Approximately 44% of seniors in Canada who live in residential care homes are diagnosed with or have symptoms of depression, according to a new CIHI (Canadian Institute for Health Information) study published today.
Depression Among Seniors in Residential Care is one of the largest studies of its kind in Canada to look at the prevalence of depression and the impact it has on individuals living in residential care facilities, such as long-term care, nursing or personal care homes.
The study included nearly 50,000 residents age 65 and older across Nova Scotia, Ontario, Manitoba, Saskatchewan and the Yukon, and was based on data from CIHI’s Continuing Care Reporting System.
While the study found that 26% of seniors living in a residential care facility were diagnosed with depression, an additional 18% had depression symptoms with no documented diagnosis. Those with a score of 3 or more on the Depression Rating Scale were considered to have symptoms of depression – the scale measures symptoms such as persistent anger, tearfulness and repetitive anxiety.
Nancy White, Manager of Home and Continuing Care Development at CIHI, said:
Depression can have a major impact on individuals’ quality of life and also represents significant costs to society. Research also suggests that among seniors depression often goes unrecognized and therefore untreated. As Canada’s population ages, and more people could potentially move into residential care, it is important to understand how this population is affected by depression or depression symptoms in order to be able to identify the right treatment options and improve quality of life for these seniors.
The study shows seniors, regardless of whether they were diagnosed with the mental disorder, who had symptoms of depression experienced considerable medical, social, functional and quality-of-life problems.
A senior with depressive symptoms is more likely to display aggressive behavior, have conflicts with family members or staff, and withdraw from activities of interest. They were also significantly more likely to have sleep problems, were less self-sufficient than seniors with no symptoms of depression, and were more likely to have difficulty communicating.
Dr. Marie-France Rivard, chair of the Seniors’ Advisory Committee of the Mental Health Commission of Canada and professor of psychiatry at the University of Ottawa, explained:
Moving into a care facility is usually quite stressful and often prompted by significant losses in terms of health, degree of independence and/or social supports. This can contribute to the development of a depressive disorder that may include feelings of hopelessness, self-blame and loneliness, possibly accompanied by physical symptoms such as poor sleep, decreased appetite and lack of energy, often leading to social withdrawal.
According to the study, elderly individuals who were diagnosed with and had symptoms of depression were twice as likely to receive a mental health evaluation from a licensed mental health practitioner and more than twice as likely to receive antidepressant medication than those with symptoms but no diagnosis. A very small number of residents received psychological therapy, regardless of the presence of symptoms and/or a diagnosis.
Two-thirds of seniors with a documented diagnosis showed no or only mild symptoms of depression on the Depression Rating Scale, suggesting that their symptoms were being effectively managed.
Previous research has shown that diagnosing depression among seniors can be challenging. Standardized clinical assessment instruments like the RAI-MDS 2.0 used in this study offer better information to detect seniors at risk of poor outcomes as a result of depression or depression symptoms. By focusing on symptoms and behaviors, the RAI-MDS 2.0 provides a more comprehensive view of the problems faced by seniors with depression or depression symptoms, and can be used to track the effectiveness of interventions that were put into place.
At Copper Ridge Place in Whitehorse, Yukon, care providers have been using the outcome scores of this assessment instrument for the last three years to better understand their patient population and provide more focused and comprehensive care plans.
Cynthia Fraser, a licensed practical nurse and an MDS assessor at the facility, said:
We assess our residents with the RAI-MDS 2.0 when they first enter the facility and we often identify people with depression symptoms that would have previously gone undetected. Once we identify a problem we present this to the team who can work with the residents to address their needs. As a result, we have seen real success in reducing residents’ depression symptoms and improving the quality of their lives.
“Depression among seniors in residential care” (PDF)
Source – The Canadian Institute for Health Information (CIHI)
Written by Christian Nordqvist