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Life of a PTA

Recognizing Depression

Published May 5, 2014 10:31 AM by Allison Young

Recently, I approached one of my patients for therapy participation and was quickly given a decline. Up to this point, the patient (who newly arrived to the skilled nursing facility a few days prior) had been agreeable to therapy. The refusal was quick and adamant, which included the following myriad of reasons: she was in pain, did not sleep the previous evening and felt she "overdid it in yesterday's session." Pain and fatigue are the most common reasons a person will not be enthusiastic at the prospect of daily gait training.

In further discussion with this particular patient, I found out she was also anxious with aide staff, feeling frustrated with her family and she was constipated. After hearing these additional details and educating on the importance of physical movement and healing, the patient really looked at me for the first time during the conversation and stated that she felt depressed.

Having been diagnosed with clinical depression more than once in my life, I take that statement with the weight it deserves. Depression can sneak into your life and steal all of the energy and motivation that you think you might possess. When you need physical activity the most, every fiber of your body resists. Depression in patients is common and comes as no surprise considering the increased stress and fatigue associated with hospitalization. By the time patients arrive to a SNF, they have already experienced major surgery or illness and most likely have been isolated from their home for quite a while. It's crucial that patients get out of bed and physically start moving at this point -- for their body and mind.

If I suspect depression or, as in this case, a patient verbally states the fact, I will alert the nursing staff and primary physical therapist. Once recognized, each department can address the depression before it can completely sabotage the patient's recovery.

Luckily, physical therapy plays a key component in overcoming or avoiding depression altogether. Armed with this knowledge, a successful therapy session becomes as important as an anti-depressive medication. Maybe even more effective.

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1 comments

Depression seems to be under recognized in the SNF setting and there are professionals who do not know what to look for.  Often it is the subtle clues that are missed by so many that will indicate a person is depressed.  Once professionals know what to look for they can take action.

I once had a WW II vet describe in detail bodies he had to collect and dispose of, he wept profusely.  When social services and nsg was informed he vehemently denied weeping or any other feelings he may have had during our therapy session.   He was never treated for possible PTSD partly because he did not want treatment and partly because no professional services were recommended for him at discharge.

I often take residents outside in the sunshine as much as possible to help alleviate their depressing moods.  It is nice to see a change in their demeanor afterwards.  

Jason Marketti May 5, 2014 12:41 PM

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