The role of regulation in the care of older people with depression living in long-term care: a systematic scoping review

Crick, Michelle; Devey-Burry, Robin; Hu, Jiale; Angus, Douglas E; Backman, Chantal

doi:10.1186/s12877-020-01675-9

Cited by 3 publications

(1 citation statement)

References 55 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…27 Furthermore, NH administrators report difficulty accessing mental health professionals willing to provide care in the facility and costs to transport residents to external treatment centers may exceed Medicaid coverage rates in some states. 28 Research is needed to determine if TH services can improve this access issue.…”

Section: Discussionmentioning

confidence: 99%

Consequences of Rapid Telehealth Expansion in Nursing Homes: Promise and Pitfalls

Powell

Alexander

2021

Appl Clin Inform

View full text Add to dashboard Cite

Background Expectations regarding use and potential benefits of telehealth (TH) in nursing homes (NHs) are high; however, unplanned and unexpected consequences can occur as a result of major policy and technological changes. Objectives The goal of this study was to elicit stakeholder perspectives of consequences of rapid TH expansion in NHs. Methods Using a qualitative descriptive design, we drew a sample based on findings from a national study examining trends in NH information and technology (IT) maturity, including TH use. We used maximum variation sampling to purposively select participants who (1) participated in our IT maturity survey for two consecutive years, (2) completed year 1 of the IT maturity survey prior to TH expansion (before March 6, 2020) and year 2 after TH expansion (after March 6, 2020), (3) represented a broad range of facility characteristics, and (4) were identified as an end user of TH or responsible for TH implementation. Using six questions from the IT maturity survey, we created a total TH score for each facility and selected participants representing a range of scores. Results Interviews were conducted with (n = 21) NH administrators and clinicians from 16 facilities. We found similarities and differences in perceptions of TH expansion according to facility TH score, NH location, and participant role. Desirable consequences included four subthemes as follows: (1) benefits of avoiding travel for the NH resident, (2) TH saving organizational resources, (3) improved access to care, and (4) enhanced communication. Undesirable consequences include the following five subthemes: (1) preference for in-person encounters, (2) worsening social isolation, (3) difficulty for residents with cognitive impairment, (4) workflow and tech usability challenges, and (5) increased burden on NH staff/infrastructure. Participants from rural NHs perceived lack of training, poor video/sound quality, and internet/connectivity issues to be potential pitfalls. Conclusion Clinicians and NH administrators should consider leveraging the desirable consequences of rapid TH expansion and implement mitigation strategies to address the undesirable/unanticipated consequences.

show abstract

Section: Discussionmentioning

confidence: 99%

Consequences of Rapid Telehealth Expansion in Nursing Homes: Promise and Pitfalls

Powell

Alexander

2021

Appl Clin Inform

View full text Add to dashboard Cite

show abstract

From Compliance to Care: Qualitative Findings from a Survey of Essential Caregivers in Ontario Long-Term Care Homes

Conklin,

Dehcheshmeh,

Archibald

et al. 2024

Can. J. Aging

View full text Add to dashboard Cite

Background The COVID-19 pandemic highlighted the importance of the care provided by family members and close friends to older people living in long-term care (LTC) homes. Our implementation science team helped three Ontario LTC homes to implement an intervention to allow family members to enter the homes during pandemic lockdowns. Objective We used a variety of methods to support the implementation, and this paper reports results from an Ontario-wide survey intended to help us understand the nature of the care provided by family caregivers. Methods We administered a survey of essential caregivers in Ontario, and a single open-ended question yielded a substantial qualitative data set that we analysed with a coding and theming procedure that yielded 13 themes. Findings The 13 themes reveal deficiencies in Ontario’s LTC sector, attempts to cope with the deficiencies, and efforts to influence change and improvement. Discussion Our findings indicate that essential caregivers find it necessary to take on vital roles in order to shore up two significant gaps in the current system: they provide psychosocial and emotional (and sometimes even basic) care to residents, and they play a monitoring and advocacy role to compensate for the failings of the current regulatory compliance regime.

show abstract

Detecting depression in persons living in long-term care: a systematic review and meta-analysis of diagnostic test accuracy studies

Mele

Watt

et al. 2022

Age and Ageing

View full text Add to dashboard Cite

Objective Depressive disorders are common in long-term care (LTC), however, there is no one process used to detect depressive disorders in this setting. Our goal was to describe the diagnostic accuracy of depression detection tools used in LTC settings. Methods We conducted a systematic review and meta-analysis of diagnostic accuracy measures. The databases PubMed, EMBASE, PsycINFO and CINAHL were searched from inception to 10 September 2021. Studies involving persons living in LTC, assisted living residences or facilities, comparing diagnostic accuracy of depression tools with a reference standard, were included. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool was used to assess risk of bias. Results We identified 8,463 citations, of which 20 studies were included in qualitative synthesis and 19 in meta-analysis. We identified 23 depression detection tools (including different versions) that were validated against a reference standard. At a cut-off point of 6 on the Geriatric Depression Scale-15 (GDS-15), the pooled sensitivity was 73.6% (95% confidence interval (CI) 43.9%–76.5%), specificity was 76.5% (95% CI 62.9%–86.7%), and an area under the curve was 0.83. There was significant heterogeneity in these analyses. There was insufficient data to conduct meta-analysis of other screening tools. The Nursing Homes Short Depression Inventory (NH-SDI) had a sensitivity ranging from 40.0% to 98.0%. The 4-item Cornell Scale for Depression in Dementia (CSDD) had the highest sensitivity (67.0%–90.0%) for persons in LTC living with dementia. Conclusions There are 23 tools validated for detection of depressive disorders in LTC, with the GDS-15 being the most studied. Tools developed specifically for use in LTC settings include the NH-SDI and CSDD-4, which provide briefer options to screen for depression. However, more studies of both are needed to examine tool accuracy using meta-analyses.

show abstract

The role of regulation in the care of older people with depression living in long-term care: a systematic scoping review

Cited by 3 publications

References 55 publications

Consequences of Rapid Telehealth Expansion in Nursing Homes: Promise and Pitfalls

Consequences of Rapid Telehealth Expansion in Nursing Homes: Promise and Pitfalls

From Compliance to Care: Qualitative Findings from a Survey of Essential Caregivers in Ontario Long-Term Care Homes

Detecting depression in persons living in long-term care: a systematic review and meta-analysis of diagnostic test accuracy studies

Contact Info

Product

Resources

About