Depression can be caused by a number of environmental, social, and biological factors and shows different symptoms as we age. With the elderly population growing, it is important to understand the symptoms and treat them effectively. Enter telehealth.
Signs of Late-Life Depression
While the Centers for Disease Control and Prevention (CDC) estimate that only 1-5% of older adults living in the community have major depression, the prevalence of depression increases to 11.5% in older hospital patients and 13.5% in those requiring home health care. In the elderly population, untreated depression can be fatal, with Caucasian males experiencing the highest risk for suicide and non-suicidal mortality.
Late-life depression is often missed by medical professionals as the symptoms of depression change throughout life and can be caused by medication for other illnesses. In older adults, symptoms of depression include frequent memory problems, confusion, loss of appetite, delusions, and social withdrawal, many of which are seen as typical parts of aging. The National Alliance on Mental Illness has issued clues to help caregivers, family members, and clinicians recognize late-life depression: persistent and vague complaints, help-seeking, moving in a slow manner, or demanding behaviors.
The Role of Technology in Treating Depression
The National Institute of Mental Health outlines treatments for depression, beginning with an exam, interview, and lab tests done by a health care provider to rule out physical causes of the symptoms. Once diagnosed, depression can be treated with medication, psychotherapy, or a combination of both.
In the United States, healthcare professionals are not evenly dispersed. In rural regions, there is a severe shortage of Mental Health Professionals, with 47% of non-metropolitan counties not having a psychologist and 67% not having a psychiatrist. Experts have observed that limited access to mental health care often correlates with drug abuse, suicide, and other public health crises.
Telehealth video conferencing and direct messaging enable clinicians to provide behavioral health services to patients through an intuitive platform, from a remote location. Telehealth allows patients to receive effective, high-quality mental health care in any region, rural or not.
Telehealth Outcomes for Depression in the Elderly
In an article published in the Journal of the American Geriatric Society, a telehealth intervention called Integrated Telehealth Education and Activation of Mood (I-TEAM) was used to treat comorbid depression resulting from chronic illnesses. The I-TEAM treatment included daily telemonitoring of vitals, symptoms, and medication intake, in addition to weekly virtual therapy sessions to teach patients problem-solving skills. The telehealth nurse also coordinated with patients’ primary care physicians, who were responsible for prescribing antidepressants.
Those receiving the I-TEAM intervention were compared with a control group who were undergoing standard in-home care augmented with psychoeducation (UC+P) on the disease and the importance of managing their condition.
At both three and six months of enrollment, patient data was collected on depression levels, health and functional status, and problem-solving coping skills. Data was then analyzed for comparison. The results found that after three months, patients receiving the I-TEAM intervention had significantly lower scores for depression (7.4) when compared with the UC+P group (14.1), and greater problem-solving abilities (I-TEAM, 14.62 vs. UC+P, 8.49). There was no significant difference between the group’s physical health scores.
These findings encourage the use of telehealth interventions to treat depression. The study argues the I-TEAM as a feasible health care option across urban, suburban, and rural areas as it uses evidence-based practices and can be delivered remotely by telehealth nurses.
Those who stand to benefit the most from telehealth services are those in medically underserved populations. Telehealth allows for exemplary and essential treatment for all those suffering from late-life depression, regardless of location. As more and more agencies integrate telehealth into their provided services, the future of telehealth for mental health care is bright.
References:
Depression and Older Adults. (2017, May 1). Retrieved from https://www.nia.nih.gov/health/depression-and-older-adults
NAMI. (n.d.). Retrieved from https://www.nami.org/Learn-More/Mental-Health-Conditions/Depression
Depression Basics. (n.d.). Retrieved from https://www.nimh.nih.gov/health/publications/depression/index.shtml
Willingham, A. (2018, June 22). There's a severe shortage of mental health professionals in rural areas . Here's why that's a serious problem. Retrieved from https://edition.cnn.com/2018/06/20/health/mental-health-rural-areas-issues-trnd/index.html
Gellis, Z. D., Kenaley, B. L., & Have, T. T. (2014, March 21). Integrated Telehealth Care for Chronic Illness and Depression in Geriatric Home Care Patients: The Integrated Telehealth Education and Activation of Mood (I‐TEAM) Study - Gellis - 2014 - Journal of the American Geriatrics Society - Wiley Online Library. Retrieved from https://onlinelibrary.wiley.com/doi/abs/10.1111/jgs.12776