Identifying and treating depression at the end of life and among the bereaved

Depression is a common psychological condition among patients at the end of life, and it can also affect a patient's family both before and after their loved one's death. It is estimated that around 25% of palliative care patients are diagnosed with depression during their illness, and that a majority experience depressive symptoms. If left unrecognized and untreated this may lead to more severe illness symptoms, poor communication with family members and, ultimately, reduced quality of life and a poor prognosis. Early assessment and management using appropriate tools as a guide are essential for enabling early treatment so that patients can be comfortable and meet unfulfilled goals during their end-of-life care. Palliative care staff play an essential part in recognizing and treating depression in patients, and by focusing on those at risk they can help to reduce the number who will go on to develop the condition. This article provides an overview of the nature of the problem in palliative care patients and bereaved families, looking at how targeted monitoring and intervention can help to alleviate the burden in the former and how support can benefit the latter.