When you've lived too long...

elsien

should depression be regarded as a normal response to a bad situation, treated with medication, both of the previous options, or are there any other possibilities?

TBH I'm not really looking for answers, more trying to sort out my thoughts.
Elderly relative, blind, not mobile, incontinent, living in an inadequate nursing home. (CQC is currently investigating but any changes - which I'm not holding my breath about - are not going to be happening any time soon.) Has capacity and is self funding so could move elsewhere but can't face the upheaval. Has just found out that their home has been sold which they accept the need for but are still finding it difficult to come to terms with. Home offers almost nothing in the way of activities and is poorly staffed so relative spends all day on their own in their room feeling very lonely. Has good days and bad days but the bad days when they won't get out of a soaking wet bed or allow anyone to change them etc are becoming more frequent, their response being that if they get pneumonia that would be a good thing as they've lived too long anyway.

The thing is I can see where they're coming from. If I had to live in that place I'd be wanting to end it all as well and I consider their reaction to be a perfectly reasonable one to the situation they are in. (Apart from the refusal to move to somewhere better.) Plus even on good days the person is in constant pain and the meds have been played with as much as they can be. So even if antidepressants were to be considered, they'd still have a poor quality of life just a medicated one. So I sort of think their current response is more honest, and should I be interfering with it if I ask to have the depression investigated, if that makes sense? Although I can't sit back and watch someone neglect themselves either.
Don't know what to do for the best, because quite frankly in this situation there isn't a best. Just a least bad.

londonsurrey

As someone who lives with depression and suicidal inclinations, I would recommend that at least the depression be investigated.

Depression is constant mental torment. Think of a toothache that will not let up. So even if they still have the poor quality of life, it's one lesser pain.

If you would insist on a toothache or a broken foot on this individual being tended to, then let their mental health be at least on par with these injuries.

They are still free to be suicidal, but at least let them be in less torment when being so. This might sound brutal, but it's an attempt to be pragmatic and kind from someone in another deep dark hole.

daska

Oh how sad but yes, it should be treated because if effective it will improve their quality of life and their ability to improve it and is unlikely to make it worse - can't guarantee that obviously as all medication has potential side-effects. Depression is insidious, it affects everything including pain levels. Best of luck

raven83

I would definitely get it looked at. I too suffer with depression/suicidal thoughts and have done since I was about 12 and it never really goes away 100%, it is always there in the background.

Agree with LS, if it was toothache then you would get it sorted, it is the same with anything to do with mental health, don't just leave it, it will only get worse.

elsien

londonsurrey wrote: »

If you would insist on a toothache or a broken foot on this individual being tended to, then let their mental health be at least on par with these injuries.

They are still free to be suicidal, but at least let them be in less torment when being so. This might sound brutal, but it's an attempt to be pragmatic and kind from someone in another deep dark hole.

That makes sense. My original line of thought was that it's not going to make much odds what is done, they're still going to be living an unhappy life in a horrible place, so what's the point in fiddling around the edges? But I'd not considered the impact on pain levels and everything else. It's hard to know whether it's depression talking, or what's the reality. But I guess if depression is investigated and nothing much else changes, at least we've given it a shot. I just find it hard to see that with the situation as it is there's much realistic prospect of them ever feeling any different. Although if it at least nudges them to be physically better looked after and takes away the increased risk of bed sores and everything else, that has to be a good thing.

rachhh

I don't wish to offend anyone by saying this, but I hope I am long gone before I end up like that. It sounds awful for your relative and awful for you to have to cope with, I hope there's somehow a happy or at least acceptable resolution to the situation that someone here can suggest.

Fire_Fox

Is it more honest to live with severe pain than mask it with medication? Clinical depression is a disorder of mental health so by definition not a normal state, it is common in the elderly but not normal. I want to know why the mental wellbeing is not already being investigated and treated, that is neglect. You may find the refusal to get out of a wet bed, refusal to move and some of the pain are sparking off from the clinical depression. Some anti-depressants can help with some types of pain. There are also other methods of addressing pain such as TENS machine, heat pads, simple distraction or nerve blocks. A better care home might be able to find a solution.

Not the politically correct answer but if I was the next of kin (guessing you are not?) I'd find a lovely care home, summon my sibling, pack up my parent's belongings and move them kicking and screaming. If needs be I'd get them a little drunk or take a sleeping tablet first. Basically on the grounds their mental state and decision making capacity is disturbed and there seems to be no method of effectively treating the depression at the current home (social or physical not just medication). By the same token I know if I ever slid back into severe depression my parents would kidnap me and take me to their home, my mother has indicated that she has had that conversation with my father in the past.

elsien

Don't worry, it's not offensive. My relative would much prefer not to be in the situation as well - in happier times we've joked about having them put down on a BOGOF with the dog. Only it stopped being funny a while back.

Firefox, no I'm not next of kin. If I were, they wouldn't have gone there in the first place. But having involved CQC, social services, Uncle Tom Cobley and all, and got nowhere, it's back to harassing the home to up their standards as best I can. I know that the mention of possible depression or any expression of concern on my part will cause world war 3 with the next of kin so it's also about getting them and the home to acknowledge other people have a valid alternative perspective whether next of kin or not. The home's response is generally "but the next of kin doesn't have a problem with the care....."

Hermia

I had a neighbour who lived into her 90s and had been wishing she was dead since her mid-70s. The doctor called it depression (and no treatment helped her mood), but everyone who knew her thought it was a totally understandable reaction to her situation. She was infirm and in pain, her beloved husband had died, she couldn't partake in any of her interests/hobbies and she was just tired and worn out. She had been a vibrant young women who was always been up to something and then turned into a middle-aged woman with many hobbies and interests. Her life was now everything she hated. The more stories she told me about her life the more I understood her feeling low. I do think feeling unhappy is an understandable response to some situations. OP - I certainly think it's worth investigating whether there is anything that can be done to improve their mood or the situation in some way.

coolcait

I agree with all those who have said - albeit not quite this way - that you shouldn't accept neglect of a person's mental health any more than you would accept neglect of their physical health.

I accept that the OP may not be in a position to take the final decision on care.

However, as a general principle, if you wouldn't see it as acceptable for a care home to allow your loved one to get bedsores or lice - and leave them untreated - why would you allow mental illness to go untreated.

That said, allowing someone to lie in a urine-soaked bed suggests that the care home is ignoring the physical, mental and emotional needs of the patient.

Someone needs to intervene.