In a study done about 10 years ago, the prevalence rate for depression syndrome and depression sub-syndrome was reported to be 5.5% and 9.6%, respectively among older adults who aged 60 years and above in Singapore (Chuan et al., 2008). While a more recent study reported the estimated prevalence of depressive symptoms among the community dwelling elderly in Singapore to be 11.4% (Ho et al., 2014). In addition to biological risk factors in older population, social stressors, family composition, levels of social support, and especially poorer economic circumstances all contribute to the risk of developing postpartum depression (Segre et al., 2007). According to Singapore government, people who is aged 65 years and above have to be retried. This is a great change for a people who suddenly no need to work, as they have been working for maybe more than 50 years already. Although there are a lot of community center and relaxing park in Bedok area, most of the retried people are not use to it at the beginning. Retirement can reduce their sense of purpose. Retirement can bring with it a loss of identity, status, self-confidence so to increase the risk of depression. There are a lot of case in Bedok that elder become social isolated after their retired. This will cause them a lot of stress and their economic states also have changes. According to Singapore Department of Statistics (2010), 63.7% of the people in Bedok earn less than $4000 a month. They will have no income but only a small amount of financial support for the government. Age is proportional to the health. There will be a lot of health issues when people getting older and older. Illness and disability, chronic or severe pain, cognitive decline, chronic disease or sickness may lead to hospital admission or high cost of medical treatment. These all can be contributors to depression. These include the fear of death or dying as well as anxiety over those health issues. On the other hand, the death of friends, family member, and pets or the loss of their spouse or partner are common causes of depression in older adults in Bedok. The most common mental health disorders, of which depression is the most significant, are mainly treated at primary healthcare facilities (World Health Organization, 2001). The World Health Organization recognizes that holistic nursing must play a key role in the care of mental health patients in primary facilities (Saxena, 2007). Primary prevention aims to reduce the incidence of having depression. When preventive measures are applied to the population that we have selected, our nurses’ objective is to prevent the elderly form getting depression. We can organize some depression talk in the community so that to acknowledge the elderly what is depression and what cause depression. Of course, we can cooperate with the Bedok community center to organize some regular social activity or dinner. It can help the old people to join together. Some low aerobic exercise such as slow walking or hiking also can benefit the elderly. They can make friends with each other and express themselves as well during these activates. On the other hand, we can work with the social worker also. We can have some regular discussion with the elderly family to see any problem that they are facing such as financial problem and relationship problem and to help them to settle. The aims for secondary is to have an early detection and early treatment for depression. Community nurses can have a regular home visit for the elder family so that we can update their health condition and as well as their mental health assessment to have an early detection of depression in Bedok old generation. We can give out some leaflet to list out what are the sign and symptom for the depression and we can have some clinic or station in Bedok so that when elderly feel that they have the sign and symptom of depression, they know where to seek for help. And then treatment also can be given out though these clinic or nurse station. So that we can have an early detection and treatment for depression. Lastly, for the tertiary health promotion, our main goal is trying to improve elder’s quality of life and reduce the symptoms of the depression the they already have. Tertiary prevention refers to interventions in response to the early signs of reoccurring depression. Once the elder is diagnosis with depression by a doctor, we have to monitor what are the current symptoms that patient is having. We have to think of a way to relief the symptoms of depression either using medication or non-medication method such as music therapy, exercise, relaxation therapy…etc. Then, we can have some private conversation will the patient to discuss about what they need and how can we help them. By reducing the symptoms of depression and helping of their needs, we hope these can help to improve the quality of life of the elderly. In conclusion, in Bedok community, the aging population is increasing. The number of elderly people that will be diagnosis with depression also will increase in the future. With the help of the community nurses, we hope that the three level of prevention and health promote can be implemented in Bedok sociality to reduce the rate of elderly from getting depression in their end of life and to improve the quality of life for those depression patients.
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