Treatment via Telemedicine Helps Depressed Elderly Patients
For homebound elderly patients who are suffering from depression and who can not get out to receive treatment, it is time to bring the treatment to them. Researchers have developed a telemedicine-based protocol to treat depressed elderly patients in their home, and preliminary results are promising.
Depression among elderly homebound patients is high
It is well known that the risk of depression increases among elderly individuals who have health conditions and who have limited physical function. According to the National Institute of Mental Health, the rate of depression among older adults who live in the community ranges from less than 1 percent to about 5 percent, but it increases to 13.5 percent among those who need home healthcare.
The new telemedicine protocol, which was developed by researchers at Rhode Island Hospital and other organizations, was used in a pilot study that included 19 elderly homebound patients diagnosed with major depression. Overall the majority of patients were satisfied or very satisfied with the program and felt that it had improve their care. The nurses who implemented the program reported similar findings, and noted that there were few technical problems and that the program was easy to follow.
More specifically, of the 19 patients who were diagnosed with major depression at the beginning of the study, the average depression severity scores were “mild” at follow-up. “We believe these results offer great encouragement for reaching this population who can experience a better quality of life from this program,” said Thomas Sheeran, PhD, ME, the head of the study.
Sheeran, who is also a clinical psychologist at Rhode Island Hospital, noted that telemedicine is already part of the home care industry market in the delivery of chronic disease management. “However, guideline-based depression care often is not included in these monitoring programs,” he noted. With this pilot study, he and his team showed that overall patient satisfaction and feasibility were very high.
Depression among the elderly is often under-recognized and undertreated, and it is a factor that contributes heavily to suicide in this population. Research shows that up to 75 percent of older adults who commit suicide visited a doctor within a month of their death, which suggests a need to better identify and treat depression among older adults.
Telemedicine may be an effective way to deliver much-needed treatment for depressed elderly homebound patients. Sheeran noted that this project, which began at the Cornell Homecare Research Project at Weill Cornell Medical College and was completed at Rhode Island Hospital along with the University of Vermont’s Telemedicine Program, has shown that community health care nurses “can identify and successfully provide this service for their elderly home care patients.”
Lifespan/Rhode Island Hospital
National Institute of Mental Health