Depression care services and telehealth technology use for homebound elderly in the United States.

Despite the increasing evidence for the effectiveness of telehealth technology in screening and treating depression in older adults, they have been slowly adopted by Home Health Care (HHC) agencies. Therefore, this study was conducted to determine how HHC agencies perceive and use telehealth technology for depression care among homebound older adult patients. : Five-hundred-and-sixteen staff from the National Association for Homecare & Hospice (NAHC) member home health care agencies completed the online survey.

Evaluation of interprofessional health care team communication simulation in geriatric palliative care.

An interprofessional education (IPE) simulation-based geriatric palliative care training was developed to educate health professions students in team communication. In health care, interprofessional communication is critical to team collaboration and patient and family caregiver outcomes. Studies suggest that acquiring skills to work on health care teams and communicate with team members should occur during the early stage of professional education.

Key determinants to using telehealth technology to serve medically ill and depressed homebound older adults.

Despite the increasing evidence for the effectiveness of telehealth technology in screening and treating chronic diseases, and comorbid depression among older adults, they have been slowly adopted by home health care (HHC) agencies. Therefore, this study aimed to identify factors that determine telehealth technology adoption. Twenty directors from the National Association for Homecare & Hospice member agencies completed a 45-min telephone interview.

Using Problem-solving Therapy to Improve Problem-solving Orientation, Problem-solving Skills and Quality of Life in Older Hemodialysis Patients.

Objectives: To determine the effectiveness of Problem-Solving Therapy (PST) in older hemodialysis (HD) patients by assessing changes in health-related quality of life and problem-solving skills.

Methods: 33 HD patients in an outpatient hemodialysis center without active medical and psychiatric illness were enrolled. The intervention group (n = 15) received PST from a licensed social worker for 6 weeks, whereas the control group (n = 18) received usual care treatment.

Training social work students to recognize later-life depression: Is standardized patient simulation effective?

Professional social workers are the largest provider of mental health services in the nation, yet they receive little coursework or clinical training in late-life depression unless they are in a gerontology specialization. Simulation training offers academic experiences that evoke conditions of the real world in a practical way. One hundred and four graduate social work students consented and completed the Standardized Patient Simulation course consisting of a human simulator interview, pre- and postdebriefing on late life depression, and self and faculty ratings of outcome measures.

Psychological Distress and Help-Seeking by Residents of a Neighborhood Naturally Occurring Retirement Community (NNORC).

This article presents findings from an annual program survey of residents of a horizontal neighborhood naturally occurring retirement community (NNORC). The study explored the relationship between several factors (age, co-residents, number of chronic illnesses, self-reported health, loneliness, sense of mastery, locus of control, pain, and psychological distress) and their ability to predict general health, level of psychological distress, and the quantity and type of help-seeking behaviors. Although residents generally reported moderate to high levels of chronic disease, pain, loneliness, and concerns about life issues, 25% of them sought no help from any of the listed resources, and 65% sought help from only one of seven resources.

Telehealth Utilization for Chronic Illness and Depression Among Home Health Agencies: A Pilot Survey.

This pilot survey study explores current telehealth use among home health care agencies for chronic illness and depression care, and identifies factors associated with agencies' perception and intention to use telehealth. Between June and August 2014, 73 directors and 13 staff nurses (N = 86) from the Pennsylvania Homecare Association member agencies participated in an online survey. Eighty-five percent of telehealth provider agencies reported utilizing telehealth for monitoring health status while only 7.

Problem-solving therapy to improve depression scores among older hemodialysis patients: a pilot randomized trial.

Aims: Depression is common among dialysis patients and is associated with adverse outcomes. Problem-solving therapy (PST) is effective for treating depression in older patients with chronic illness, but its effectiveness has never been reported in hemodialysis (HD) patients. We investigated the feasibility and satisfaction of PST and its impact on depression scores among older HD patients.

Integrated telehealth care for chronic illness and depression in geriatric home care patients: the Integrated Telehealth Education and Activation of Mood (I-TEAM) study.

Objectives: To evaluate an integrated telehealth intervention (Integrated Telehealth Education and Activation of Mood (I-TEAM)) to improve chronic illness (congestive heart failure, chronic obstructive pulmonary disease) and comorbid depression in the home healthcare setting.

Design: Randomized controlled trial.

Setting: Hospital-affiliated home healthcare setting.

Meta-analysis of the effect of cardiac rehabilitation interventions on depression outcomes in adults 64 years of age and older.

Heart disease is a major cause of hospitalization and is associated with greater impairment than arthritis, diabetes mellitus, or lung disease. Depression is prevalent and a serious co-morbidity in heart disease with negative consequences including higher levels of chronic physical illness, decreased psychological well-being, and increased health care costs. The objective of the study was to examine with meta-analysis the impact of community-based cardiac rehabilitation (CR) treatment on depression outcomes in older adults.

Outcomes of a telehealth intervention for homebound older adults with heart or chronic respiratory failure: a randomized controlled trial.

Purpose:  Telehealth care is emerging as a viable intervention model to treat complex chronic conditions, such as heart failure (HF) and chronic obstructive pulmonary disease (COPD), and to engage older adults in self-care disease management. 

Design And Methods:  We report on a randomized controlled trial examining the impact of a multifaceted telehealth intervention on health, mental health, and service utilization outcomes among homebound medically ill older adults diagnosed with HF or COPD. Random effects regression modeling was used, and we hypothesized that older adults in the telehealth intervention (n = 51) would receive significantly better quality of care resulting in improved scores in health-related quality of life, mental health, and satisfaction with care at 3 months follow-up as compared with controls (n = 51) and service utilization outcomes at 12 months follow-up.

