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Late adulthood is a stage of one life that should very entertaining as it’s meant to enjoy ones achievements, after laboring for many years. But for many individuals this is not the case. Most of them live under depression due to leading stressful lives and in fear of what might happen to them. Some of them suffer from terminal illnesses like diabetes, asthma, blood pressure among others, and these normally put them under a lot pressure. This topic will help explore the life changes in old age and its association with depression.
Depression is defined as a condition of despondency marked by feeling of inferiority and hopelessness (Cool, 2001). It’s a state that affects an individual adversely and is caused by certain circumstances that occur in an individual’s life. It’s a brain condition since people with it have high levels of cortisol, which has daring effects on certain parts of the brain. It contributes to chronic inflammation and this can greatly affect the circulatory system as it damages the blood vessels which are used in the flow of blood. Depression too affects the nervous system by destroying the neural networks.
There many symptoms of depression of depression where the most common are the sadness and disappointment. One may lose appetite and pleasure in almost all activities. Some individuals lose weight as they rarely have meals and if they have them they are normally not balanced. Depending on the source of your depression one is seen to be having some sense in of guilt which you are battling with. (Doris, et al. 1999) Men in most cases tend to hide their feeling so instead they normally become aggressive and irritable easily.
Sleepless nights is also a symptom of a depressed individual. (Helpguide.org) Women have a higher incidence of thyroid problems since hypothyroidism can cause depression. For some individuals especially those experiencing atypical depression some symptoms are opposite rather than sleeping less they tend to do it excessively, eating more especially carbohydrates thus leading to weight gain. (Helpguide.org)
Depression can occur at any age but is more pronounced in old age which ranges from sixty and above. As one gets old the more unproductive one becomes and that‘s why people retire. Many people take retirement differently. For some being in employment use to provide some sort of social class an ones they retire it’s taken away from them. They become uncomfortable as they normally find it hard to adapt in their new status. For many their self-esteem is lowered giving them a feeling of inferiority which is not the case. The change that occurs in their mind and body determines how they will live the rest of their lives. In Erick Erickson’s psychological dilemmas some individuals start thinking of their failure in the past life thus leading to unending regrets. It leads to depression as at their age it’s too late to change anything.
A major cause late adulthood depression is loss of a loved one especially one that one had special attachment to. He or she may be a spouse, a child, a close friend or even a worker. They normally find it hard to fill that gap left. It’s normally as if all their hopes in life were determined by those people and ones they are gone, they find life not worth living anymore and it’s in such instances that some contemplate suicide and if successful they follow the departed lot.
Depression has adverse effects in an individual especially in old age. The major one is normally suicide as they normally find life not worth living anymore due to the hopelessness. Research has shown that men are four times more likely to commit suicide than women as they tend to keep their feeling to themselves but women express them by sharing that which is bothering them with those that they trust. (healthcentral.com. n.d) the most common way is by crying as they feel relieved.
According to the National Mental Health Association, one in every eight women will develop depression at some point during their life time. Many factors contribute to this unique feature raging from reproductive hormones to social responses. The entertaining news is that depression is treatable and the more you understand its particular implications on both men and women, the more equipped you will be to tackle the problem head on. Treatment and cure depends on an individual.
There two main drugs being used to tackle it and these include serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs). (Havard Mental Health Letter, 1999) Examples of serotonin reuptake inhibitors are Paxil and Zoloft. They have certain side effect which include: dry mouth, constipation, dizziness among others. Examples of tricyclic antidepressants include Pamelor and Norpramin which are used to treat severe depression also known as melancholia.
Another very efficient way of dealing with depression is supporting reproductive relationships. The elderly in most cases try as much as possible to do this but some of us are too inconsiderate to notice it. They tend to feel lonely as most of their children have left them and the person they get is of great value to them thus it’s upon us not to let them down it this.
Depression too may be a side effect of a certain pre-existing medication thus the affected individual needs to see a physician who may refer him/her to a psychiatrist with geriatric training or experience. It’s important for one to follow the doctor’s prescription as there’s a chance of the condition of depression returning if one quits the medication. Its medication may vary depending on an individual for example if it has occurred to you severally, medication for you may last longer but if it’s once its medication is not that serious.
For those taking care of depression patients need to be patient with them as they may constantly ask for re-assurance as they feel they got something physically wrong with them. It is important for them to reassure them as much as possible and try to spend as much time as possible with them. Just make them know it is a normal condition and that they are not losing their minds. Another important aspect about depression is that its hereditary that is it can be past from parents to their children thus one need not tire him/herself trying to decipher the cause. The family members need to know whether such a condition run in their blood line so that they can devise the necessary measures to deal with them.
Herbal remedies and natural supplements can also be used in treating depression and are much safer than antidepressants for the older adults. However some herbal supplements may cause some side effects depending on an individual thus its important for one to check with your physician before using them. Some of them include the following: Omega-3 fatty acids which boost the effectiveness of antidepressants, St. John’s wort and Folic acid help relieve mild symptoms of depressions but should not be used with antidepressants especially alcohol.
Other than the right treatment for depression, treatments can cause or even worsen existing depression.
