Long-Term Care Survey Alert

Published on Tue Jul 02, 2013 PDF

Be honest: Do you secretly expect nursing home residents to be a little depressed or sad?

If so, you’re not alone: “It’s a common myth that nursing home residents are going to be somewhat depressed,” says Susan Scanland, principal of Geriscan Geriatric Consulting in Summit, PA. “Caregivers — including physicians — may reason that they’d be depressed, too, if they were in a nursing home.”

But this widespread belief can keep staff from getting to the root of a resident’s blues. For example, is a medication, such as a blood pressure drug, contributing to the depression? Does the person  have a physical illness causing the mood?

And recent research shows that even mild depression, if prolonged, can dampen an elderly person’s immune system, paving the way for infection or even cancer. “Depression is correlated to a decline in functional status and even death in the elderly person,” Scanland cautions.

To screen for depression, Scanland advises asking the elderly person these three questions:

• How are things going in your life?

• How are you sleeping?

• What do you enjoy doing? (Scanland notes that a grieving resident will usually still look forward to and enjoy some aspects of his life, while someone with clinical depression has trouble doing that.) If the resident’s answers warrant, the nurse can conduct a more in-depth assessment using the SIGECAPS tool below. “A resident with four to five of the following symptoms for two weeks or more probably has clinical depression,” Scanland says.

S = Sleep disturbance.

I = Interest diminished.

G = Guilt. “The person may not even know why she feels guilty, however,” says Scanland.

E = Energy changes such as increased anxiety or decreased energy or fatigue.

C = Concentration (decrease in concentration).

A = Appetite change (increase or decrease).

P = Psychomotor symptoms, such as restlessness, anger, nervous reactions or agitation.

S = Suicidal thoughts.