Supporting an older person through depression

Depression deserves treatment at any age. Older people can miss out when symptoms are put down to ageing or when services do not meet their needs. If the support they receive is not helping, ask for a review of their treatment and the practical barriers to using it.

Explain what makes care difficult to access: getting to appointments, hearing a phone conversation, reading information or using an online service. Ask what adjustments are available and whether their physical health, mental health and care needs are being considered together. In England, NHS guidance says access should be based on need rather than age.^[1]

Ask which parts they want help with and what they want to keep doing themselves. Being older or having depression does not mean someone wants you to take over.

More about supporting someone with depression.

With their agreement, offer to arrange an appointment, go with them or write down what has changed. Include mood, sleep, eating, pain, memory and daily tasks, plus medicines and recent changes to them. Ask what they want you to say and leave room for them to speak.

The GP may consider physical causes and arrange tests where appropriate, alongside assessing mental health. A blood test does not diagnose depression. Ask what the plan is, when it will be reviewed and who to contact if things get worse.^[2]

If health problems prevent them attending the surgery, ask how to request a home visit. The practice decides what is medically necessary; explain why a phone or video appointment might not meet their needs.^[3]

You can ask whether an older adults’ mental-health service is appropriate. Service names and referral routes vary. Prepare a letter or appointment notes.

Older people can benefit from treatment for depression, including talking therapies. In England, adults can contact NHS Talking Therapies directly; elsewhere, start with their GP or the route for their nation.

A referral may still leave them with a letter to answer, a form to complete or another call to make. With their agreement, check what happens next, who should contact whom and what to do if they hear nothing. Offer help with that particular step.

Ask about hearing, sight, mobility or communication support before the appointment. Explain if travel, fatigue, a phone call or using an online service makes attendance difficult. If they want you there, ask how you can join; leave room for them to speak and choose how much you take part.^[4]

If they take several medicines, ask their prescriber or pharmacist to check for interactions and side effects. Questions about antidepressants in later life.

Memory problems can have several causes, including depression, sleep problems and dementia. You do not need to decide which it is before asking for help. If memory difficulties affect daily life, offer to help arrange a GP assessment and bring examples of what has changed.

If confusion starts suddenly, call 999 or go to A&E. Do not wait for a routine memory appointment.^[5]

The NHS guide for people worried about dementia includes routes to Dementia UK and Alzheimer’s Society.

Ask what they miss: a particular friend, getting out, a familiar activity or having someone to talk to. Offer a specific plan they can accept or decline, such as lunch together or a lift to a group they choose. Check what would make it possible: transport, somewhere to sit, an accessible toilet or someone to go with them the first time.

Local befriending, lunch clubs and day centres may help. Check cost, access needs and any waiting list. Age UK’s friendship services and day-centre information are starting points; availability differs locally. Ask the GP practice about social prescribing too.^[6]

Re-engage offers free companionship services, mainly for people aged 75 or over who are lonely or isolated. Check which services are available and suitable; refer someone only with their permission.

For someone aged 55 or over who would like a conversation at any time, see The Silver Line. Company can sit alongside treatment. You do not have to provide every part of their social life yourself.

Keep ordinary company in the week. Talk about something you both enjoy, watch a programme, share a meal or do a familiar job together. A visit does not have to begin with another question about how they feel.

Make room for what they still want to contribute, whether that is choosing the music, sharing a recipe or helping with something they know about. Let it be a choice.

Agree which jobs they want help with, such as shopping, letters or getting to appointments. Ask before rearranging things, taking over bills or setting up a routine. If several people help, agree who does what so your visits do not all become the same checklist.^[7]

If daily tasks are becoming difficult, see getting more help at home. For other ideas, try day-to-day support with depression or support from a distance.

Difficulty joining a conversation or activity may have a practical cause. Ask whether they can hear comfortably, see the information or sit without pain. Try a quieter place, better lighting or a different time of day, depending on what they want.

For hearing problems that have come on gradually, ask about a hearing assessment or help using an existing hearing aid. Sudden or rapidly worsening hearing loss needs prompt medical advice. An optician can advise about sight difficulties. If reading standard print is difficult, RNIB’s free Talking Books service offers accessible options for eligible readers, including CD and USB.

Persistent pain or poor sleep deserves attention alongside depression. Help them explain how it affects the day and ask their GP about assessment and treatment. You can help with an appointment without taking responsibility for making them sleep or following a treatment programme yourself.^[8]

If meals, washing, dressing or managing at home are becoming difficult, talk with them about a care needs assessment. Give examples of help they need, including gaps that family cannot fill. Your own assessment as a carer is separate.

In England, ask the council’s adult social-care service. The needs assessment is free; any care offered may involve charges and a separate financial assessment. In Wales, contact their local council for a needs assessment. In Scotland, contact the council’s social-work department. In Northern Ireland, contact the local Health and Social Care Trust. Funding rules differ between nations.

Ask what support is recommended, who will arrange it, what it costs and when it will start. Help might involve a paid care worker, meals or equipment, depending on their needs and local arrangements. Do not let a plan rely on family doing tasks nobody has agreed to take on.^[9]

If you are arranging paid help yourselves, agree what the person wants help with, check the provider and ask about costs, continuity and cover if a worker is unavailable. Age UK can help you understand care options.

Choose a time when they are willing to talk about what they would want if they became more unwell or you were unavailable. Keep it practical: who could check in, which regular tasks need covering, and how someone would contact the right service.

With their agreement, keep useful contacts and the agreed plan somewhere the relevant people can find it. Ask what information they want shared with family, friends or professionals. A backup plan should name people who have actually agreed to help.

They may also want advice about arranging help with money or future decisions. The options depend on where they live and what they want to arrange. See emergency planning and decision-making arrangements and mental capacity. Being older or having depression does not by itself mean someone cannot make decisions.^[10]

Start with benefits after State Pension age, including Attendance Allowance or Pension Age Disability Payment, and Pension Credit. If you receive a pension yourself, check how it affects carer benefits before assuming you cannot get any help.

Before claiming carer benefits, check the effect on both people’s finances. A payment to a carer can affect some severe-disability additions paid to the person they support. The Pension Credit section explains what to check.

Age UK’s advice line can help with questions about care, benefits and local support.

Write down what you currently do and what you can continue to offer. Ask other people for named jobs and tell services about gaps in essential care. Being close to them does not mean you have agreed to provide every part of their care.

Use the guide to sharing responsibility, request support for yourself or read what to do when you are running on empty. If they refuse help, you can still pass concerns to their GP, even when the GP cannot share confidential information with you.