Journal of Palliative Care & Medicine
Open Access

You have to work hard these days not to come across a daily article or news item on dementia, and care homes get a lot of bad press. The Care Quality Commission has published a report on dementia care standards in England's care homes and hospitals. It was discovered that the medical, mental health, emotional, and social requirements of people with dementia were satisfied with variable to poor care in 34% of care homes.

Depression is widespread among senior citizens, as well as those suffering from dementia. Depression is observed in up to 56 percent of patients in the early stages of the disease and up to 61 percent of those in the later stages. Loneliness, along with depression, is the leading cause of calls to a nationwide helpline for seniors.

Given the prevalence of dementia and the quality of many care institutions, one may expect depression to be more prevalent among individuals living in them [1,2].

We interviewed 2,014 carers and family members caring for dementia patients in eight European countries: England, Estonia, Finland, France, Germany, the Netherlands, Spain, and Sweden. We looked examined data from 414 patients with late-stage dementia and their caregivers for this study on depression. We looked at people with late-stage dementia because this group hasn't been studied much.

Home Care vs. Residential Care

Because family carers provide so much unpaid care, it's no surprise that staying at home as long as possible is a significant goal in government policy recommendations, as it reduces dementia care expenses. However, the majority of individuals say they would want to stay at home - aside from the comfort of familiarity, having to consider where you will spend your final days is a huge step. And, if you get proper care and support, being at home should improve your quality of life.

So, why are people who live in nursing homes less depressed? Given that our survey was conducted around the globe, it cannot be entirely attributable to the state of care institutions in England. The standard of living in the eight countries we studied is likely to differ [3].

Reading Feelings

When family members are finding it difficult to deal with caring for their loved one, they may decide to relocate into a care facility. This is particularly common in the later stages of dementia, when persons have severe memory issues, difficulty expressing themselves, and are often unaware of their problems. Because little is known about this later stage – and because people lack an understanding of their symptoms – our study focused on patients in this late stage.

One of the challenges in diagnosing depression in people with severe dementia is the dementia patients' inability to communicate their feelings. Instead, we asked family carers (spouse, husbands, or children) to rate their depression levels for individuals living at home, or formal carers if they lived in a care home. We didn't collect any information on formal depression diagnosis.

There are also other probable explanations, notwithstanding the fact that individuals who live at home are statistically more depressed than those who live in care facilities. One is that caregivers spend very little time with individual residents and thus have a limited understanding of them. Furthermore, if they did not know that individual before to their dementia, it may be difficult to decipher deeper meaning in some expressions or behaviours.

Family carers, on the other hand, spend significantly more time with their loved ones. If you look at it this way, formal carers are unlikely to be able to accurately assess a resident's degree of happiness and sadness. This does not rule out the possibility that depression is more prevalent in nursing homes [4].