|
E-mail this page to a friend!
Elder Care News
Depressed Senior Citizens in Primary Care Benefit
Most From Team Approach
By Laura Kennedy, Contributing Writer
Health Behavior News Services
November 21, 2006 - Depressed older adults being
treated in primary care settings do better with psychosocial therapies
than with antidepressant medicines, suggests a new review of evidence.
Furthermore, older adults with depression have the
best response when these cognitive-behavioral therapies are delivered by
interdisciplinary health teams, say reviewers led by psychologist Karyn
Skultety.
| |
Related Stories |
|
| |
Hospital Dumping of the Old and Demented Hits Los
Angeles Court
LAPD accuses several
hospitals of
dumping patients on skid row
November 17, 2006 - The hospital staff called a cab and paid the driver
to take older woman with dementia to skid row and drop her off,
according to a Los Angeles Times story reporting on “the first criminal
prosecution of a medical center accused of ‘dumping’ patients on skid
row.” Earlier this year the 63-year-old patient, Carol Ann Reyes, was
videotaped leaving in the taxi from Kaiser Permanente’s Bellflower
hospital in LA. Taken away in her gown and socks, she was found
wandering skid row streets.
Read more...
Millions of Elderly Could Be Quietly Sliding into
Major Depression
Lesser depressions
often lead to major depression but goes undiagnosed in elderly
April 4, 2006 – Elderly patients with any form of
depression less than major depression are more than five times as likely
as healthy seniors to descend into major depression within a year,
according to a study published today in the Annals of Internal Medicine.
The study's authors believe that perhaps millions of elderly patients
who do not meet the criteria for a diagnosis of major depression are
indeed depressed, suffering and not being treated for it.
Read more...
Depression Not Likely to Return in Elderly Who
Continue Antidepressant
March 18, 2006 - Senior citizens age 70 and older
who continued taking the antidepressant that helped them recover from
their first episode of depression were 60 percent less likely to
experience a new episode of depression over a two-year study period than
those who stopped taking the medication, according to a study funded by
the National Institute of Mental Health (NIMH), part of the National
Institutes of Health. The study helps answer a major question in the
treatment of depression — when to discontinue medication.
Read more...
Read more
Elder Care News |
|
The review recommends this integrated approach
instead of the more conventional focus on antidepressant medications.
The suggestion is based on only eight studies, yet,
“We think the findings give us some valuable information on what works,”
says Skultety, who works in the Veterans Administration Palo Alto Health
Care System in California.
The reviewers also note that older adults prefer to
seek help for depression from primary care physicians, and that many
prefer psychosocial treatments. “They’re on a lot of medications
already, and usually they’re trying to work with their doctors to reduce
the number of medications they’re on, not increase,” Skultety said.
The review, part of a new series, appears in the
November issue of the journal Health Psychology. Each evidence-based
review centers on a specific psychological assessment or treatment
conducted in the context of a physical disease process or risk reduction
effort.
The review comprised eight randomized controlled
trials comparing psychosocial treatments in primary care to “usual care”
for patients aged 55 and older. The number of participants ranged from
96 in the smallest study to 1,801 in the largest.
Usual care in all the studies involved allowing
primary care physicians to assess depression and offer treatment as they
deemed appropriate.
Psychosocial interventions included education and
counseling provided by nurses, social workers, psychologists,
counselors, or physicians.
The strongest treatment effects appeared in the two
studies that incorporated interdisciplinary teams, in which mental
health providers worked in collaboration with medical providers to
develop plans for care. These models resulted in “consistently
significant improvements in depressive symptoms,” the reviewers found.
The reviewers note that they could not combine
results across the studies, because of large variations in study
populations, interventions and providers involved. Clear guidelines for
future projects are a must, said Skultety, so that results can be
compared and combined to reveal the most effective treatments.
Furthermore, she said, all future studies need to
report the number of patients who drop out of each treatment program.
“Just showing that [a treatment] works isn’t quite enough. You also have
to show that you can actually get people to stay engaged in it over
time.”
“Even at this point I think there’s enough evidence
to say this is a desired model if you’re going to work in primary care,”
said Forrest Scogin, president-elect of the Clinical Geropsychology
Section of the American Psychological Association.
Interdisciplinary teams have become commonplace in
treating diabetes and other chronic conditions, Scogin said. “You’re
involving more professionals in the treatment, so really it becomes more
of a fiscal issue.”
While Skultety said that involving
interdisciplinary teams can be time-consuming initially, she added
“You’re actually looking at saving yourself time down the road because
you’re addressing everything at once. Otherwise, a lot of older adults
present depression with just vague physical complaints, and they come
back again and again and again.”
Estimates of depressive symptoms among older adults
in community and primary care settings range from 10 percent to 25
percent, say the authors. Depression exacerbates physical health
problems in seniors and vice versa.
|
Nursing Home Abuse, Medical Malpractice? Contact a lawyer.
click here
|
|
|
Click to More Senior News on the
Front Page
Copyright: SeniorJournal.com |
