Depression Management Program for Elderly Clients with Relapsing Depression
Kathleen Falk, MS, FNP, Adult Day Health Center, Metropolitan Jewish Health System, Brooklyn, NY, USA
DEPRESSION MANAGEMENT PROGRAM FOR ELDERLY CLIENTS WITH RELAPSING DEPRESSION
The Depression Management Program was a pilot project that addresses individuals within the ADHC population with relapsing depression and related co-morbid decompensation. This project utilized evidence based practice strategies to reduce incidence of acute psychiatric decompensation and co-morbid hospitalizations. The Depression Management Project was designed to maximize opportunities for integration of brain functioning (stimulate parts of the brain that are not associated with depression), therefore mediating symptoms of anxiety and depression.
A Nurse led group format was utilized to target twelve clients who have been vulnerable to relapsing depression. Nursing interventions were intensified in regards to current psychiatric care, medication regimen and responses to medications. Therapeutic modalities offered in the group included cognitive/behavioral techniques, group therapy support process, psycho-educational sessions. Complementary venues of music therapy, oral histories, culinary workshops, cultural events and the arts were experienced as preparation for the client to re-enter the community. A Family Nurse Practitioner/Certified Psychiatric Nurse ran weekly sessions for six months, then on going every two weeks. Pain was a contributing factor to affective symptoms. Pain management was addressed by adding yoga, Tai chi, and meditation sessions. The participants, as reflected by their rating survey, totaling 96% in the excellent and good categories, have overwhelmingly embraced the Depression Management Project. At the twenty-four month mark, 100% of the participants remained in the group, and are living in the community. All have been free of relapsing depression and no psychiatric or medical hospitalizations have occurred. Depression Diagnostic Scales were administered pre and post the Depression Management Program. Results were statistically significant. Scores for intensity of depressive responses decreased on average 2 points on the Geriatric Depression Scale, and 5 points on the Zung Rating SDS Index, six months after the program started.