Depression and anxiety

Allow the client to talk and use your listening skills. This can sometimes be as effective as medication.

Ensure adequate pain control, as pain often contributes to depression.

Encourage the client to keep active as far as possible this can boost confidence and mood.

Encourage the client to relax. You might suggest mindfulness or complementary therapies.

Suggest support groups and support lines such as MIND or the Scottish Association for Mental Health

Discuss with the client what they can do that they really enjoy – such as listening to music, audiobooks or reading.

If you have concerns that the client is severely depressed or gives signs of thinking about suicide, contact your manager, the clients GP, District Nurse or Palliative Care Coordinator, as part of your responsibility for duty of care.

Depression is very common in dying older people, especially those with dementia. Depression:

• Is strongly and consistently associated with a poor quality of life.
• Can impact on ability to function socially
• Reduces physical functioning.
• Is often associated with symptoms that are difficult to control.
• Has a major impact on the resident’s family.

Physical symptoms commonly associated with depression include:

• Weight/appetite change
• Insomnia
• Early morning wakening
• Loss of energy
• Fatigue
• Slowing down of movements
• Asking the client if they feel depressed.

Emotional symptoms include:

• Low mood
• Mood change e.g. angry or irritable
• No interest in what is going on
• Excessive feelings of guilt, worthlessness, hopelessness
• Social withdrawal and loss of pleasure in daily activities
• A wish for an earlier death.

Marie Curie: Coping with depression and anxiety

Scottish Palliative Care Guidelines: Depression

Some elements of this section are summarised and adapted from Macmillan Foundations in Palliative Care (FIPC) materials 2020, published by Macmillan Cancer Support, 89 Albert Embankment, London SE1 7UQ, United Kingdom. © Copyright Macmillan Cancer Support 2020, produced by the Digital Health & Care Innovation Centre (DHI). Macmillan Cancer Support accepts no responsibility for the accuracy of the content, which is based on UK practice and guidelines at the date of UK publication; nor for the context in which the content is published; nor for any adaptations made for local use. The content as published in this app/website is solely the responsibility of the Digital Health & Care Innovation Centre, Inovo Building, 121 George St, Glasgow G1 1RD.