Elderly Institutions


The risk factors for developing depression are vast and could not be exhausted by a single research. The following seven factors are considered high-risk target groups that are most vulnerable towards depression especially for the elderly (Evans, 2000).


·Painful physical illness that could also be disabling




·Recent bereavement


·Adverse life changing events


·Past family depression history


·Hearing difficulties




Leaving home for an institution is a major reason for depression of elderly people.An elderly person, who has spent his entire life independent and living under one roof, feels exasperated when he or she is shifted from his home to a new place ('Cognitive Impairment Associated With Depression in the Elderly', 2007). This usually makes them behave desperately and make radical choices such as suicide. When a person grows old, he tends to get attached to things that he experienced along his life journey. Such things include life habits, environment and surrounding as well as friends. These are things that elderly people are attached to and feel traumatized when they can no longer do them at will.


Homes are more than just places of comfort for the elderly. They usually carry loads of emotional experiences and relationship ties with family and friends; hence, valued more by the elderly since they carry their emotions. Home to the elderly is more than a construction site where one sleeps or watches television. To them, it is family surrounding them along with the bond and social ties forged within the community, a sense of belonging. An institution cannot replace such a feeling no matter the kind of care they are giving. Living a secluded life at home is better than an uprooted life. Often elderly people tend to live a fulfilled life at home in seclusion from family members than being at an institution where they are being taken care of. Environment, for this reason, plays a huge role when it comes to depression. It creates new challenges and increases on to the desperation of the elderly.


The presence of an institution also acts as an instigator towards the depression of the elderly. Most elderly persons view the establishment of such institutions as their end of the road. It signifies the looming experience of death, and this fact is not welcoming to any individual. The main purpose of elderly institutions is to give general care of the aged who have been neglected by their families or who have serious psychiatric issues such as Alzheimer’s disease. In addition, institutions are also viewed as places where no recovering is expected. This is a traumatic feeling for the old. They become aware that they cannot be able to return to their old belongings or family experiences (Runcan, 2012). As much as the institution is established to help them, how it is perceived by the elderly makes them become vulnerable to depression.


Only a small portion of the elderly require fully institutionalized care while a majority of them require the support of community and social ties to some degree. An institution can offer time for family and friends to visit, but it is still perceived as an institution to the elderly. They do not value it regardless of the care it gives them. The presence of being in a community setting is much more satisfying and relaxing than being held up in an institution.


The only common denominator in an institution is that it cares for the elderly, but they have different needs. Some of them might be challenged mentally while others suffer terminal diseases and others are perfectly okay and oblivious of any illness. When such individuals are placed in the institution they have to interact with each other. Sharing stories and life experiences can be breathtaking and essential but it also exposes them to vulnerabilities. When a group of terminally ill people share experiences on how sick or terminally ill, they are it tends to become depressing. A sense of hope dies together with any expectation of getting better. Depression is largely exacerbated when one loses hope and stops believing.


Past failure and family breakups are also a huge factor that leads to depression. Institutions offer the elderly an opportunity to relax and think more of their lives. Although it is protocol to engage them in fun and enjoyable recreational activities, loneliness leads to visualizing on past events (Ronneberg, Miller, Dugan & Porell, 2014). Thoughts in past failures lead to more psychological pressures and leaves room for depression. When one does not have moral support from family and friends they tend to be traumatized even more and psychiatric help can be a step forward but does not solve the issue.


Role of Elderly institutions towards curbing Depression


As much as depression is a psychological disorder that continues to challenge elderly people, institutions also play a huge part towards impacting the issue. According to the University of Massachusetts Boston’s Gerontology Department, nearly 1 in 5 adults aged 65 and above suffer from depression (Ronneberg, Miller, Dugan & Porell, 2014). The research continues to elaborate that the situation is pressing since a huge number of these individuals are found in elderly institutions; hence the situation depends highly on such institutions for mitigation. Institutions can offer more socially interactive activities such as religious meetings where the elderly can become active in socializing. Such congregational meetings reduce isolation and loneliness which are an onset of depression.


Those clients who have already been depressed could be helped through regular prayer services that instill a sense of hope and activate cognitive resource that eventually counter the disorder. The importance of family and friends can also not be ignored at this level. Institutions should encourage family members to accompany their elderly relatives in such religious services or arrange home visits for the clergy. Religion plays a huge role in a given society. It creates a sense of togetherness and harmony. These values ought to be upheld by such institutions so as to add significance to the elderly lives.


Elderly institutions should strive more to offer all round help to the elderly clients by creating awareness of the effects of depression among the elderly and how it can be mitigated.Stigma associated with depression has been ignored over the years, but it does exist and hinders the ability of caring institutions to offer help. The elderly tend to acquire help from physicians rather than professionals with explicit mental health experience since they don’t want to identify themselves as depressed (Runcan, 2012). Hence, empowering general physicians to identify the symptoms of depression can offer an insight into the type of help these elderly need or require.


Participation is the key for depression to be recognized and treated. Symptoms of depression vary and are influenced by the habit of the victim. Behavioral changes are essential when identifying such symptoms, but it is impossible to keep track of all elderly individuals in a given institution. When the institution works close with family members, it becomes much easier to identify the trigger patterns that might lead to depression. Most elderly individuals deal with depression differently; some might opt not to eat while others might prefer loneliness. All these events are identification mechanisms that could trigger depression. Once the institution realizes the trigger, working on the treatment becomes an easier task.


