期刊
INTERNATIONAL PSYCHOGERIATRICS
卷 13, 期 4, 页码 477-492出版社
SPRINGER PUBLISHING CO
DOI: 10.1017/S104161020100789X
关键词
depressive disorder; depression; aged; aged, 80 and over; homes for the aged; housing for the elderly; collaborative care; primary health care; geriatric psychiatry; health services for the aged; combined modality therapy; patient care team; education, continuing; health promotion; education, continuing, medical; health education; exercise; voluntary workers; frail elderly; socioenvironmental therapy; psychotherapy
Objective: To describe a population-based, multifaceted shared-care intervention for latelife 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) training 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 latelife depression in a residential care facility where local psychogeriatric services are scarce, staff-to-resident ratios are low, and the needs of depressed residents are substantial.
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