Depression in dementia: A volunteer’s perspective

Dementia affects one person every three seconds around the world. How can we help?

Written by: Lisa

Art by: Lisa

The global ageing population is increasing, creating new major public health challenges for the 21st century.  One person every three seconds will be diagnosed with dementia, a neurodegenerative condition which involves gradual cognitive decline and behavioural changes. The majority of dementia cases affect those who are 65 and over, with the most common type of dementia being Alzheimer’s disease.  Dementia cases have created, and continue to create, a health and social care burden, with estimated annual costs of $818 billion worldwide.  

Currently in the UK, at least one in five people at some point in their lives will suffer with depression. Among those living with dementia, however, depression rates are much higher: between 25-74.9%, compared to 22-28% observed in the general population. This is particularly observed among those with vascular dementia or Parkinson’s disease dementia.  Depression is also one of the most common behavioural complaints of those living with Alzheimer’s and raises the risk of patient institutionalisation, including being a common cause of caregiver distress.  

Depression is partly a reaction to situational factors, such as loneliness and lack of stimulation or activity.  After an individual is diagnosed with dementia, there is a tendency to withdraw from meaningful relationships with their community, family, and friends. The individual consequently becomes more reclusive and isolated, which leads to low self-esteem and a loss in self-confidence to engage in the activities they once enjoyed.  

An interesting theory from the social constructionist perspective attempts to understand the evolution of the ‘self’ after individuals are diagnosed with dementia.  The sense of self contributes to one’s own identity, and is shaped by a person’s interactions throughout life. Often those diagnosed with dementia feel like a different person to the one they were before. A common reason for this is that they are aware of the negative stereotypes associated with dementia, linked to the condition’s symptoms e.g. memory loss and behavioural changes.  The mistake with this perception is that dementia patients still possess an intact sense of self-worth and self-respect, and are therefore conscious of being treated categorically in terms of a collection of symptoms rather than as the individual they are.

Practitioners are three times more likely to prescribe dementia patients with antidepressants than those without dementia of the same age, despite no definitive evidence available for their effectiveness.  This may be due to a variety of factors related to the dementia syndrome, ranging from a different neurochemistry to specific genetic mutations.

An alternative to prescribing drugs is to invest more resources into increasing social support for those with dementia and depression. As a growing number of studies have shown, depression could be reduced by a significant degree by engaging in active activities and interacting with people. This evidence supports the idea that those with dementia and depression could considerably improve their quality of life and well-being through simple lifestyle alterations .

Programmes such as Dementia Friends – organised by the Alzheimer’s Society – aim to fight the stigma and social isolation surrounding dementia. The Society has taken large strides to raise awareness and encourage positive change in 23 countries around the world, with over two million Dementia Friends volunteering across England and Wales.

Since joining the Alzheimer’s Society as a Dementia Friend volunteer, I have realized the importance of spending time with someone living with dementia.  Individuals with dementia can initially feel lonely, low in self-confidence and confused.  Getting involved in activities they enjoy and even talking with them about simple daily events could add a great deal of positivity to their day.

Combating loneliness, and even depression in dementia through volunteering is a sustainable and worthwhile way of working towards a dementia-friendly society.  From initiatives such as Dementia Friends, conversation around this stigmatised condition is fostered. Additionally, this provides ways of taking a proactive role in integrating individuals with dementia back into the community.  Therefore, from my experience and on behalf of the Alzheimer’s society, I could not encourage you enough to volunteer and do the same.  

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