The increasing rate of depression among people who are 65 years and above poses a major public health concern since it undermines the well-being of the elderly population. This paper illustrates that while more individuals among the aging population are becoming victims of depression, very few take the matter seriously since most of them assume that it is a normal part of aging. As a result, most people who are 65 years old and above rarely seek treatment and continue to suffer in silence. Depression undermines the quality of life, leads to the loss of functionality, increases health care costs and may trigger higher mortality rates among the elderly population. The following paper reveals that care management and treatment of depression among the elderly population is of utmost importance to help the aging persons lead fulfilling lives. The objective of this paper is to evaluate and ascertain various measures to minimize the cases of depression among the elderly population and improve the condition of the individuals. Overall, this paper seeks to illustrate the measures that the health care practitioners can take to detect, treat and prevent depression among older adults with the focus on the QSEN initiative and implementation of evidence-based policies, specifically the intermediary teams.
Keywords: depression, elderly, QSEN initiative, intermediary teams
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Depression in Adults over 65 Years Old
Depression among the elderly population aged 65 years and above is a serious public health problem in the contemporary society. Surprisingly, one would assume that the aging population is at a lower risk of mental disorders, but that is not the case since research indicates that persons over 65 years of age are more prone to suffer from depression and anxiety-related issues (Goldsmith & Robinson Kurpius, 2015). Although senior adults face many difficulties, including the death of loved ones, stressful life events, retirement, various medical problems and loss of independence or function, depression is not normal so that it requires urgent medical intervention (Ezzati et al., 2014). Depression complicates the existing conditions such as diabetes, heart problems, arthritis, hypertension and stroke. Moreover, depression leads to reduced quality of life, higher health care costs, increased rates of institutionalization, greater functional impairment and higher risk of mortality arising from suicide and cardiac failure (Angstman et al., 2015). The effective treatment of depression lowers depressive symptoms, thereby improving functioning and quality of life. With the right measures, including the utilization of the QSEN initiative and adoption of various evidence-based policies such as the interdisciplinary teams, depression in adults over 65 years is easy to detect, highly treatable, and preventable.
Assessment of Depression in the Elderly Population
The rising incidence of depression among the elderly population aged 65 years and over raises a lot of concerns due to the negative outcomes associated with the condition. The American Association for Geriatric Psychiatry reveals that mental disorders affect 1 in 5 elderly people aged 65 years and above which is around 15-20% (about 7 million annually) (Goldsmith & Robinson Kurpius, 2015). Shockingly, out of that number, only 10% seek treatment for depression since most of them assume that it is a normal part of aging. Depression is characteristic of a persistent sad and empty feeling, lack of interest in activities, anxiety, poor concentration, feeling of hopelessness, self-critical thinking and pessimism (Ezzati et al., 2014). One would think that with the prevalence of mental disorders in this age group, there would be an abundance of treatment programs, but this is not the case. There is a tendency to confuse the symptoms of depression in the aging population with the effects of the multiple diseases suffered by the elderly and side effects of the medications used to treat them. The rising cases of depression among the elderly population illustrate the need to devise strategies to detect, treat and minimize the cases of depression among this vulnerable population.
The Implications of the QSEN Initiative in Management Care of Depression among the Elderly
Following the rising cases of depression among the elderly population, nurses and other health care providers require specific and sufficient knowledge to enable them provide quality care by adopting the Quality and Safety Education for Nurses (QSEN) initiative. It is critical to encourage health practitioners to embrace the six competencies advocated for by the QSEN initiative to ensure that they can provide appropriate care to the elderly population that suffers from depression. The QSEN initiative requires the nursing practitioners to offer patient-centered care, work as part of interdisciplinary teams, focus on evidence-based practice (EBP), strive for quality improvement (QI), and be competent in information technology with the aim of ensuring the best outcome for the patient (Kowalski & Anthony, 2017). There are various ways in which the nurses and other health care providers can demonstrate the six competencies in the management and treatment of depression among senior adults aged 65 years and above.
Health practitioners should provide patient-centered care when treating depression among the elderly population. The implication is that the health care providers should understand that each senior adult is unique and requires individualized care. The commonest mistake that the practitioners make is trying to generalize the elderly population and assume that their needs are all the same. However, the QSEN model emphasizes that it is critical to provide care on the basis of the patients preferences and needs (Lewis, Stephens, & Ciak, 2016). The practitioner should avail information, listen, and educate the elderly patients on the major symptoms of depression, find the root causes and guide them on the way they can lead better lifestyles (Kowalski & Anthony, 2017). Providing patient-centered care makes the older adults feel involved and get motivated to undergo the treatment.
The health care providers should also strive to work as part of interdisciplinary teams in the management and treatment of depression among the older adults. Research indicates that depression in the elderly population requires a collaborative approach to ensure the best possible outcome. The QSEN initiative emphasizes the need to collaborate with a variety of health care professionals and the patients family to establish the most appropriate care plan for the patients (Lewis et al., 2016). Most elderly patients suffer some chronic ailments, and they are often under the surveillance of several professionals, including their physicians, the nurse and mental health experts. Accordingly, the nurse should be able to collaborate with all those involved in caring for the elderly patients to ensure that the patient gets appropriate treatment.
