The prevalence of clinically significant depression among elderly people receiving home care services is estimated to range from 15% to 26%. Few homecare patients receive appropriate management of depression. Older suicide victims have often had late onset depression that was not detected or treated, although typically these individuals have had contact with their primary care physicians prior to their deaths. A randomized clinical trial of 500 adults, 65 years of age and older, will test a collaborative home care depression model designed to improve depression care in home health services. In cooperation with the patient's primary care physician, homecare registered nurses, physical therapists, psychiatric nurses, and social workers provide screening for depression, Problem-Solving Treatment, and antidepressant medication follow-up. A psychiatrist provides ongoing consultation to the patient's physician and homecare depression care specialists. The depression care model is integrated within standard homecare practices with components that are feasible in real world practice. The study will assess the effects of the depression care model on patient's health outcomes, satisfaction, and social functioning as compared to usual care. Usual care has been enhanced through staff training regarding depression among the elderly, a structured routine screening protocol, and provision of current depression practice guidelines to referring primary care physicians. Preliminary data on the detection of major depression and dysthymia and on implementation problems and solutions will be presented.
Learning Objectives: At the conclusion of this presentation, participants will be able to: (1) Identify the major barriers to older adults' receipt of care for depression, and (2) Describe four key considerations for implementation of Project HOPE-D.
Keywords: Depression, Home Care
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: SunPlus Home Care
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.