Depression & anxiety in clients — what to watch and report

Lasting sadness, lost interest, sleep or appetite changes, and talk of being a burden are reportable — depression in older adults is a treatable illness, not normal aging. Any talk of death or self-harm: take it seriously and call your supervisor now; if there's an immediate plan, call 988 or 911.

1. 1Watch for lasting changes (2+ weeks): sadness or emptiness, dropping activities they used to enjoy, sleeping much more or less, appetite change, neglecting hygiene, hopeless talk.
2. 2Anxiety signs: constant worry, restlessness, avoiding leaving the house or being alone, physical complaints with no clear cause.
3. 3Listen without judging or 'fixing': 'That sounds really hard' goes further than 'cheer up' or 'you have so much to be thankful for'.
4. 4Take every mention of death, self-harm, or 'everyone would be better off without me' seriously — report to your supervisor the same day, never promise to keep it secret.
5. 5If the client has a plan or means to hurt themselves right now: do not leave them alone; call 988 (or 911 if in danger) and then your supervisor.
6. 6Keep routines, daylight, gentle activity, and social contact going — they genuinely help, alongside (never instead of) professional care.

You are not expected to counsel or diagnose — your job is to notice, respond with warmth, and get the observation to people who can act on it.