How to help depressed older people living in residential care: a multifaceted shared-care intervention for late-life depression.
OBJECTIVE
To describe a population-based, multifaceted shared-care intervention for late-life depression in residential care as a new model of geriatric practice, to outline its development and implementation, and to describe the lessons learned during the implementation process.


METHODS
A large continuing-care retirement community in Sydney, Australia, providing three levels of care (independent living units, assisted-living complexes, and nursing homes).


METHODS
The intervention was implemented for the entire non-nursing home population (residents in independent and assisted living: N = 1,466) of the facility and their health care providers. Of the 1,036 residents whowere eligible and agreed to be interviewed, 281 (27.1%) were classified as depressed according to the Geriatric Depression Scale. INTERVENTION DESCRIPTION: The intervention included: (a) multidisciplinary collaboration between primary care physicians, facility health care providers, and the local psychogeriatric service; (b) training for primary care physicians and other facility health care providers about detecting and managing depression; and (c) depression-related health education/promotion programs for residents.


CONCLUSIONS
The intervention was widely accepted by residents and their health care providers, and was sustained and enhanced by the facility after the completion of the study. It is possible to implement and sustain a multifaceted shared-care intervention for late-life depression in a residential care facility where local psychogeriatric services are scarce, staff-to-resident ratios are low, and the needs of depressed residents are substantial.
Llewellyn-Jones
R H
RH
Aged Care Psychiatry Service, Hornsby Ku-ring-gai Hospital, NSW, Australia. rljones@mail.usyd.edu.au
Baikie
K A
KA
Castell
S
S
Andrews
C L
CL
Baikie
A
A
Pond
C D
CD
Willcock
S M
SM
Snowdon
J
J
Tennant
C C
CC
D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D005260:Female; D016330:Frail Elderly / Q000523:psychology*; D006707:Homes for the Aged; D006801:Humans; D007318:Inservice Training; D007380:Intermediate Care Facilities; D008297:Male; D020380:Needs Assessment; D009517:New South Wales; D010348:Patient Care Team; D010353:Patient Education as Topic; D012931:Social Environment