Geriatric major depression is twice as common in patients receiving home care as in those receiving primary care. Most depressions in patients receiving home care are untreated. The poor medical and functional status of these patients and the complex organizational structure of home health care pose a challenge for determining safe and effective strategies for treating depressed elderly home care patients.

Home health nurses have difficulty making accurate assessments of depression among older home care patients. Inaccuracy in assessment of depression by home health nurses is a significant barrier to treatment in this elderly homebound population.

The purpose of the current feasibility study was to examine the use, utility, and areas for refinement of a newly developed web-based and Android™ application (app) (i.e., CareHeroes) with multiple features to support individuals caring for loved ones with Alzheimer’s disease or other forms of dementia (AD). The study was performed over an 11-week period with triads of AD caregivers, assigned home care case managers, and primary care providers (PCP). The study involved quantitative and qualitative methodologies. Eleven AD caregivers (seven daughters, two sons, and two spouses), six case managers, and five PCPs participated. Data demonstrate participants were mostly satisfied with the multiple features and ability to access and use CareHeroes. Barriers for use include concerns about time constraints and not being familiar with technology. Although the study findings are promising, a longer term study to evaluate the impact of the CareHeroes app is indicated.

TRIAD showed that training nurses to assess for depression using an approach developed in partnership with home healthcare agencies led to appropriate referral and care for depressed patients.

This study evaluated the accuracy of home care nurses' ratings of the Outcome and Assessment Information Set (OASIS) depression items. The accuracy of home care nurses' depression assessments was studied by comparing nurse ratings of OASIS depression items with a research diagnostic assessment based on the Structured Clinical Interview for Axis I Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID). The setting for this study was a nonprofit, Medicare-certified, voluntary home healthcare agency. Sixty-four home care nurses assessed 220 patients aged 65 and older with the OASIS upon admission. Of the 220 patients, using standard SCID criteria, 35 cases of major or minor depression were identified. The home care nurses accurately documented the presence of depression in 13 of 35 cases (sensitivity=37.1%; positive predictive value=0.56). Of the 220 patients, 185 had no SCID-identified major or minor depression. The nurses agreed on the absence of depression in 175 of 185 cases (specificity=94.6%; negative predictive value=88.8%). This study indicates that home care nurses often do not accurately rate OASIS depression items for older adult patients.

No abstract

Most of the 5.4 million people affected by Alzheimer's disease and other forms of dementia (AD) are noninstitutionalized, receiving care by unpaid family caregivers and medically managed by a primary care provider (PCP). Health Information Technology has been recognized for its potential in improving efficiency and quality of AD care and support for AD caregivers. Simultaneously, smartphone technologies have become an increasingly common way to deliver physical and behavioral health care. However, little is known about how smartphone technologies have been used to support AD caregiving and care. This article highlights the current need for smartphone-based interventions for AD and systematically identified and appraised current smartphone apps targeting and available for AD caregivers. Findings indicate that individual available apps have limited functions (compared with the complex needs of caregivers) and little has been done to extend AD caregiving apps to Hispanic populations. Implications for research, practice, and policy are discussed.

This study found that patients with depressed mood or anhedonia identified on the OASIS were nearly three times more likely to fall. The authors describe the ways these findings are being used in a fall prevention program. The clinical-research partnership used in the study was found to help agencies develop clinically driven research, analyze clinical and administrative data for quality improvement, and provide a foundation for research consultation/collaboration in applied settings.