They include: Blood pressure medication especially clonidine, Ulcer medication (Zantac, Tagamet), Heart drugs containing reserpine, Steroids (cortisone and prednisone), High cholesterol drugs especially Lipitor, Mevacor, and Zocor and Tranquilizers like valium Xanax and halcion. (Helpguide.org)
In conclusion, depression is a condition that is treatable and manageable thus people need not worry.
Government of India (India Institute of Medical sciences).
Life in itself is a gift. The fact that everyone wants to live regardless of the state of affairs in the individual’s life is testament of the true value of life. This aside, it is also fact that death is real and that everyone will die at some point. The suffering that one endures in the process of death, especially where disease is the cause, can make one desire to die in order to escape the pain. Physician assisted suicide or PAS, as it is commonly referred to, is a different form of suicide. In PAS, a physician prescribes an overdose of drugs, which the patient then takes himself or herself, to induce death.
This is such that the physician does not give the drugs directly to the patient. This phenomenon is commonly confused with Euthanasia, another form of suicide or “mercy killing”. In Euthanasia, a suffering patient is allowed to die in order to stop the suffering that they are undergoing. In euthanasia, contrary to PAS, the physician is the one administering the drugs. Physician assisted suicide has generated a serious debate as to its legality and constitutionality not only in the United States of America, but the world over. There have been protagonists as well as antagonists to this phenomenon and both sides apply different scopes of reasoning in order to arrive at their decisions.
Rationale of the majority
The world over, PAS has received heavy criticism and intense rejection. This is because a vast majority of the population prefers being pro life to being against it. It is also a common belief among many individuals that one should die at their right time; the time when their Deity chooses. This has been the main reason fronted by a majority of those against physician assisted suicide. These individuals pose quite a number of reasons as to why they vehemently oppose PAS.
First of all, the majority argue that suicide is in itself wrong and even so for the ill. They hold the view that life is precious and God-given and hence no individual has the right to take the life of another. The majority argues that no individual can give him or herself life and so no individual can take the life of another. The fact that there are individuals who are willing to take their own lives is not only wrong but also unacceptable to the majority. They confer that especially for the sick; suicide cannot be an option on the table. Just as suicide is wrong and prohibited for the healthy, so should it be for the sick. The ill suffer a great deal, especially when the disease in case is a terminal one. Many at times, these individuals suffering from terminal diseases wish to take their own lives as a measure to stop the suffering that they undergo. This, however, is not acceptable to the majority, who feel that allowing individuals to be able to take their own lives is, in effect, allowing them to play God.
The majority also feel that allowing physician assisted suicide is totally incompatible with the healing goals that drive the field of medicine. Many of the individuals who want to end their lives are tired of all the pain and suffering that they are enduring. This forces many of them to ask their physicians to end their lives. However, it is illegal for a physician to end the life of a suffering patient, even in severe cases. The American Medical Association (AMA) argues that allowing physicians to end the lives of suffering patients digresses from the healing goals of medicine. The Hippocratic Oath that all physicians take at the start of their service is what guides the AMA into taking this stance. All physicians vow to protect life, and this leads the majority to taking a tough stance with PAS.
It is also argued by the majority that PAS only arises as an option in the absence of proper palliative care. The medical field has witnessed progress of leaps and bounds over the past few hundred years. This has resulted in the development of proper medicine and medical techniques that are capable of curing diseases, as well as, alleviating pain. This fact drives the majority to believe that proper palliative care of debilitating patients is the key to foregoing PAS. They believe that the ability of modern medicine to alleviate even extreme pain should be employed to ease the pain that patients feel. This, they argue, will enable patients to die a peaceful, and more importantly, natural death. They feel that instead of allowing physicians to end the lives of suffering patients, the society should invest more in quality palliative care that will make the lives of suffering patients bearable.
According to the majority as well as the AMA, death requests by patients are Prima Facie evidence of the poor care that the patients experience. The fact that a patient will resort to suicide is a pointer to the care and treatment that they receive. In a hospital or hospice in which patients are well taken care of, and their needs addressed, the requests for physician assisted suicide have been found to be significantly low. This is a sharp contrast to the institutions where patients are poorly taken care of or neglected. The negligence of nursing staff to ailing patients drives many patients into seeing themselves as burdens on those around them. This plays a key role in the patient resorting to requesting for PAS.
The AMA also argues that allowing physician assisted suicide impacts greatly on the physician’s life. This is because allowing PAS desensitizes the physicians to basic human needs and especially the needs of the ill. Physicians are trained not only to cure ailments but also the suffering of patients by fulfilling their needs; both physical and psychological. The ability of a physician to fulfill the physical and psychological needs of a patient has a great impact on the recovery of the patient. The physical needs of the ill may include alleviation of pain and discomfort while the psychological needs may include being cared for and being treated well. It is the duty of the physician to fulfill these two needs in order to help the patient in their recovery. Allowing physicians to conduct PAS will only impact on the quality of healthcare that the ill receive. It will ultimately desensitize physicians from the physical and psychological needs of the ill.