Integrating mental health parity for homebound older adults under the medicare home health care benefit.

Despite high rates of mental illness, very few homebound older adults receive treatment. Comorbid mental illness exacerbates physical health conditions, reduces treatment adherence, and increases dependency and medical costs. Although effective treatments exist, many home health agencies lack capacity to effectively detect and treat mental illness.

Anxiety and related symptoms in older persons with dementia: directions for practice.

Anxiety disorders and related symptoms commonly occur in older people with cognitive impairment or dementia, significantly worsening functioning and reducing quality of life. This review of the literature outlines the extent of the problem, and focuses on current best practices in psychosocial interventions anxiety in persons with dementia. Discussion follows on promising nonpharmacological interventions that are recommended for further consideration and future research.

Problem solving therapy for subthreshold depression in home healthcare patients with cardiovascular disease.

Background: Randomized trial evaluated problem-solving therapy in home care (PSTHC) for homebound older adults with cardiovascular disease receiving acute home care services. This study hypothesized that compared with usual care plus education intervention, home-based PST-HC would significantly reduce depression and anxiety scores, lead to improved quality of life, and greater satisfaction with treatment among elderly with cardiovascular disease.

Methods: Thirty-eight participants were recruited from a university-affiliated home healthcare agency for the trial.

Social work practitioner knowledge and assessment of late-life depression.

Late-life depression has attracted considerable attention in the social work literature. This study examined levels of knowledge and self-efficacy (confidence) in evaluation of depression in late life among a random sample of social workers (N = 168) from the National Association of Social Workers. Relationships among knowledge on aging, job-related variables, and predictors of knowledge of geriatric depression were examined.

Assessment of a brief CES-D measure for depression in homebound medically ill older adults.

Depressive symptoms are highly prevalent among medically ill homebound elderly and are associated with significant functional decline, lower quality of life, and increased health care utilization. Despite this, depression is generally underdiagnosed and undertreated among medically ill homebound older adults. The objective of this study was to determine the validity of a brief depression measure (CES-D) and examine the nature of depressive symptoms reported by the older sample.

A systematic review of community-based health interventions on depression for older adults with heart disease.

Purpose: This systematic review examined the effectiveness of community-based heart-health interventions on depression outcomes among homebound elderly (64 years and older) with heart disease.

Design And Methods: A comprehensive literature search and meta analysis was performed to evaluate randomized controlled trials examining outpatient or home-based interventions. Methodological quality was assessed by standard criteria developed by the Cochrane Collaborative Initiative.

Depression Screening in Medically Ill Homecare Elderly.

PURPOSE: This article provides data on a depression screening model (HOME) in acute home health care designed to detect clinical depression among medically ill homebound older patients. The model was developed to address the lack of mental health services in home health care settings and to specifically improve geriatric depression screening as part of routine care. Authors report on the concordance of homecare and research interview ratings of depression in older homecare patients.

Problem-solving therapy for late-life depression in home care: a randomized field trial.

Objective: The authors present data from a pilot research program initiated to develop, refine, and test the outcomes of Brief Problem-Solving Therapy in Home Care (PST-HC) that targets the needs of older adults identified with severe depressive symptoms in an acute home care setting.

Methods: A pilot randomized clinical trial compared the impact of PST-HC to usual care (UC) in a sample of older medically ill home care patients identified with severe depressive symptoms. Forty patients were randomly assigned to either six weekly sessions of PST-HC in their home or standard home care services.

New York State case manager survey: urban and rural differences in job activities, job stress, and job satisfaction.

The impact of stress in the workplace on employees' well-being and effectiveness has been increasingly recognized in recent years. The purpose of this research was to study the quality of working life of case managers in urban and rural community mental health programs in New York State. The objectives were to describe specific job activities and examine differences in the perceptions of job stress and job satisfaction.

Predictors of depressive mood, occupational stress, and propensity to leave in older and younger mental health case managers.

Age differences and relationships between occupational stressors, work environment, depressed mood, and propensity to leave were examined among 263 case managers (CMs) in community-based mental health agencies. For younger CMs, satisfaction with the supervisor, perceived job pressure and lack of organizational support were significant predictors of propensity to leave the job. Older CMs who reported lower satisfaction with financial rewards, the type of work they did, and greater use of avoidance/resignation and help seeking coping strategies, were more likely to rate themselves higher on the depressed mood scale.

Mental health attitudes among Caucasian-American and Korean counseling students.

Attitudinal differences among 104 Korean and 107 Caucasian-American counseling students was investigated using the Mental Health Values Questionnaire (MHVQ). Caucasian-American students reported significantly greater attitudinal scores on the negative traits, untrustworthiness, and unconventional reality subscales. In contrast, the Korean sample reported higher attitudinal scores on the achievement and affective control subscales.

Kin and nonkin social supports in a community sample of Vietnamese immigrants.

A two-wave longitudinal study is reported that examined the relationship between social support and depression among 79 Vietnamese immigrants living in a multicultural community in a large urban setting. Extending past work, the research employed a refined perspective on social supports, as measured by kinship networks, nonkinship networks, perceived satisfaction with the supports, and their influence on psychological distress as measured by the Center for Epidemiologic Study Depression Scale. Results indicated that sociodemographic variables did not predict depression scores.