In the same context, it is critical to adopt evidence-based practice (EBP) in the diagnosis and treatment of depression in the elderly patients. For example, evidence-based practice should address questions related to mental health and aging, risks and protective factors and stressor factors (Goldsmith & Robinson Kurpius, 2015). The implication is that the nurse should be aware of the current trends in the causes, management and treatment of depression among individuals aged 65 years and older. Practitioners should embrace new knowledge and innovations to ensure they apply the best treatment strategy in view of the patients needs (Kowalski & Anthony, 2017). Furthermore, health care providers must constantly be up to date with the latest research to provide the most effective mental and behavioral health services to the elderly population.
The QSEN model also applies Quality Improvement (QI) in the treatment of depression among the elderly population. Health care providers should strive to improve the systems of care to ensure that they provide the highest quality of care. It is undeniable that the management and treatment of depression among the elderly is still a new phenomenon, hence the need to continue enhancing service delivery to this vulnerable category of population. Quality improvement strives to ensure the minimization of diagnostic and treatment errors (Lewis et al., 2016). Overall, nurses should strive to offer safe, efficient and effective care to the elderly patients who suffer from depression.
The QSEN model maintains the need to be familiar with information technology in the management and treatment of depression among the elderly population. The health care providers should be able to use electronic medical records which are rather handy when saving the medical history of the elderly patients as well as when searching for credible websites that address the learning needs of the population (Kowalski & Anthony, 2017). Adequate knowledge of information technology is critical to help nursing practitioners maintain records of the patients past and current mental status, their cognitive ability, the available social support, and the medical status. Overall, the knowledge of information technology enables the health care provider to keep a record of care, treatment and services which are critical in the diagnosis and treatment of depression among the elderly population.
How Intermediary Teams Can Minimize and Improve Outcomes
It is critical to implement evidence-based policies such as those involving the interdisciplinary teams to treat and minimize the cases of depression among the elderly population. Reliable studies indicate that a collaborative approach leads to significant improvement compared to the management of depression by a primary care physician alone (Angstman et al., 2015). Interdisciplinary care involves specialized knowledge of multiple disciplines, including a physician, nurse, mental health experts, social workers, and physical and occupational therapists among others. There is increasing support from the American Geriatrics Association in regard to the benefits of the interdisciplinary teams in improving function and decreasing depression among older adults aged 65 years and above. A collaborative approach meets the complex needs of the elderly population, including medical, physical and psychosocial needs that are the reason behind depression (Ezzati et al., 2014). The professionals perform various roles, including detailed assessment, analyzing the information, devising intervention strategies, initiating treatment, and following up on the patient’s progress.
Interdisciplinary teams are reliant on coordinated effort in the provision of care. For example, the community and public health nurse offers education and counseling to reduce the stigma associated with mental health problems, screening, referrals as well as encourages medication adherence and monitoring (Goldsmith & Robinson Kurpius, 2015). Moreover, the physician provides a history of the patients medical background to detect changes in their mental status. Additionally, mental health experts such as psychologists conduct psychological evaluations and diagnosis to determine the level of intervention such as antidepressants, psychotherapies, cognitive training techniques, behavior modification and disease management strategies and environmental modifications (Ezzati et al., 2014). Other key players include social workers who educate the family on what the management of depression entails and also avail the community resources to assist the elderly patient access treatment. Furthermore, families in a community dwelling or resident staff in nursing homes or assisted care facilities give an insight into the senior adults daily functioning and provide a chance to address some environmental and social issues that might affect the mental well-being of the patient. Overall, the roles of the interdisciplinary teams complement each other.
In conclusion, the adoption of the QSEN initiative and evidence-based policy such as the one involving interdisciplinary teams would greatly contribute to the detection, diagnosis and treatment of depression among the elderly population. The QSEN initiative is significant because it emphasizes the need for health care providers to embrace the six competences, including patient-centered care, working as part of interdisciplinary teams, evidence-based practice (EBP), quality improvement (QI), and possession of knowledge of information technology, which are aimed at ensuring the best outcome for the elderly patients suffering from depression. Interdisciplinary teams enhance collaborative care or the specialized knowledge of multiple disciplines such as the physician, nurse, mental health experts, families, social workers, physical and occupational therapists and others. The implication is that interdisciplinary teams are grounded on coordinated effort in the provision of care to aging patients suffering from depression. Each professional plays a designated role that complements the role of others to enhance the condition and well-being of the patient. Overall, by emphasizing the implementation of the QSEN model and interdisciplinary teams, it becomes apparent that more than ever before, health practitioners are putting considerable efforts to address the rising cases of depression among older adults aged 65 years and above.