Depression prevalence in newly-admitted aged care residents
- More than half of all permanent aged care residents had symptoms of depression.
- About 45% of newly admitted residents admitted to permanent aged care had symptoms of depression.
- Nearly one-third of permanent aged care residents with symptoms of depression did not have a medical diagnosis, nor was one being sought.
- Women were more likely than men (69% compared with 64%) to have a diagnosis, or one being sought.
Findings from research investigating GP led depression screening in residential care
- High rate of cognitive impairment among people living in aged care facilities is recognised as making it more difficult for general practitioners (GPs) to detect and treat depression
- Study found GPs identified ¼ of their patients had Cornell Scale scores indicative of probable major depression that was either unrecognised or inadequately treated.
- Note: GPs are less likely to attend to the mood state of patients in a nursing home than patients sitting in front of them in the consulting room.
Recommendations from the study
- GPs to regularly monitor patients diagnosed with depression
- The Cornell Scale for Depression in Dementia be used as part of the standard assessment process and is administered on admission of a new resident, routinely (e.g. annually), and as the need arises (when a change in behaviour occurs that may be associated with depression).
- Patients with repeat high scores may indicate the need for further assessment by a psychologist or psycho geriatrician.
Source: Davidson S., Koritsas S., O’Connor D., Clarke D., (2006).
Risk factors for older people
Anxiety and depression in older people may occur for different reasons, but physical illness or personal loss can be common triggers.
Factors that can increase an older person’s risk of developing anxiety or depression include:
- an increase in physical health problems/conditions e.g. heart disease, stroke, Alzheimer’s disease
- chronic pain
- side-effects from medications
- losses: relationships, independence, work and income, self-worth, mobility and flexibility
- social isolation
- significant change in living arrangements e.g. moving from living independently to a care setting
- admission to hospital
- particular anniversaries and the memories they evoke
Psychological treatments
There are a variety of psychological treatments for depression – in non-melancholic depression psychological therapy may be the sole or major treatment (without medication being used). Some of the main ones include:
- Mindfulness therapy
- Cognitive Behaviour Therapy (CBT)
- Interpersonal Therapy (IPT)
Psychologists and residential care
Current evidence suggests that the use of psychologists for dealing with behaviour problems in older people in residential care results in substantial cost savings, notably:
- a tenfold reduction in hospitalisation
- a threefold reduction in drug side effects
- halving of the number of visits by general practitioners
- a quarter the number of visits by geriatric psychiatrists
MWP 