How to Help Depressed Older People Living in Residential Care: A Multifaceted Shared-Care Intervention for Late-Life Depression

• Published in: International psychogeriatrics 2001-12, Vol.13 (4), p.477-492
• Main Authors: Llewellyn-Jones, Robert H., Baikie, Karen A., Castell, Sally, Andrews, Carol L., Baikie, Anne, Pond, C. Dimity, Willcock, Simon M., Snowdon, John, Tennant, Chris C.
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Combined Modality Therapy; Depressive Disorder - diagnosis; Depressive Disorder - psychology; Depressive Disorder - therapy; Female; Frail Elderly - psychology; Geriatrics; Homes for the Aged; Humans; Inservice Training; Intermediate Care Facilities; Male; Medical sciences; Mental depression; Miscellaneous; Needs Assessment; New South Wales; Older people; Patient Care Team; Patient Education as Topic; Physicians; Primary care; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Retirement communities; Social Environment; Treatments
• ISSN: 1041-6102; 1741-203X
• DOI: 10.1017/S104161020100789X

Objective: To describe a population-based, multifaceted shared-care intervention for late-life depression in residential care as a new model of geriatric practice, to outline its development and implementation, and to describe the lessons learned during the implementation process. Setting: A large continuing-care retirement community in Sydney, Australia, providing three levels of care (independent living units, assisted-living complexes, and nursing homes). Participants:) The intervention was implemented for the entire non-nursing home population (residents in independent and assisted living: N = 1,466) of the facility and their health care providers. Of the 1,036 residents who were eligible and agreed to be interviewed, 281 (27.1%) were classified as depressed according to the Geriatric Depression Scale. Intervention Description: The intervention included: (a) multidisciplinary collaboration between primary care physicians, facility health care providers, and the local psychogeriatric service; (b) trainning for primary care physicians and other facility health care providers about detecting and managing depression; and (c) depression-related health education/promotion programs for residents. Conclusions: The intervention was widely accepted by residents and their health care providers, and was sustained and enhanced by the facility after the completion of the study. It is possible to implement and sustain a multifaceted shared-care intervention for late-life depression in a residential care facility where local psychogeriatric services are scarce, staff-to-resident ratios are low, and the needs of depressed to residents are substantial.