There is increasing recognition of the severe consequences of depression in long term care residents with dementia. Most health care providers are unprepared to recognize and to manage the complexity of depression in dementia.

Purpose: The purpose of this research was to describe long term care (LTC) nurses' knowledge and attitudes about the nursing care of residents with depression co-occurring with dementia. Design: Focus groups discussions were tape-recorded and guided by a set of structured questions on topics related to knowledge and attitudes about caring for residents with depression in dementia. In addition, the facilitator used probes to encourage elaboration. Sample: Nurses were recruited from two nursing homes in Florida to participate in 60 to 90-min focus groups. Participants received a stipend of $20.

Results: Twenty four LPN nurses participated in the study. Experience ranged from 9 months to 18 years. The nurses expressed confusion about differentiating depression from dementia and antidepressant medications from antipsychotics and antianxiety medications. They felt comfortable recognizing depression in residents they knew well who were cognitively intact. When they recognized depression in a resident, they were reluctant to request the involvement of a mental health professional or the use of antidepressant medications.

Implications: Long term care nurses are challenged to provide care to an increasing number of residents with dementia. Depression is a common complication of dementia.  There is a need to examine nurses' knowledge and attitudes about the problem before effective educational strategies can be designed and tested. These findings can be used to target educational materials to change attitudes and increase knowledge about mental health needs of long term care residents with depression co-occurring with dementia.