My father turned 75 a few weeks ago and seems to have given up on life. He has lost interest in his grandchildren who for decades have given him so much joy. He spends most days in bed, saying that he feels tired and is ready to join our mother who died two years ago. Any hope for him?
Yes, because it depends on several factors. What is his physical health like? Does he suffer from diabetes, hypertension or both? What, in other words, was happening to him before he turned 75 and prior to losing his wife?
Was he in robust health, regularly exercising and eating well or was he an elderly couch potato who watched cartoons all day as he consumed fast food and beer? These two extremes in old people play a crucial role in the long-term outcome of both their physical and mental health. Diabetes predisposes people to depression, meaning that if you have the disease, the chances of becoming depressed are higher than in the general population.
Similarly, those with poorly controlled high blood pressure are more likely to suffer small and even large strokes which themselves are associated with greater chances of developing depression. Not surprisingly, the same goes for heart attacks.
Depression is a common precursor to heart attacks while those who have heart attacks and are already depressed take longer to recover from the treatment they are given. The same applies to other unlikely conditions, including some cancers.
In the case of your father, another predisposition to developing depression is the fact that your mother died recently and it is now well-accepted that men who lose their wives after the age of 70 are more likely than not to die of “a broken heart” than those who do not.
All this has however not told you what to expect in the case of your father. Sadly, only a doctor who examines him can give you an accurate prognosis.
If for example your father enjoyed good health into his 70s and if this sounds like a grief reaction with anticipation of his own death, chances are that with therapy and some medication, it should be possible to get him back to good health.
Perhaps as important as physical health, sometimes his social health is more important. It is known, for example, that loneliness is a major killer among the elderly.
Therefore, if your father, upon turning 75, retired from an active life in which he travelled on duty, played golf regularly with friends but suddenly finds himself in some upcountry rural home where nobody knows him, this is a prescription for early death.
At his age, many other explanations for the new behaviour are possible. Depression occurring for the first time in the elderly is more common than many people (including doctors) fail to recognize. Sadly, many are diagnosed with dementia, a condition which in many cases is not reversible.
Depression in the elderly on the other hand is easy to treat and, in many cases, leads to a complete cure. Only a doctor can tell the difference.
More sinister, however, and in some cases looking exactly as your father seems to be, are instances of slow-growing tumours of the head. The importance of detecting these growths early is the fact that some are possible to remove with a complete cure.
Delay in the diagnosis makes outcomes less certain. Sometimes the elderly bleed into the outer linings of the brain, following minor knocks to the head (subdural hematoma). Again, this is a completely curable condition which sometimes comes to light on account of behavior changes in an older person. Some people with this condition have received a diagnosis and treatment for mental disorders including depression.
As you can see from the foregoing, the mental and physical health of the elderly are intricately intertwined and what on the surface might appear to be a depressive illness might turn out to be a tumor, a bleed or even social neglect by the children.
Happily, for all concerned, there is adequate expertise to resolve all these complex issues provided the old man is seen without further delay.
