Causes & Signs of Geriatric Depression: A CSW Training Guide

Updated December 2023

Federal government data shows that 10% to 15% of Canadian seniors suffer from depression. And that number is far higher among those in residential care.

Unfortunately, lack of awareness and stigmatization ensures that many cases of geriatric depression go unreported, undiagnosed, and untreated.

Community support workers (CSWs) are not trained to treat elderly clients with depression or make a clinical diagnosis—however, if CSWs can identify the warning signs, they can quickly intervene and connect those clients with potentially life-saving health care services.

This kind of early intervention is key. There are many treatments available for seniors battling depression, including counselling, medication, psychotherapy, and newer forms of brain stimulation. Once diagnosed, depression is highly treatable.

CSWs are front-line health care professionals who often work closely with elderly clients. They have a unique opportunity to help reverse the negative trend of geriatric depression in Canada. The best place to start is by learning how seniors are impacted by this mood disorder, and which warning signs to watch for.

Common Causes of Depression in Seniors

In addition to genetic factors, traumatic life events and/or serious medical conditions are common causes of depression in seniors. Experiencing the death of a spouse, a serious medical diagnosis, moving into a nursing home, or undergoing invasive surgery are all considered typical depression triggers.

While these events will naturally cause a sense of loss, fear, and grief, for most people the feelings will gradually reduce over time. For others, the negative experience persists and turns into depression.

Medical conditions can also put seniors at risk for developing depression. People who have suffered a stroke, have dementia, hypertension, diabetes, cancer, or chronic pain are particularly prone to this mood disorder.

Certain medications can also contribute to depression, including:

  • Blood pressure medications
  • Beta-blockers
  • Steroids
  • Sedatives

4 Signs of Geriatric Depression The CSW Should Watch For

It is a myth that some degree of depression is inevitable as we age. Many cases of geriatric depression go undiagnosed because caregivers assume the symptoms are normal side effects of getting older.

The truth is that despite the losses seniors often face (death of loved ones, reduced independence, chronic health issues, etc), good mental health is absolutely attainable at any age.

So how can CSWs recognize the difference between temporary fluctuations in mood and a legitimate case of depression? There are four predominant signs of geriatric depression CSWs can look for to help identify clients who are suffering and help them get the support they need:

1. Complaints of physical pain

Seniors with depression are more likely to report physical discomfort than talk about troubling thoughts and feelings. Some of the most commonly reported ailments in depressed seniors include:

  • Sleep problems
  • Feeling low energy and weak
  • "Phantom" pains: headaches and muscle/joint aches with no known physical cause

2. Evidence of persistent negative thoughts

Seniors with depression will usually demonstrate the following negative thought patterns:

  • Obsessive ruminations, sense of impending disaster
  • Harshly self-critical
  • Focus on death and/or suicide (or attempts to hurt themselves)
  • Relentless focus on past failures or current perceived shortcomings
  • Crying for no apparent reason
  • Loss of self-esteem (stops bathing, wearing makeup, doing hair, etc.)
  • "Deadening" or absence of feeling

3. Withdrawal from social activities

Your elderly client may have once participated in events at an adult day care centre or within the local community. As depression sets in, so does the tendency toward isolation. Signs include:

  • Loss of interest in activities that were once a source of pleasure
  • Decrease in physical exercise
  • Refusal to see or speak with friends or loved ones

4. Physical changes

Elderly people with depression will experience both psychological and physical symptoms. Physical changes to watch for include:

  • Feelings of fatigue, even after sleeping
  • Sudden weight loss or weight gain
  • Constipation
  • Aches and pains
  • Restlessness—the need to constantly move around

With awareness comes empowerment, both for CSWs who want to help their elderly clients reclaim quality of life and for seniors who deserve to live free from the crippling (and deadly) consequences of depression.


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