title: Mental Health Disorders in Elderly People Receiving Home Care: Prevalence and Correlates in the National U.S. Population.
abstract: BACKGROUND
  Current evidence on mental health disorders (MHDs) in the U.S. elderly home care population is highly varied and limited to the local level.
  
  
  OBJECTIVE
  The objective of this study was to examine the prevalence and characteristics of U.S. elders with MHDs on the national level.
  
  
  METHODS
  This is a primary analysis of secondary use data from a 5% random sample of the 2010 National Outcome and Assessment Information Set (OASIS) data spanning a 60-day home care session. MHDs included depression, anxiety, substance abuse, psychotic disorders, aggression, and socially inappropriate behaviors and were identified by diagnosis, symptoms, or mental health service order in the plan of care. Logistic regression was used to identify correlates of MHD.
  
  
  RESULTS
  The final analysis was conducted on records from 28,475 elderly patients with an average age of 79 (range 65-110). Patients were primarily female, White, Medicare beneficiaries, referred from short-stay acute hospitals, and living with others at home. Prevalence of MHDs was approximately 40%; depression (28.0%) and anxiety (18.9%) were common. Factors associated with MHDs were younger age, female, smokers, frail, living alone, referred from psychiatric hospitals, cognitively or sensory impaired, poorer health status, recent history of falls or multiple hospitalizations, and insufficient social support. Only about one third of patients identified with MHD received mental health services during the 60-day home care episode, including psychiatric nursing services and depression interventions.
  
  
  CONCLUSIONS
  MHDs are a national health concern in the older U.S. home care population and are common but largely undermanaged. Future research in the home care sector should be aimed at developing targeted MHD screening and interventional protocols and training the current workforce, as well as expanding the future workforce to improve psychiatric care for the homebound elderly.
authors.affiliation: Jinjiao Wang, PhD, RN, is Postdoctoral Research Fellow, School of Nursing, Vanderbilt University, Nashville, Tennessee. Joan A. Kearney, PhD, APRN, is Assistant Professor, School of Nursing, Yale University, New Haven, Connecticut. Haomiao Jia, PhD, is Associate Professor; and Jingjing Shang, PhD, RN, is Assistant Professor, School of Nursing, Columbia University, New York.
authors.forename: Jinjiao
authors.initials: J
authors.lastname: Wang
authors.forename: Joan A
authors.initials: JA
authors.lastname: Kearney
authors.forename: Haomiao
authors.initials: H
authors.lastname: Jia
authors.forename: Jingjing
authors.initials: J
authors.lastname: Shang
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017050:Episode of Care; D005260:Female; D006699:Home Care Services; D006801:Humans; D016015:Logistic Models; D008297:Male; D006278:Medicare; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D008605:Mental Health Services; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology