A change in mood which lasts at least 2 weeks and includes sadness, negativity, loss of interest, pleasure and /or decline in functioning.


At least 6 weeks, but can last several months to years, especially if not treated.


May be indecisive and thoughts highlight failures and a sense of hopeless.

Mental Status Testing:

Capable of giving correct answers, however often may state “I don’t know”


Generally intact, thought may be selective. Highlights negativity.

Sleep wake cycle

Disturbed, usually early morning awakening.

Hallucination and delusions:

Can be present in severe depression. Themes of guilt and self-loathing.


May deny being depressed but often exhibit anxiety. Others may notice symptoms first. Increased complaints of physical illness. Social withdrawal is common.

Care approaches:

Identify the symptoms of depression early. Help person to follow treatment offer support.


Treatable and reversible condition.


antidepressants, ECT, interpersonal therapy, behavior therapy. Assist individual to improve confidence and self esteem through conversation and physical activity.

Forman, MD and Zane, D. 1996. Nursing strategies for acute confusion in elders. American Journal of Nursing. 96 (4) 44-51.

Lipowski, Z. 1989. Delirium in the elderly Patient. The New England Journal of Medicine. 320 (9) 578-582.


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