The AMA also argues that allowing physicians to conduct PAS can be detrimental to the health system. This is because physicians can take advantage of this permission to perform indiscriminate killings of the ill, the weak and the disabled. The loophole created by this can be exploited, by unscrupulous individuals, to kill their own family members, relatives or business associates. This will result in physicians becoming legal assassins, protected by law, that kill as they wish. Some physicians will not shy away from hiring their services to anyone with an ailing patient in a hospital or a hospice. This will drive the physicians away from their goal, which is saving lives, to a different goal; that of taking lives.
The phenomenon of physician assisted suicide has also been received with open arms in different parts around the world. As early as 1999, the state of Oregon in the United States of America had legalized PAS, albeit with a few guidelines that must be followed. It appears that support for PAS has been growing with Washington and Vermont jumping into the ‘legalize PAS’ bandwagon. Among those of dissenting opinion to the majority, there are a number of reasons that make them support physician assisted suicide. Many of these reasons, however, hinge on the autonomy of the patient.
Many of those that support this form of suicide argue that it helps to save the patient from a lingering and painful death. Many of the terminally ill that are in hospices suffer unimaginable pain due to their illnesses. The sad fact is that even with the administration of medication, some patients continue to endure extreme pain. Such patients, who are in a debilitated state, desire to stop their pain and suffering by ending their lives. The minority argues that the individual should have the right to make a decision on whether they want to continue living a painful life, or they want to have a quick painless death. Many of such individuals may choose the latter, but as of now, only the individuals living in Oregon, Washington and Vermont have that pleasure.
The minority does not find it fair, that an individual should be forced to live a painful life, yet the people forcing the individual to live that life, do not share the pain he or she feels.
Today, the civil rights and freedoms of an individual are protected jealously from abuse. The minority argues that the freedom of choice has no meaning if an individual is not allowed the exclusive permission to make decisions concerning their own lives. They argue that the autonomy of the individual must be respected and honored. An individual must be allowed to choose life or death as they wish. This is because it is the same individual when ill, who will endure all the pain. The fact that an individual will suffer alone should be enough to warrant that the state allow the individual to chose life or death without interfering in their decision.
Our society is diverse. No two individuals are the same, and no two societies are the same either. This social diversity forces us as individuals to respects the rights, freedoms, beliefs as well preferences of others. Just as there are the religious in our societies so are there the atheists, and the way these two groups perceive life cannot be the same. Telling an atheist that he or she cannot decide to end their own life because life is God-given is ironic and absurd to them. Society accommodates everyone, and it is only fair that the state also accommodate these groups of individuals who believe that they have the right to choose life or death in the event of a terminal illness.
The minority also argues that allowing physician assisted suicide will play a great role in protecting ailing individuals from physician paternalism and unwanted treatment. The fact that an individual may be suffering in a hospital or hospice or nursing home does not grant the physician the exclusive right to offer treatment as they wish. The autonomy of the individual and their ability to make decisions for themselves dictates that the physicians obtain consent for treatment, especially in the treatment of terminal illnesses. Apart from the risk of death associated with the treatment, the willingness of the patient must be respected. By allowing PAS, the minority argues that the problems of physician paternalism and unwanted treatment will be solved.
Diseases come in all shapes and sizes. The massive array of diseases in the world today continues to puzzle even the most educated of physicians. To claim that there is a cure for every disease or every symptom is impossible and for this reason, the minority supports the use of PAS. In most of the terminal diseases, the last stages are the most difficult for the patient. This is because as the body systems fail, many other diseases attack the individual. Many of these diseases cannot be clearly established by physicians and attempts to cure them are mostly futile. This leaves the ailing individual in a serious dilemma. The lack of comprehensive information on some of these diseases coupled with their resistance to medication can force one to request for PAS.
This protects the individual from debilitating conditions over which even the physicians have no complete control. The inability of some of these ailments to be managed by existing medications warrants that the sufferers of these ailments are allowed to decide whether to live on in pain or to die painlessly.
Last but not least, the minority in support of PAS argue that the prolongation of life, to the extreme end of the stick, is solely the decision of the patient. Take, for example, the case of a patient who is 85 years old and suffering from Alzheimer’s disease. The state of the patient restricts them from movement and eating has also become a problem to the patient. The patient requires round the clock care and is in constant pain. With such a difficult life, requesting for PAS can be the only way to abate the suffering of the patient. The minority argues that the state has no interest whatsoever in forcing the prolongation of life of an individual who wants to die. This premise should, therefore, allow the individual to make a decision on their life. In forcing the prolongation of life, the state only adds to the suffering that the patient endures on a daily basis. On the other hand, allowing the patient to choose life or death gives the certainty that a suffering individual who chooses life does not want to die and vice versa. This will enable individuals to decide if they want to suffer and live or end the suffering and die.
The issue of physician assisted suicide is one that has been debated heavily from religious, to political to even ethical perspectives. However, it cannot be ignored that both sides of the coin present arguments that are logical, and that hold water.
Weir, Robert F. Physician Assisted Suicide. Bloomington [u.a.: Indiana Univ. Press, 1997. Print.
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