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Risks of Depression Among Long-Term Care Residents

Seniors are at high risk of developing depression in nursing homes, and if staff aren’t adequately trained on mental health interventions, it poses severe health risks to residents and diminishes their quality of life.

Seniors need mental health care. Nursing home residents may be at risk of developing depression, or of their current mental health issues worsening. Research has shown that roughly half of the seniors living in long-term care homes can suffer from diagnosed depression or show the symptoms of depression.

By nature, depression is a silent symptom. People are more attuned to more obvious forms of health issues. Some of the symptoms of depression to be aware of are:

  • Repetitive health or anxiety issues
  • Constant feelings of sadness, worry and anger
  • Unrealistic fears
  • Tearfulness
  • Negative statements

Risk Factors for Depression in Nursing Homes

Depression in nursing homes appears to be a vicious circle—someone with pre-existing depression (or those who are at risk of mental health issues) moves into a nursing home where they experience a low standard of care, which compounds their mental and emotional symptoms.

Nursing home residents encounter many challenges medically, socially and functionally. For example, residents experience a lot of loss and grief, isolation and declining health and mental capabilities.

Loss and Grief

Losing loved-ones and friends can trigger depression. It’s normal for individuals to grieve and hurt when their loved ones pass away. However, occasionally, this grief can consume them and cause them to feel hopeless or helpless and stops them from functioning normally. If that is the case, then it is time to seek extra help.


Residents of long-term care facilities can feel isolated from their family members and friends. They may not be able to leave the nursing home to visit their children, grandchildren or friends as much as they would like. These situations can cause intense feelings of loneliness, which is a predictive factor for depression.

Declining Health

As people age, their health tends to worsen. Poor health causes mobility issues and pain. In turn, pain and mobility problems lower the residents’ quality of life, causing symptoms of depression and anxiety.

Some studies demonstrated that elderly individuals who suffer from chronic pain are between 2.5 and 4.1 times more likely to experience depression.

In addition to being a risk factor for depression, chronic pain may also be a symptom of it. Patients who have been diagnosed with depression are 3 times more likely to experience chronic tissue or muscle pain and 6 times more likely to suffer from nerve pain.

Cognitive decline can also impact mood, which can cause irritation, agitation and depression. Another aspect of declining health is hearing loss. Several studies have suggested a link between hearing loss and an increased risk of depression. One theory to explain the connection is that seniors may stop attending events if they can’t follow the conversations. By doing so, they are isolating themselves, leading to feelings of loneliness.

Nursing Home Care and Residents’ Mental Health

Staff needs to be aware of the prevalence of depression in nursing homes and have a range of interventions in place. Maintaining a high standard of care can improve quality of life and alleviate or prevent depressive symptoms. Nursing homes that don’t prioritize adequate mental health interventions are failing to provide appropriate standards of care.

Family members should monitor their loved ones for changes in mood and find out more about the facility’s mental health protocols.

While there are many predictive factors for depression that are a normal part of aging, be warned that depression in nursing home residents is also a warning sign of abuse—particularly physical, emotional and sexual. If your loved one starts experiencing depression and you suspect that it is due to abuse, report it immediately.

Nursing Home Abuse Support Team

The Nursing Home Abuse Center (NHAC) was founded to bring justice to those affected by nursing home and elder abuse. Our mission is to educate and empower victims of abuse and their families to take a stand against this unlawful mistreatment. We work to return dignity back to those who have been broken down by nursing home abuse and neglect.

“Depression Among Seniors in Residential Care,” Canadian Institute for Health Information. Retrieved from: Accessed June 7, 2019.

“Depression and Chronic Pain in the Elderly: Links and Management Challenges,” Clinical Interventions in Aging. Retrieved from: Accessed June 7, 2019.

“Depressive Symptoms and Cognitive Decline: A Longitudinal Analysis of Potentially Modifiable Risk Factors in Community Dwelling Older Adults,” Journal of Affective Disorders. Retrieved from: Accessed June 7, 2019.

“Grief and Depression,” WebMD. Retrieved from: Accessed June 7, 2019.

“Risk Factors and Intervention Programs for Depression in Nursing Home Residents: Nursing Home Staff Interview Findings,” Journal of Gerontological Social Work. Retrieved from: Accessed June 5, 2019.

“Rumination and Loneliness Independently Predict Six-Month Later Depression Symptoms among Chinese Elderly in Nursing Homes,” PLoS One. Retrieved from: Accessed June 7, 2019.

“Sensation and Psychiatry: Linking Age-Related Hearing Loss to Late-Life Depression and Cognitive Decline,” The American Journal of Psychiatry. Retrieved from: Accessed June 7, 2019.