title: Analysis of a care planning intervention for reducing depression in older people in residential care.
abstract: Approximately 40% of older people in residential care have significant symptoms of depression. A training and care-planning approach to reducing depression was implemented for 114 depressed residents living in 14 residential care homes in North Yorkshire, UK. Care staff were offered brief mental health training by community mental health teams for older people. They were then assigned to work individually with residents in implementing the care-planning intervention, which was aimed at alleviating depression and any health, social or emotional factors that might contribute to the resident's depression. Clinically significant improvements in depression scores were associated with implementation of the care-planning intervention as evidenced by changes in scores on the Geriatric Mental State Schedule-Depression Scale. There was evidence of an interaction between the power of the intervention and degree of dementia. These improvements were not accounted for by any changes in psychotropic medication. The training was highly valued by care staff and heads of homes, and they considered that the care-planning intervention represented an improvement in quality of care for all residents, irrespective of levels of dementia. Staff also reported improvements in morale and increased confidence in the caring role as a result of their participation. The limitations of this study are discussed. On the basis of a growing body of evidence, it is argued that there is an urgent need for a suitably powered randomised controlled trial and economic evaluation, to test the cost-effectiveness of personalised care planning interventions aimed at reducing depression in older people in residential care.
authors.affiliation: Psychology Services, Selby and York Primary Care Trust, York, UK. jake.lyne@sypct.nhs.uk
authors.forename: K J
authors.initials: KJ
authors.lastname: Lyne
authors.forename: S
authors.initials: S
authors.lastname: Moxon
authors.forename: I
authors.initials: I
authors.lastname: Sinclair
authors.forename: P
authors.initials: P
authors.lastname: Young
authors.forename: C
authors.initials: C
authors.lastname: Kirk
authors.forename: S
authors.initials: S
authors.lastname: Ellison
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging / Q000523:psychology; D003866:Depressive Disorder / Q000517:prevention & control* / Q000523:psychology; D005260:Female; D006299:Health Services for the Aged / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D007318:Inservice Training / Q000379:methods*; D007588:Job Satisfaction; D008297:Male; D008605:Mental Health Services / Q000592:standards / Q000706:statistics & numerical data; D009013:Morale; D018802:Patient-Centered Care / Q000379:methods* / Q000706:statistics & numerical data; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012112:Residential Facilities / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D006113:United Kingdom