Evaluating Depression Management for Elderly Clients in Home Health Care

Abstract

Depression affects 350 million people worldwide and is considered the primary cause of disability internationally (World Health Organization, 2012). Depression often goes underdiagnosed and undertreated in all ages, but even more so in older adults as it may be mistaken for a normal part of aging. (Center for Disease Control [CDC], 2012). The development of depression can result in increased rates of rehospitalization and increased risk for cognitive decline and mortality, including suicide (Geriatric Mental Health Foundation, 2010). One in seven elderly clients receiving home health services meet criteria for major depression, and one in three have clinically significant depression (Bruce, et al., 2011). Home health nurses are responsible for providing 85% of skilled home health care to this population, placing these nurses in a position to serve a vital role in helping these clients through effective screening and management interventions (Brown, Raue, Roos, Sheeran & Bruce, 2009). This project was implemented at two home health agencies located in eastern North Carolina. The purpose of the project was to compare usual practice with best practice for the identification and management of depression among elderly home health clients. The two project objectives were 1) to explore the current screening tools, processes, and nursing preparation in place at the agency for identifying and managing client depression, and 2) to make 2-4 recommendations, based on findings, to the agency administration and nursing staff. Public health interventions including collaboration and policy development were used, and key informants for this project included staff nurses and administrators at the agency.