May 9, 2008 Elderly in a long-term care setting are more likely to be prescribed antidepressants and to self-report depression compared to those in a home-health care setting, according to a study by social work students at Indiana State University.
The study of 272 elders, with an average age of 81, examined how often patients reported feeling depressed and were prescribed antidepressants at both a long-term care facility and through a home-care agency in west-central Indiana.
At the long-term care facility, 30 percent of the elders in the study reported feeling depressed, compared with 11 percent who received care in their homes through medical and social services.
The long-term care facility also prescribed antidepressants to more than half of the elders in the study (62 percent) at some point after they were admitted, compared to only a quarter of the home-cared elders.
Jodi Shapuras and Lindsay Egan, undergraduate students in the social work program at ISU, conducted the research at their internships as part of a senior-level field practicum class.
“We are both interested in working with the elderly population in our careers, so we conducted this research to get a better feel for the prevalence of depression in those who need some level of outside care,” said Shapuras of Mitchell, Ind. “As social workers, it is important to understand the mental health issues, such as depression, within the different care settings.”
Shapuras and Egan said they weren’t surprised by their findings.
“We actually hypothesized that the long-term care patients would utilize antidepressants more and would self-report depression more,” said Egan of Terre Haute, Ind. “When an individual moves to a long-term care facility, they undergo a tremendous amount of changes. They are no longer able to live independently and are relying on others for care, and this greatly affects how they feel about themselves and the world around them.”
Shapuras added that in the home-care setting, elders are still residing within a familiar environment.
“They are still at home and independently able to complete some activities of daily living, such as bathing, cooking or feeding themselves, whereas a long-term care patient may not be able to do all of these tasks,” Shapuras said.
Shapuras and Egan presented the findings of their study, “Comparison of Depression in Elders Who Receive Home-Health Care to Elders Residing in a Long-Term Care Facility,” at ISU’s 12th annual Undergraduate and Graduate Research Showcase, and received first place in the undergraduate oral presentation division.
The researchers hope that their findings will bring awareness to the problem of depression in elderly needing care, and to the degree to which antidepressants are prescribed in the long-term care setting.
“I would like to see more effective alternative treatments researched, as opposed to what seems in many cases to be the automatic prescribing an antidepressants,” Egan said.
Shapuras also would like more research to be done in this area.
“It seems as though medications are sometimes viewed as the ‘fix-all’ when depression becomes apparent,” she said. “I hope to work in the field of gerontology as a social worker and to make some positive changes somewhere along the line.”
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