Depression

Evidence suggests that depression is associated with high levels of morbidity and mortality and adversely affects the quality of life and social functioning (Katona, 1994). Some of these patients do not move about much, and with depression added to this premise, the transition from what these patients were used to, to a completely new environment is usually traumatic.

Nursing care providers can ease the trauma felt by these new arrivals by conducting assessments to determine whether these individuals are suffering from depression, so as to remedy this malady as soon as possible.

Depression affects approximately 5% of the population at any one time, with depressive symptoms being more common in people over 65, with prevalence estimates ranging from 10 to 15% (Baldwin, 1995). Depression in nursing homes has been recognized as especially problematic states Ames, (1994). Depression is not a normal consequence of aging, and it is known to be under-recognized and under-treated, especially in hospitals, outpatient settings, and nursing homes. (Patry, 2004).

Problem Background

Older people entering long-term care facilities face major adjustment challenges and are particularly vulnerable to mental health problems (Murphy, 1982; Mikhail, 1992; Manion & Rantz, 1995). Newly admitted residents in long-term care facilities are particularly vulnerable to depression and the early recognition and treatment of depression is therefore crucial around the time of admission to a home. (Bagley et al., 2000). By day 14 of their nursing home stay, thirty-eight percents of the admitted residents sampled in a study conducted by Boyle et al. (2004) were positive for depressive symptoms. Depression then is still a highly significant problem among those admitted to a nursing home. (Boyle, 2004).

In contrast, the authors’ stated that depression recognition in the nursing homes has improved. Michigan's Quality Improvement Organization (MPRO) conducted a study of 14 nursing facilities to improve the accuracy of assessments, targeting, and monitoring of care. 69% of participants were female 46% were 76-85 and 37% were 86 or older. Among men, 24% were age 75 or younger 51% were 76-85 and 25% were 86 or older.

It was found that out of 818 residents, 313 (38%) had depressive symptoms by day 14. Out of the 313, 213 (68%) were admitted with a diagnosis of depression. (Boyle, et al., 2004). The nursing homes in this study use the Geriatric Depression Scale (GDS) to assess symptoms of depression; however, its use is highly selective. (Boyle, et al., 2004). The authors stated that additional research in developing strategies to ensure continuity of care to people across treatment settings would be useful.