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Depression in the Elderly Creates Health Issues
Jan L. Warner & Jan Collins

Question: My father is 72, and has always had a weight problem. Since my mother died last year, however, Dadís weight has ballooned to 230 pounds. (Heís 5-feet, 10-inches tall). This means he obviously isnít eating right Ė or eating too much, which, in turn, is making his diabetes worse. Since Mom died, Dad also seems to have trouble cooking and keeping up the house, which has gotten pretty dirty. Mom did most of this when she was alive, but Dad used to be fairly competent in these areas, too. Iím worried that maybe heís sliding into Alzheimerís. He refuses to see a doctor. What can we do?

Answer: It sounds like there are a couple of issues that might be dovetailing here. First of all, your Dad could be depressed because of the stress of losing his wife. While loss of appetite can be a symptom of depression, some depressed people also eat to excess.

Youíre right to be concerned about your Dadís weight. At 5 feet, 10 inches and 230 pounds, thatís a body mass index (BMI) of 33. BMI is the standard measure for calculating obesity; a BMI of more than 30 is considered obese. Obesity, of course, is now an epidemic in the United States, and is closing in on tobacco as the nationís No. 1 underlying preventable killer. Obesity is especially dangerous to folks with diabetes. A recent British study indicates that obesity can reduce the life expectancy of diabetes patients by up to eight years, so itís essential that your Dad manage his weight so that he can reduce the risk of serious complications from diabetes, such as heart attack and stroke. Being overweight also increases the risk for cancer and hypertension.

Unfortunately, your Dad is in good Ė or should we say, bad -- company. A recent study by RAND, a California think tank, reports that growing incidence of obesity among older Americans could reverse the gains this group has made in staying healthier. By 2020, the treatment of medical problems related to excessive weight will consume one in five health-care dollars in people aged 50 to 69, the study found.

Severely obese older people are more than twice as likely as people of normal weight to be in fair or poor health and have about twice as many chronic conditions. Then thereís the cost: the RAND study found a 44 percent increase in health-care costs among people who are moderately or severely obese, compared to those who arenít.

The biggest challenge facing you and your family is getting your father to understand the terrible downsides that obesity brings without becoming preachy or making your father think you are assuming a parental role. Since sometimes itís not what is said, but who says it or how it is said, we suggest that you engage a geriatric care manager to help bring Dad around. We also suggest taking your Dad to see a qualified nutritionist, who can help him understand the rudiments of a healthy diet and perhaps lay out a regular meal plan for him. There are excellent geriatric exercise specialists who can help establish a good routine for him.

The next challenge is helping him follow these regimens. You and your siblings could invite your Dad to eat at each of your homes on a regular basis. (You would, of course, make sure that you donít serve cheeseburgers and fries.) A regular dinner schedule would get him out of the house and might help cheer him up. And, taking a walk with Dad in the evenings or weekends encourages both exercise and communication.

While itís possible that your Dad could be showing early signs of Alzheimerís, itís also possible that his difficulties cooking and housekeeping could simply be signs of depression. For that reason, make your concerns known to Dadís family physician.

Redouble your efforts to talk your Dad into seeing a doctor for a thorough physical and psychological evaluation. Perhaps a trusted friend of his could intercede and help convince him?



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Planning Your Future with 20-20 Vision™


Today, more than 36 million Americans are age 65 or over. There are more than 22 million family-member caregivers. Then there are the Baby Boomers. All are grappling with the major decisions that accompany the latter stages of life. This book is for them. Written by two experts with decades of experience between them, it is a comprehensive guide that instructs readers about how to create a plan to deal with all aspects of aging, helps maximize options and ensure wishes are carried out.

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