Patient And Caregiver Depression During End Of Life Care

Transitioning into hospice or end of life care can be a challenging time for everyone involved, not just patients living in the Manchester area and elsewhere, but their caregivers, family, and friends.

Everyone involved will likely experience different emotions and go through different stages of grief before and after their loved one passes away.

The process is familiar to the employees at Above and Beyond Home Health Care and Hospice, who have been working with Eastern Iowa residents at the end of their lives for several years.

But to many of our patients and their families, the experience often is something new, so they don’t know what to expect or fully understand what they’re feeling and experiencing.

In these situations, we’re always happy to talk with families and their caregivers and let them know that it isn’t just the patient who may have a difficult time with this type of change but anyone who is around him or her.

Caregivers are especially susceptible to having good days and bad days and feeling a wide range of emotions. This is true whether they’re a family member without a lot of medical training who offers to help out as needed or for trained caregivers.
We also like to reassure patients that many of their feelings are common, and let them know about area resources if they need information about mental health, depression, grieving or some of the unique challenges caregivers go through.

Feeling depressed

One of the more common conditions that can be felt by patients and caregivers alike is depression. More than just feeling “a little blue sometimes” or having an unusually sad day, depression is a chronic mental condition with strong feelings that can include everything from anxiety to fatigue to anger, not just sadness. By clinical definition, this lack of enjoyment needs to go on for at least two weeks.

Untreated depression can lead to other chronic physical and mental symptoms such as chronic pain, lack of motivation and lower immunity levels, making people less prepared to fight off other infections or sicknesses that may come along.

Plenty of research has been going into the causes and effects of depression, along with ways to reduce its symptoms, everything from medication to counseling to diet to exercise.

Of course, patients receiving home care or hospice care may find it difficult to focus on all of these. For instance, they could be on a limited diet or have mobility challenges so may not be able to eat certain foods or exercise very easily.

If you’re not familiar with current research on depression, this is month is a good opportunity to learn more.

October is considered Depression Awareness Month, where people are encouraged to learn more about what they might be going through along with people in their lives.

The month also includes National Depression Screening Day Oct. 11, where people are invited to take the opportunity to seek help for any possible mental health conditions they might have. This can include visiting a primary care provider or a mental health specialist who can learn and diagnose if someone has certain conditions, and if so, discuss if there are any solutions to help them.

Depression in end of life care

In end-of-life situations, both caregivers and the patients have high potential for depression. Part of the reason is the situation itself – approaching death and having to say good-bye to loved ones can be stressful.

Though hospice programs are designed to focus on quality of life and help people through a difficult time, patients may feel overwhelmed with everything. They may be scared of what’s coming next whatever their religious affiliation, or they may feel that they have too many details to take care of, such as funeral planning or estate paperwork.

Clients also could be in a good deal of pain, tired and not sleeping well, which could also contribute to possible feelings of depression.

On the caregiver side, they also could be stressed about losing a loved one and being tired of providing constant care. Some caregivers who are family members may have needed to put other parts of their life on hold to help, including their careers.

Although they may feel obligated to be giving and helpful, there may be some moments where they feel unproductive and simply worn out. Providing round-the-clock care could also make them feel isolated and tired.

If they’re providing care for someone with dementia, this can be even more frustrating and challenging.

Above and Beyond Home Health Care is happy to work with families concerned about depression. We can discuss different options to help everyone, including respite care. Here, one of our trained personnel can stay with a patient for a few hours or even longer to give caregivers – and perhaps a patient – a well-deserved break.

Caregivers can run errands, get together with friends, get a pedicure or whatever they want. It also might be beneficial for the patient to have another person to interact with them on a temporary basis.