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Depression in nursing homes

Published online by Cambridge University Press:  03 August 2010

John Snowdon
John Snowdon*
Affiliation:
Sydney Medical School and Concord Hospital, Sydney, Australia
*
Correspondence should be addressed to: Clinical Professor John Snowdon, Sydney Medical School, Jara Unit, Concord Hospital, Sydney, NSW 2139, Australia. Phone: +61-2-97675000; Fax: +61-2-97678951. Email: jsnowdon@mail.usyd.edu.au.
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Abstract

Background: Although studies have shown the prevalence of depression in nursing homes to be high, under-recognition of depression in these facilities is widespread. Use of screening tests to enhance detection of depressive symptoms has been recommended.

Methods: This paper aims to provoke discussion about optimal management of depression in nursing homes. The utility of the Cornell Scale for Depression in Dementia (CSDD) is considered. CSDD data relating to residents assessed in 2008–2009 were collected from three Sydney nursing homes.

Results: CSDD scores were available from 162 residents, though raters stated they were unable to score participants on at least one item in 47 cases. Scores of 13 or more were recorded for 23% of residents in these facilities, but in most of these cases little was documented in case files to show that the results had been discussed by staff, or that they led to interventions, or that follow-up testing was arranged.

Conclusions: Results of CSDD testing should prompt care staff (including doctors) to consider causation of depression in cases where residents are identified as possibly depressed. In particular, there needs to be discussion of how to help residents to cope with disability, losses, and feelings of powerlessness. Research is needed, examining factors that might predict response to antidepressants, and what else helps. Accreditation of nursing homes could be made to depend partly on evidence that staff regularly search for, and (if found) ensure appropriate responses to, depression.

Keywords

screeningCornell Scalecausative factorsdiagnosisnursing staff
Type
Review Article
Information
International Psychogeriatrics , Volume 22 , Special Issue 7: Focus on mental health issues in long-term-care homes , November 2010 , pp. 1143 - 1148
Copyright
Copyright © International Psychogeriatric Association 2010

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