Nursing home institutions usually deal with 60% of the general depressed elderly individuals. The rest are either at general hospital care or their homes being taken care of by family members. As a result, institutions have a huge burden of identifying and treating depression cases to improve quality care and life. Enabling treatment should be well recognized by such institutions and its caregivers to improve on the information gathered and multidisciplinary means towards mitigating the problem. Nurses are for this reason in the best position to being offered such information since they are the long-term caregivers of the elderly. Lack of medical know how cripples any treatment intervention being offered by the institution. Identifying the long-term caregiver and equipping them with enough medical know how greatly improves the situation.


Role of Family Members towards fighting Depression


Depression is characterized by helplessness and self-degradation especially for family members who have their relative suffering the disease. It not only traumatizes the victim but also inhibits the behavioral activity of his or her family members (Lemmens, Eisler, Migerode, Heireman & Demyttenaere, 2007). Although the victim has to deal with the disease, family can offer support in different manners.


Comprehending the symptoms and indicators of depression is an important aspect in controlling the defect. A huge proportion of elderly individuals suffering from depression live for long without their family members noticing any depression signs (Brühl, Luijendijk & Muller, 2007). Not only does this increase the susceptibility of becoming suicidal but also increases the number of patients suffering from the disease. Statistics only shows the number of those suffering from the disease whose symptoms has been diagnosed. Most elderly are neglected by their relatives and left to suffer without being given any form of medication. Although the signs might differ, they range in the following factors:




·Alcohol abuse


·Suicidal thoughts


·Sleeping troubles (Oversleeping, poor sleeping)


·Concentration problems


·Decision making problems




All these factors are signs of depression and family members can better judge the situation since they have lived with the victim long enough. Identifying behavioral changes amounting to these signs becomes easier for them.


Stigmatization associated with depression influences victims to keep quiet. Encouraging depressed family members to seek medication is an important aspect towards treatment. It becomes hard to acknowledge or recognize when one is suffering from depression and requires a little push to do so('Cognitive Impairment Associated with Depression in the Elderly', 2007). The elderly become even hard to convince that they should seek help or acknowledge the fact since they view themselves as superior to other family members. Approaching them becomes an issue but family members must try to encourage treatment. The right approach towards treatment goes a long way towards relieving the issue. Talking to the individual as a family and letting them become aware of the medical condition they are suffering from eases the stigma. Depression is usually seen as a social ill rather than a medical condition. These rules out any acknowledgment process due to stigma. Explaining in detail the situation and the medical threats it poses reduces the chances of refusing medication.


Offering suggestions on what professionals they should visit shows an expression of willingness which offers moral support especially to the elderly. Making the elderly feel appreciated and part of the family makes them to become cooperative. The elderly are attached to these form self willingness.


Support Tools for Elderly Institutions dealing with Depression


Sometimes the lack of performance from elderly institutions is directly linked to lack of funding from the relevant stakeholders. As much as depression is an issue among elderly people, the tools that an institution needs to influence change require financial backing. The need for more nursing facilities is looming and must be addressed now before the issue becomes worse. In Canada, citizens over the age of 65 accounts for only 12% of the population but consume more than 44 of the national budget health care and account for 50% of acute health days (Carr, 2010). The situation shows the need for creating enabling support systems to ensure that depression and other diseases affecting the elderly are mitigated.


Long term health care that provides the necessary financial and resources support for depression is also a feasible idea. Most elderly houses focus on physically ill diseases such as immobility and psychological disorders. As much as this offers a solution creating homes designed for psychological issues alone will shift more attention to finding solutions to the problem. Knowledge is easily shared when professions can focus on diseases brought about by close linked determining factors. Depression has many risks determining factors and thus requires special attention since it affects over a wide range of age groups. Also, research needs to be done on a regular interval basis. Learning from research and trends in depression issues illuminates light on many factors that can support the whole situation through finding solutions.






Brühl, K., Luijendijk, H.,& Muller, M. (2007). Nurses’ and Nursing Assistants’ Recognition of Depression in Elderly Who Depend on Long-Term Care. Journal of the American Medical Directors Association, 8(7), 441-445. doi:10.1016/j.jamda.2007.05.010


Carr, C. (2010). Tools for dealing with depression and anxiety. Br J Healthcare Assistants, 4(3), 146-147. doi:10.12968/bjha.2010.4.3.47069


Cognitive Impairment Associated With Depression in the Elderly. (2007). The Journal of Clinical Psychiatry, 68(10), 1601-1612. doi:10.4088/jcp.v68n1020


Evans, M. (2000). Diagnosis of depression in elderly patients. Advances In Psychiatric Treatment, 6(1), 49-56. doi:10.1192/apt.6.1.49


Lemmens, G., Eisler, I., Migerode, L., Heireman, M., & Demyttenaere, K. (2007). Family discussion group therapy for major depression: a brief systemic multi-family group intervention for hospitalized patients and their family members. J Family Therapy, 29(1). doi:10.1111/j.1467-6427.2007.00369.x


Ronneberg, C., Miller, E., Dugan, E., & Porell, F. (2014). The Protective Effects of Religiosity on Depression: A 2-Year Prospective Study. The Gerontologist. doi:10.1093/geront/gnu073


Runcan, P. (2012). Elderly institutionalization and depression. Procedia - Social And Behavioral Sciences, 33, 109-113. doi:10.1016/j.sbspro.2012.01.093






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