Assessing involvement in multiple social activities is important when using social activities to prevent and treat depression. Future work with improved measures can further clarify how specific activities may reduce risk for depression.
Medicare policy changes and this study's findings prompt further consideration for revising other health insurance policies. In addition, expanded cultural competency trainings that are specific to transgender and GNC individuals are crucial.
The objective of this paper is to increase understanding of geriatric depression in the public community long-term care system to guide intervention development. Protocols included screening 1,170 new clients of a public community long-term care agency and interviewing all clients with major, dysthymia, or subthreshold depression (n=299) and a randomly selected subset of non-depressed older adults (n=315) at baseline, 6-month, and 1 year. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript depression, one-half of a percent had dysthymia only, and another 19% had subthreshold depression. Over the year observation period, 40% were persistently depressed; 32% were assessed as depressed only at the first observation; and the remainder was intermittently depressed. There were high levels of comorbid medical, functional, and psychosocial conditions. Mental health service use was low, and clients reported attitudinal and other barriers to depression treatment. Findings suggest the need for universal screening for depression with some strategies for triaging the most severely and persistently depressed for treatment. Although there will be challenges to the development of depression interventions, the public community long-term care system has high potential to assist vulnerable older adults receive help with depression.
Structured AbstractObjective-To compare outcomes of mortality, institutionalization, physical and mental quality of life, overall life satisfaction, and satisfaction with living arrangements, for depressed and nondepressed clients after one-year of community long-term care (CLTC) services.Design-Prospective cohort study with repeated assessments at 6 and 12 months.Setting-A publicly-funded CLTC agency that coordinates in-home care such as meal delivery, personal care and nursing care to functionally disabled and low income adults throughout a Midwestern State.Participants-Adults 60 years and older, starting CLTC services with minimal or no cognitive impairment (n=551).Measurements-Outcomes included the Medical Outcome Study's Short-Form (SF-8) for physical and mental quality of life and single-items for life satisfaction and satisfaction with living arrangements. Diagnostic Interview Schedule and the Center for Epidemiological Studies Depression Scale determined clients' depression status.Results-Depressed clients (n = 266) had significantly worse scores for all outcomes than nondepressed clients (n = 285), but mortality and institutionalization were not significantly related to depression. Depression was significantly associated with more positive change in mental health (mean change: depressed group = 4.60, S.D. = 14.0; non-depressed group = -1.50, S.D. =11.2) and overall life satisfaction (mean change: depressed group = 0.10, S.D. = 1.1; non-depressed group = -0.10, S.D. = 0.8).Conclusion-After one year of CLTC services, depressed clients experienced more improvement in quality of life and life satisfaction, yet their outcomes remained significantly lower than nona Direct correspondence and request for reprints to Leslie K. Hasche.Presented at: Gerontological Society of America, Maryland, November, 2008. No Disclosures to Report.Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access Author ManuscriptAm J Geriatr Psychiatry. Author manuscript; available in PMC 2011 June 1. Every state provides publicly-funded community long-term care (CLTC) through a range of case management, in-home and community-based services for low-income, functionally disabled older adults. CLTC services can include but are not limited to personal care, homedelivered meals, homemaker/chore services, adult day services, and respite. Almost one in four older adults within this rapidly growing service sector experience depression (major depression: 7%, subthreshold depression: 18%) (1), and CLTC workers report that depression complicates the delivery of services (2). Evidence that the c...
Informal caregiving is a critical component of the US long-term care system, but can have significant negative impacts on caregiver employment, finances, and well-being. An online survey of Colorado caregivers was piloted in 2016-17 to explore whether workplace and social policies such as access to paid family leave and public health insurance can buffer the negative financial impacts of caregiving and help caregivers to remain in the workforce. Using standardized measures, the survey assessed caregivers' employment and financial status, well-being (physical and mental health, caregiver strain, benefits of caregiving), access to workplace supports, and covariates (e.g., caregiver demographics, health, social support, and service utilization). Ninety-five caregivers, recruited through community agency partners, completed the survey. Respondents were predominately female (89%), middle-aged (M = 57), non-Hispanic White (64%) or Latino/a (22%), and caring for a parent (40%) or spouse (30%) for over one year. Half (51%) reported working full- or part-time jobs, while 16.4% had stopped working because of caregiving. In multivariate regression modeling, predictors of financial strain included the care recipients' financial strain and the caregiver's reduction or ceasing of work. Medicare may be protective to minimize caregivers' need to reduce or cease work. Implications for caregivers' ability to stay engaged in the workforce and prepare for their own retirement are explored.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.