Study reveals that the lack of information that clarifies their reality; poor access to health, lack of doctors who speak Spanish and cultural issues intensify the problem
Since her daughter Clara died, Mrs. Gladys participates little in family celebrations, she is constantly sick and her appearance seems very fragile. She says that everything is fine, that they are the ailments of age and refuses to go to see a therapist since she affirms that she is “not crazy” and that sadness or lack of desire to do something are pure imaginations of her children .
The truth is that 14 years have passed since Clara died, but seeing Gladys it seems that her daughter died yesterday, although the lady, an immigrant from Guadalajara, denies it and says “it will happen to me.”
“She says everything is normal. All health problems are attributed to their age, ”says Josefina, her oldest daughter. They prefer anonymity, because these topics are only spoken in family: “they are not to be aired in public.”
A study by Dr. María P. Aranda of the Edward R. Roybal Institute of Aging at the University of Southern California (USC), indicates that 30% of patients over 55, immigrants and Latinos, in appointments with their General practitioners show symptoms of depression. But they don’t know it, they refuse to accept it and when they accept it, finding a therapist who speaks Spanish is not easy for them.
The study named The role of culture and language in the care of depression; experiences between Latinos or older Latinas and health providers, also found high rates of Hispanics with chronic medical conditions and functional disabilities, compared to other races or ethnic groups.
Untreated depression during old age can lead to deterioration in general health, worsening of a disability of diseases, which includes suicide. In addition, at a more expensive cost of medical care. Currently, only one in 10 older adults with depression receives adequate care, the report mentions.
Aranda, who led the study with 259 Latino people, mostly with Spanish as their first language, indicated that clinical depression is a psychiatric disorder that manifests itself with different indicators such as lack of mood, problems with concentration, lack of energy, poor motivation to live, sleeping disorders, lack of appetite and low levels of self-esteem, among others.
The doctor, who recently presented her results at the annual Gerontology conference in Austin, Texas, said that these problems are more present in the Latino community of the elderly, because culturally this group is not accustomed to being treated psychologically. There is a negative connotation of mental illness. In other words, who visits the therapist, most likely should be ‘crazy’, they say, and they don’t want to be perceived that way.
Other aspects that affect the problem of clinical depression in this group are access to health programs; so it is not uncommon to find many in this age without medical insurance, particularly because of the economic or legal status, but mainly because there is no acceptance in the Latino community of this type of illness.
However, an element that sharpens this health condition is the lack of doctors who can communicate in the Spanish language, said the doctor, since there are very few who dominate the language. And among those who do speak it, many do not know the Mexican or Latin culture, something necessary to be able to understand the social aspects that could cause clinical depression.
In 2017, the California Public Policy Institute (PPIC) indicated that 34% of the total (5,401,149) seniors in the state had been born outside the country; that is, 1,836,390 did not have English as their first language.
On the other hand, the book ‘Aging in America’ by Robert Scardamalia, published in 2014 (p.155), underlines that, in California, 15.7% of the population over 65 speaks Spanish, that is, a little more than 800,000 of the 1,102,819 Hispanic grandparents in the state.
Vilma Turcios lost two children in El Salvador in the late 1970s, as a result of the war. Although he spent 20 years looking for them, he could never find them.
Since then, the now migrant has suffered from depression, but it was not until a few years ago that she was finally able to find a program that would help her get ahead.
“Alfonso (his doctor) has helped me a lot. He listens to me in Spanish and gives me a lot of confidence to share my things. He gives me outings to know how to deal with my problem, ”said Vilma, who visits AltaMed’s PACE program two or three times a week in downtown Los Angeles.
This immigrant, already 80 years old, indicated that many people with whom she is related think that depression is madness or that it is a thing of the devil. “I do not. I have come to understand that depression is a very dangerous disease. ”
Dr. Alfonso Sánchez said that the Spanish-speaking monolingual population has a hard time accepting that they are suffering from depression due to the belief that only “crazy” people go to the psychologist.
When the patient’s resistance is strong, he says, he recommends talking to a pastor or priest. Then they return to look for it and understand that what they suffer is common in many people. That they don’t have to suffer extreme situations to go to a therapist.
When the patient obtains results in his treatment, he shares it with his family and friends, a situation that gives more confidence to other people.
Not everything is stress nor the age
Professor Aranda indicated that, for some people, the fact of developing some type of clinical depression is not always caused by stress as it is often attributed. It can be something genetic, brain changes due to senile dementia or an important transition in life. An accident, the loss of a loved one, or even a change in work can cause or intensify problems.
Erroneously, on many occasions problems or symptoms are attributed to age and everything is blamed on old age. That is not true. Hence the importance of talking to a doctor regularly to get help, take an antidepressant medication or register for a special emotional counseling program.
Some people try to hide the symptoms of depression with opposite attitudes. At the same time, other senior citizens who become so depressed that they do not want to leave their home and always have some justification for staying in their home. These people physically do not seem sick, but being alone and locked up for long periods of time could lead to depression.
Possible solutions
Regardless of the level of depression, Dr. Aranda said, it is important to always see a GP. It can detect the symptoms before they get worse. He said that currently antidepressants help a lot and that on many occasions she has seen positive and significant changes thanks to these medications.
Other possible solutions, he concluded, is that it is necessary to carry out a communication campaign where the clinical depression can be discussed so that people understand that visiting a therapist may be an option and that it is not necessarily for extreme cases. And increase the number of bilingual professionals, ensuring that all medical insurance has an accessible and bilingual system for the Spanish-speaking community.
“This article was written with the support of a journalism fellowship from The Gerontological Society of America, Journalists Network on Generations and the Silver Century Foundation. ”
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