The aged patient requires a lot of attention. Depression is prevalent among elderly persons. Aged patients must frequently cope with the loss of loved ones and other important persons in their life. They are also stressed by changes in their own self-images and the way they are perceived by others. Deterioration in bodily function also contributes to depression in aged patients.
A patient's depression may be so severe that he or she may consider suicide a reasonable alternative to living with a severe chronic illness or living alone after the death of a spouse. Among this bereaved population, more deaths within the first 4 years after the spouse's death result from suicide than from all other causes.
The interviewer must never assume that older patients' complaints are natural for their age. People do not die of old age; they die of illnesses. Most of these patients are alert and capable of independent living. The ones who are unable to care for themselves are usually accompanied by a family member or an attendant. The interviewer must obtain as much information as possible from these sources. The interviewer should also refrain from using patronizing mannerisms that belittle the individual. A friendly, respectful approach reassures the patient. Aged patients should be advised about everything that will be done to them. This makes patients confident that there will be no unpleasant surprises. Because of advanced age, such patients may be afraid of dying. Those who are afraid should be reassured that everything possible will be done to make them better. Many people survive an illness because of their desire to live and therefore fight to stay alive. Overzealous reassurance is not appropriate for all aged patients; many regard death as a reasonable outcome.
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