Identification of depressive disorder among older people in care homesa feasibility study (original) (raw)
Related papers
Mental Health and …, 2011
This chapter is in two main parts. The fi rst part will offer an overview of the care home population including a profi le of their mental health and what is known about the prevalence of depression amongst care home residents. The second half will focus on the assessment and management of depression in care homes, interventions to alleviate symptoms of depression and what more could be done to improve outcomes, including the contribution of primary care services.
Treating depression in nursing homes: practice guidelines in the real world
The Journal of the American Osteopathic Association, 2003
Depression in nursing home residents is a common phenomenon, though there is a wide range in the severity of this disorder as experienced by elderly adults in the United States. Treating older patients for depression is costly in both human and financial terms. The authors review guidelines and recommendations for the diagnosis of depression and medical treatment of depressed elderly adults from the 1993 Clinical Practice Guidelines for Depression in Primary Care by the US Agency for Health Care Policy and Research (now the Agency for Healthcare Research and Quality), making note also of similar guidelines provided by the American Medical Directors Association in 1996 and those provided by the American Psychiatric Association in 2000. In November 1999, the authors used a Delphi survey to gather data from prescreened panelists (N = 10) to have the panel review and clarify the importance and feasibility of each "A" rated item in the US Agency for Health Care Policy and Resea...
BMC geriatrics, 2005
The objective of this study was to examine the Minimum Data Set (MDS) and Geriatric Depression Scale (GDS) as measures of depression among nursing home residents. The data for this study were baseline, pre-intervention assessment data from a research study involving nine nursing homes and 704 residents in Massachusetts. Trained research nurses assessed residents using the MDS and the GDS 15-item version. Demographic, psychiatric, and cognitive data were obtained using the MDS. Level of depression was operationalized as: (1) a sum of the MDS Depression items; (2) the MDS Depression Rating Scale; (3) the 15-item GDS; and (4) the five-item GDS. We compared missing data, floor effects, means, internal consistency reliability, scale score correlation, and ability to identify residents with conspicuous depression (chart diagnosis or use of antidepressant) across cognitive impairment strata. The GDS and MDS Depression scales were uncorrelated. Nevertheless, both MDS and GDS measures demons...
Decreasing hospitalization rates for older home care patients with symptoms of depression
Journal of the American Geriatrics Society, 1998
To target medically ill older home care patients with symptoms of depression in order to reduce their rate of hospitalization. A case-control study. A private, nonprofit home care organization, the Visiting Nurse Association of St. Louis. Home care patients 65 years of age and older with symptoms of depression who were participants of a Total Quality Management (TQM) intervention (n = 81) were compared with an historical control of home care patients 65 years of age and older with symptoms of depression (n = 69). Utilization of TQM principles to develop a plan including: (a) an educational seminar on depression for home care staff involved in the project; (b) letters to physicians introducing the TQM project; (c) use of the Geriatric Depression Scale (GDS) for screening; (d) recommendation to the primary physician of a home social service (SS) consultation for patients with a GDS of 10 to 14; (e) recommendation to the primary physician of three interventions for patients with a GDS ...
Prevalence of depression and depression recognition in nursing homes
Social Psychiatry and Psychiatric Epidemiology, 2001
s Abstract Background The aim of this study was to estimate the prevalence of depression among nursing home residents, and the extent of depression recognition among nursing home staff. Random samples totaling 319 nursing home residents, drawn from a simple random sample of six downstate New York nursing homes were evaluated psychiatrically for depression. Samples of nurse aides, nurses and social workers also assessed the same residents for the presence of depressive symptomatology. Method Psychiatrists assessed residents using the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) criteria.Depression measures used were the Cornell Scale for Depression in Dementia, the Feeling Tone Questionnaire, the Hamilton Depression Rating and the Structured Clinical Interview for DSM-III-R Personality Disorders Scale. Nursing and social services staff assessed residents using Depression Recognition Measures. Results Based on psychiatric evaluation, the prevalence estimate for probable and/or definite major depressive disorder among testable subjects was 14.4 % (95 % CI of 10.6 %-19.3 %); 15.4 % were not able to be assessed due to their refusal, impairment of consciousness, or severe physical illness. The estimate for minor depression was 16.8 % (95 % CI of 12.6 %-21.9 %). The prevalence of significant depressive symptomatology (including the category of possible de-pression) was 44.2 % (95 % CI of 38.2 %-50.3 %). The corresponding estimates of any depression were 19.7 % for social workers, 29 % for nurses and 32.1 % for nurse aides. Conclusions The prevalence of depressive disorders among nursing home residents is high; depression recognition is relatively low, with only 37 %-45 % of cases diagnosed by psychiatrists recognized as depressed by staff. A structured Depression Recognition Scale increased the rates of recognition (sensitivity of staff ratings) to 47 %-55 %, demonstrating the utility of the scale in increasing awareness of symptomatology. s
Recognising depression in residential facilities: an Australian challenge
International journal of geriatric …, 2008
Background Depression in aged care facilities (ACFs) is reportedly under-recognised and under-treated. Observer-rated and self-rated depression rating scales can help identify cases of depression, and could be used to estimate the prevalence of depression in ACFs. Method Direct care staff in 168 ACFs used a survey form and administered the Cornell Scale for Depression in Dementia (CSDD) and (in those able to be tested) the 15-item Geriatric Depression Scale (GDS-15) to every fourth resident. In seven facilities the same subjects were clinically assessed and (where appropriate) diagnosed by a psychiatrist. Results Survey forms and CSDD ratings were completed by staff concerning 91.6% of the one-in-four selected subjects. Their mean age was 82.1 years. CSDD scores of 8 or more, indicating depression, were recorded for 34.7% of the ACF residents, comprising 40.5% of the 1,084 high care (nursing home level) residents, and 25.4% of the 674 low care residents.
Health Science Journal
Background: Depression is a common mental disorder manifested by loss of interest or pleasure, feelings of guilt or low self-esteem, disturbed sleep or appetite, low energy and poor concentration. Depression is a normal part of aging, but unfortunately it is very common in the elderly. Aim: The assessment of the subjective disposition of the elderly as reflected in the last week. Design and Methods: The sample consisted of 200 elderly of 4 nursing homes in Heraklion of Crete. The study was conducted with the quantify-descriptive method. Depression was quantified using the Zung Self-Rating Depression Scale (ZSDS). Analysis included the test x2 analysis, the r-Pearson partial correlation coefficient and the calculation of Cronbach's alpha (α). The data analysis was performed using the statistical programme IBM SPSS 19.0. Results: Cronbach's alpha for the ZSDS questionnaire was 0.81. Most of sample were female (64.5%), aged above 80 years (68.5%), with low level of education (9...
The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2008
To empirically evaluate the psychometric properties of the 15-item Geriatric Depression Scale (GDS-15); determine the optimal cutoff points and screening performance for the detection of major depression; and examine differential item functioning (DIF) to determine the variability of item responses across sociodemographics in an elderly home care population. A secondary analysis of data collected from a random sample study. Homebound subjects newly admitted over a 2-year-period to a large visiting nurse service agency in Westchester, New York. Five hundred twenty-six subjects over age 65, newly admitted to home care for skilled nursing. Major depression was diagnosed using both patient, Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and best estimate procedures. Self-report measures included the GDS-15, activities of daily living (ADL), instrumental ADL, and pain intensity. Cognitive impairment was assessed using the Mini-Men...