Depression and the Older African American

Depression and the Older African American

Introduction

The rate of depression in older African Americans has been found to be similar to their white counterparts. However, they are less likely to be identified and treated with antidepressant drugs. Some factors may include mistrust of health-care professionals, poor recognition of depression by primary care doctors, poor access to mental healthcare, and the cultural or spiritual beliefs of the older African American. The focus will be primarily on the cultural or spiritual beliefs and the resilience of the older African American and nursing implications when addressing depression in these individuals.

Key Principles and Nursing Implications

Generally, African American culture sees health being harmonious with nature and illness is seen as caused by demons or bad spirits (Purnell, L.D. & Paulanka, B., 2009, p. 33). According to Wittink, Joo, Lewis & Barg (2009), “African American older adults in our study brought up the term ‘faith’ frequently when discussing depression” (p. 404). Throughout the study, depression was described “as a loss of faith” (Wittink, Joo, Lewis & Barg, 2009, p. 404). Purnell & Paulanka (2009) stated, “Churches play a major role in the development and survival of African Americans” and sickness is perceived as a separation from God (p. 31). Going to church, laying on of hands and praying daily leads to putting God back into the center (Purnell & Paulanka, 2009, p. 31). Older African Americans believe that the use of prayer reflects the faith that they have in God. According to Wittink, Joo, Lewis & Barg (2009), “Faith was seen as an all-encompassing framework which involves the physicians and the treatment they offer” (p. 404). In care of depression of the older African American, nurses in the clinical setting should consider discussing spiritual faith of the patient in order to get them to reveal the signs and symptoms of depression. According to Smith, Robinson & Segal (2011), these signs and symptoms of depression can include the following: feelings of hopelessness and loss of self-worth, unexplained aches and pains, anxiety, memory problems, lack of motivation, decreased energy level, irritability, loss of interest in socializing, decreased desire in eating, and neglecting personal care. When considering the elderly patient, it also important to differentiate between depression and dementia. In depression, mental declination occurs more rapidly than in dementia. The elderly patient who is depressed can give the correct time, date and orientation, whereas a dementia patient would be confused and disoriented. In depression, the elderly patient would have difficulty in concentrating, have slow language and motor skills, and would be aware of memory