Older people coping with low mood: a qualitative study.

Margaret Von Faber,Roos C Van Der Mast,Geertje Van Der Geest,Gerda M Van Der Weele,Jacobijn Gussekloo,Ria Reis,Jeanet W Blom

doi:10.1017/s1041610215002264

Abstract

To gain new insight into support for older people with low mood, the perceptions, strategies, and needs of older people with depressive symptoms were explored. Two in-depth interviews were held with 38 participants (aged ≥77 years) who screened positive for depressive symptoms in general practice. To investigate the influence of the presence of complex health problems, 19 persons with and 19 without complex problems were included. Complex problems were defined as a combination of functional, somatic, psychological or social problems. All participants used several cognitive, social or practical coping strategies. Four patterns emerged: mastery, acceptance, ambivalence, and need for support. Most participants felt they could deal with their feelings sufficiently, whereas a few participants with complex problems expressed a need for professional support. Some participants, especially those with complex problems, were ambivalent about possible interventions mainly because they feared putting their fragile balance at risk due to changes instigated by an intervention. Most older participants with depressive symptoms perceived their coping strategies to be sufficient. The general practitioners (GPs) can support self-management by talking about the (effectiveness of) personal coping strategies, elaborating on perceptions of risks, providing information, and discussing alternative options with older persons.

Highlights

Depressive feelings are common at old age and have a negative influence on the health and well-being of older people and their social relations (Beekman et al, 2002; Cuijpers et al, 2009)
Most factors that influence the perspectives of individuals in general practice on depressive feelings have been described previously, such as self-responsibility in dealing with low mood or depressive feelings (e.g. Switzer et al, 2006; Wittkampf et al, 2008; Prins et al, 2011, van der Weele, et al, 2012)
Our findings suggest that older people with complex problems, generally satisfied with their coping ability, refer to limited means for coping due to high morbidity, fatigue, and problems with concentration or pain

Summary

Introduction

Depressive feelings are common at old age and have a negative influence on the health and well-being of older people and their social relations (Beekman et al, 2002; Cuijpers et al, 2009). In our earlier combined screening/intervention program, the majority of older people who screened positive for depressive symptoms declined the intervention offered (van der Weele et al, 2012). Various studies have described the different views of older patients and physicians on the diagnosis of depression and the treatment of depressive symptoms (van Schaik et al, 2004; Prins et al, 2008; Wittkampf et al, 2008). To gain new insight into support for older people with low mood, the perceptions, strategies, and needs of older people with depressive symptoms were explored

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Discussion

Conclusion