Widespread Depression in Elderly Is Under-Reported

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Source: Montefiore Medical Center

Released: Mon 30-Jan-2006, 13:40 ET

Widespread Depression in Elderly Is Under-Reported

http://www.newswise.com/articles/view/517613/?sc=dwhp

Description

An innovative, year-old program at Montefiore Medical Center may offer a

model for identifying and treating the homebound elderly with

depression. The program trains all of its home care agency staff to

identify patients with depression and refer them to a Montefiore

psychiatrist.

Newswise — New York City’s Department of Health and Mental Hygiene this

week announced that depression in senior citizens is “a serious and

under diagnosed condition.”

An innovative, year-old program at Montefiore Medical Center may offer a

model for identifying and treating the homebound elderly with

depression. The program trains all of its home care agency staff --

nurses, social workers and therapists -- to identify patients with

depression and refer them to a Montefiore psychiatrist who provides

treatment in the patient’s home.

“This is the only program in greater New York in which a geriatric

psychiatrist is integrated into a home care agency,” said Kennedy,

MD, director of the initiative and chief of Montefiore’s Geriatric

Psychiatry program. “Even though one in eight elderly home care patients

suffers from depression, few home care agencies incorporate mental

health services into their programs -- and fewer still provide

psychiatric care.

“In our first year of this program, home care nurses, social workers and

therapists referred 200 patients and 130 were seen by a psychiatrist,”

said Dr. Kennedy. “A majority of the patients were elderly and we were

successful in reducing their depression.”

The three-year experimental program is funded by the UJA Federation of

New York, which provided a $150,000 subsidizing grant in 2005.

“The Montefiore Home Health Agency cares for more than 5,000 patients

annually and we can estimate that as many as 678 elderly patients could

suffer from depression,” said Dr. Kennedy. He based this estimate on a

study in the American Journal of Psychiatry in 2002, that showed on

average 13.5 percent of home care patients suffer from depression. The

results to date of Montefiore’s new program will be reported at the

American Association for Geriatric Psychiatry’s annual meeting in March.

Training Sessions Are The Key To Success

“Key to the program’s success is training our staff to recognize

depression,” said a Marcus, MD, project psychiatrist in Montefiore’s

Division of Geriatric Psychiatry. Each nurse, social worker and

therapist receives four hours of specialized training sessions.

“Without this training, home care providers would have difficulty making

accurate assessments of depression and suicidal tendencies among older

home care patients,” said Dr. Marcus.

The nurses are trained under a special program operated by the Cornell

Home Care Research Partnership. A Montefiore psychiatrist is present at

each training session. This establishes a relationship between that

psychiatrist and the Home Health Agency staff being trained.

Causes and Implications of Depression In The elderly

“Depression among elderly home care patients can develop for any number

of reasons, but frequently it is a result of a disability (such as a hip

fracture), memory loss or loss of a loved one,” said Dr. Kennedy. “If a

home care nurse recognizes depression, she or he refers the patient to

one of the agency’s social workers, who consults with a program

psychiatrist. Patients with active suicidal tendencies, psychosis and

those thought to need medication are referred for psychiatric

evaluation,” said Dr. Kennedy. “Without psychiatric help, these patients

tend to deteriorate physically, as well. They tend to cut back on

eating, exercise, socializing and taking their medications. This is what

we are working to prevent, loss of quality of life and deteriorating

physical health.”

Dr. Kennedy says that Medicare and Medicaid currently reimburse for

these psychiatric visits, but the level of reimbursement is not

adequate. “While inadequate reimbursement may be one factor discouraging

psychiatric home care, not having the home care agency staff trained to

recognize depression is a larger, more pervasive problem,” said Dr. Kennedy.

Montefiore Medical Center, The University Hospital and Academic Medical

Center for the Albert Einstein College of Medicine, ranks among the top

one percent of all US hospitals based on its investments in medical

innovation and cutting-edge technology.

Montefiore invests more in order to enable compassionate, personalized

care and the most positive outcomes for patients and their families in

New York, the tri-state area and beyond.

Montefiore’s unique combination of ‘state-of-the-art’ technology with

‘state-of-the-heart’ medical and nursing care in a teaching and research

environment provides patients with access to world-class medical

experts, the newest and most innovative treatments and the best medical

center experience anywhere.

This 1,062 bed medical center includes the Henry and Lucy Moses

Division, the Jack D. Weiler Hospital and The Children’s Hospital at

Montefiore, a large home healthcare agency and a 21-site medical group

practice located throughout the Bronx and nearby Westchester.

Montefiore treats all major illnesses and has distinguished centers of

excellence in cardiology and cardiac surgery, cancer care, tissue and

organ transplantation, children's health, women's health, surgery and

the surgical subspecialties. Montefiore Medical Center focuses on

providing family-centered healthcare in a nurturing environment that

extends well beyond its hospital and ambulatory settings.

--

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