When we think about caring for an elderly loved one, we tend to focus on the physical things: can they get out of bed safely, are they eating properly, are they taking their medication? But there is another side to wellbeing that is just as important and far too often overlooked: their mental health.

Depression and anxiety are remarkably common in older adults, yet they frequently go unrecognised and untreated. Families often put changes in mood or behaviour down to "just getting old," but that is not always the case, and it does not have to be accepted as inevitable.

How Common Is It?

The numbers are striking. According to Age UK, around 22% of men and 28% of women over 65 experience symptoms of depression. Anxiety disorders affect around 1 in 10 older adults. And these figures are likely underestimates, because many older people do not report how they are feeling.

There are particular moments in life that increase the risk: bereavement, a health diagnosis, loss of mobility, moving to a new environment, or becoming increasingly isolated. These are the very situations in which home care often begins, which is why we believe mental wellbeing should be at the centre of every care plan, not an afterthought.

Recognising the Signs

Depression and anxiety do not always look the way you might expect in an older person. The signs can be subtle and easily attributed to other causes.

Signs of Depression

• Withdrawing from activities they used to enjoy
• Loss of appetite or significant changes in eating habits
• Sleeping much more or much less than usual
• Persistent low mood or tearfulness
• Saying things like "what is the point" or "I am just a burden"
• Neglecting personal care or losing interest in their appearance
• Increased irritability or agitation
• Physical complaints with no clear medical explanation, such as unexplained pain or fatigue

Signs of Anxiety

• Constant worry about things that previously did not trouble them
• Reluctance to leave the house or try new things
• Difficulty sleeping due to racing thoughts
• Physical symptoms such as a racing heart, breathlessness, or trembling
• Repeatedly asking for reassurance
• Avoiding social situations or becoming clingy with family members
• Increased confusion or difficulty concentrating

The challenge is that many of these signs overlap with other conditions, including dementia. If you notice changes in your loved one's mood or behaviour, it is always worth raising it with their GP, even if you are not sure whether it is "serious enough."

Why It Gets Missed

There are several reasons why mental health problems in older people go unnoticed.

The "just old age" assumption. Both families and healthcare professionals can fall into the trap of assuming that low mood is a normal part of ageing. It is not. While life changes can trigger depression, depression itself is a medical condition that responds to treatment.

Generational attitudes. Many older adults grew up in an era when mental health was not discussed openly. They may feel ashamed, embarrassed, or simply not have the vocabulary to describe what they are experiencing. "I am fine" may be their default response even when they are struggling.

Physical health takes priority. When someone has multiple health conditions, the focus of medical appointments tends to be on physical symptoms. Mental health can slip through the gaps, particularly if no one thinks to ask about it.

Isolation hides the problem. If your loved one lives alone and you visit once a week, you may only see them when they are putting on their best face. The reality of the other six days may be very different.

What Families Can Do

If you suspect your loved one is struggling with their mental health, your instinct to help is exactly right. Here are some practical steps.

Start the Conversation

You do not need to have all the answers. Simply asking "how are you really feeling?" and then listening, truly listening, without rushing to fix things, can make an enormous difference. Let them know it is safe to be honest with you.

Avoid phrases like "cheer up" or "you have got so much to be grateful for." These are well-intentioned but can make someone feel worse. Instead, try: "I have noticed you seem a bit down lately, and I want you to know I am here."

Speak to Their GP

Depression and anxiety in older adults are treatable. A GP can assess whether medication, talking therapy, or a combination would be appropriate. Many people respond well to treatment and see significant improvement in their quality of life.

In Kent, the NHS Talking Therapies service (formerly IAPT) offers free psychological therapy for people of all ages, including older adults. Referrals can be made by a GP or you can self-refer. Do not assume therapy is "only for younger people"; it is effective at any age.

Encourage Connection

Isolation is both a cause and a consequence of poor mental health. Encouraging your loved one to maintain social connections, even small ones, can help break the cycle.

This might mean: - Regular phone calls or video calls with family - Attending a local lunch club or day centre - Visits from friends or neighbours - Joining a community group aligned with their interests

In Kent, organisations such as Age UK North West Kent (01474 564898) and the Kent Association for the Blind offer social groups and activities specifically for older adults.

Consider Companionship Care

Sometimes what a person needs most is not help with physical tasks but simply someone to spend time with. Companionship care involves a carer visiting regularly to provide company, conversation, and gentle encouragement to stay active and engaged.

At Maucare, our carers are trained to notice changes in mood and wellbeing, not just physical health. They build genuine relationships with the people they care for, and that consistent, reliable human connection can be remarkably therapeutic.

How Home Care Supports Mental Wellbeing

Good home care does far more than meet physical needs. For someone experiencing depression or anxiety, the routine and reliability of regular care visits provides structure and something to look forward to. The relationship with a consistent carer gives them someone to talk to who genuinely knows them.

Our carers also encourage the small things that make a real difference: getting dressed and sitting in the lounge rather than staying in bed all day, having a proper meal rather than skipping lunch, going for a short walk to the end of the garden. These are not dramatic interventions, but they are the building blocks of better mental health.

When our team notices that someone's mood is declining, we talk to the family and, with their permission, flag it with the GP. Because we see your loved one regularly, often more than anyone else does, we are well placed to notice the early signs of a problem before it becomes a crisis.

You Matter Too

Finally, a word for you, the family member reading this. Supporting a loved one with depression or anxiety takes its own toll. You may feel helpless, frustrated, or guilty that you cannot fix it. Those feelings are completely normal.

Please do not neglect your own wellbeing. Speak to your own GP if you are struggling. Contact Carers First on 0300 303 1555 for support specifically for unpaid carers in Kent. And know that arranging professional care for your loved one is not a sign of failure; it is a sign of love.

If you would like to talk about how we can support your loved one's mental wellbeing as part of their care, we would welcome that conversation. Call us on 01322 466 578.