Materiały źródłowe

• #1 Depression (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK568733/

  Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. The common features of all the depressive disorders are sadness, emptiness, or irritable mood, accompanied by somatic and cognitive changes that significantly affect the individuals capacity to function. […] The nursing diagnoses found in people with depression should be individualized to the patient. The list below contains some nursing diagnoses that frequently occur due to their connection to the DSM 5 diagnostic criteria: Self-directed violence, the risk for; Hopelessness; Coping, ineffective; Self-Esteem, chronic low; Fatigue; Nutrition, imbalanced, less than body requirements. […] The nurse, caring for the depressed person, should direct interventions toward resolving the issues identified through the nursing diagnoses. A priority is the patients safety, including alleviating the risk of suicide. The following list includes interventions for the depressed person: Monitor for suicidal risk; Keep the environment safe by eliminating sharp objects and items that could be used to harm self; Encourage patient to do as much as possible for self. The patient may need more direction with activities of daily living if depression is severe; Use sleep hygiene to encourage sleep; Engage the patient in a therapeutic relationship; Use empathy when communicating with the patient; Reinforce elements of therapy such as challenging negative thoughts about self, the world, and the future; Encourage patient to participate in activities; Have patient list positive characteristics about the self; Have patient set a realistic goal for the day and review goal attainment; Review and evaluate patient coping strategies and support systems; Monitor eating patterns and encourage nutritional intake; Monitor medications for effectiveness and side effects; Include family in care if the patient chooses.

• #1 Psychiatry.org – What Is Depression?

  https://www.psychiatry.org/patients-families/depression/what-is-depression

  Depression (major depressive disorder) is a common and serious mental disorder that negatively affects how you feel, think, act, and perceive the world. […] Nearly three in ten adults (29%) have been diagnosed with depression at some point in their lives and about 18% are currently experiencing depression, according to a 2023 national survey. Women are more likely than men and younger adults are more likely than older adults to experience depression. While depression can occur at any time and at any age, on average it can first appear during ones late teens to mid-20s. […] Symptoms of depression symptoms can vary from mild to severe and can appear differently in each person. These symptoms can include: Feeling sad, irritable, empty and/or hopeless. Losing interest or pleasure in activities you once enjoyed. A significant change in appetite (eating much less or more than usual) and/or weight (notable loss or gain unrelated to dieting). Sleeping too little or too much. Decreased energy or increased tiredness or fatigue. Increase in purposeless physical activity (e.g., inability to sit still, pacing, handwringing) or slowed movements or speech that are severe enough to be observable by others. Feeling worthless or excessively guilty. Difficulty thinking or concentrating, forgetfulness, and/or difficulty making minor decisions. Thoughts of death, suicidal ideation, or suicide attempts.

• #1

  https://www.who.int/news-room/fact-sheets/detail/depression

  Depression is a common mental disorder. […] There is effective treatment for mild, moderate and severe depression. […] Depression can cause difficulties in all aspects of life, including in the community and at home, work and school. […] There are effective treatments for depression. These include psychological treatment and medications. Seek care if you have symptoms of depression. […] Psychological treatments are the first treatments for depression. […] Effective psychological treatments for depression include: behavioural activation, cognitive behavioural therapy, interpersonal psychotherapy, problem-solving therapy. […] Health-care providers should keep in mind the possible adverse effects associated with antidepressant medication, the ability to deliver either intervention (in terms of expertise, and/or treatment availability), and individual preferences.

• #1 Overview – Depression in adults – NHS

  https://www.nhs.uk/mental-health/conditions/depression-in-adults/overview/

  Depression is more than simply feeling unhappy or fed up for a few days. […] Depression is not a sign of weakness or something you can „snap out of” by „pulling yourself together”. […] The good news is that with the right treatment and support, most people with depression can make a full recovery. […] It’s important to seek help from a GP if you think you may be depressed. […] The sooner you see a doctor, the sooner you can be on the way to recovery. […] Treatment for depression can involve a combination of lifestyle changes, talking therapies and medicine. […] For moderate to severe depression, a combination of talking therapy and antidepressants is often recommended. […] Many people with depression benefit by making lifestyle changes, such as getting more exercise, cutting down on alcohol, giving up smoking and eating healthily. […] Sharing your experiences with others in a similar situation can also be very supportive.

• #1 Depression (major depressive disorder) – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/depression/symptoms-causes/syc-20356007

  To help diagnose depression, your health care provider may use a physical exam, lab tests, or a mental health evaluation. […] Help is available. You don’t have to deal with depression by yourself. […] Living with depression isn’t easy and you’re not alone in your struggles. […] Always remember that effective treatments and supports are available to help you start feeling better. […] Depression care at Mayo Clinic. […] Depression is a serious disorder that can take a terrible toll on you and your family. […] Depression often gets worse if it isn’t treated, resulting in emotional, behavioral and health problems that affect every area of your life. […] Examples of complications associated with depression include: Excess weight or obesity, which can lead to heart disease and diabetes.

• #1 Depression and Older Adults | National Institute on Aging

  https://www.nia.nih.gov/health/mental-and-emotional-health/depression-and-older-adults

  Depression is a common problem among older adults, but it is not a normal part of aging. […] Depression is serious, and treatments including counseling and medication can help. For most people, depression gets better with treatment. Talk with your doctor if you think you might have depression. […] Depression in older adults can be hard to recognize. For some, sadness is not their main symptom. They could instead be feeling emotional numbness or a lack of interest in activities, or they may not be as open to talking about their feelings as younger adults. […] The signs and symptoms of depression can look different, depending on the person and their cultural background. […] Depression is a medical condition that requires treatment from a doctor. […] Depression, even severe depression, can be treated. Its important to seek treatment as soon as you begin noticing signs.

• #1 Adolescent & Adult Depression Treatment Center | Minneapolis, MN

  https://prairie-care.com/treatment/depression/

  Depression is a common mental health condition and there are various treatment options to fit someones needs. […] Depression affects the way a person feels, thinks, and maintains their daily life. […] Often, depression is treated by working with a mental health professional to build a treatment plan that is unique to their needs. […] For someone to be diagnosed with depression, these feelings must be present for at least two weeks. […] Adults with depression have long periods of time where they have immense sadness, emptiness, or hopelessness. […] Adults can lose interest in daily activities, such as hobbies, sports, relationships, and more. […] These emotions and activity changes can severely impact the way someone lives their life, ultimately jeopardizing their work, school, activities, and relationships they care about.

• #1 Major Depression Nursing Care Management

  https://nurseslabs.com/major-depression/

  Major depression is classified under mood disorders which are characterized by disturbances in the regulation of mood, behavior, and affect that go beyond the normal fluctuations that most people experience. […] Major depression is a syndrome of a persistently sad mood lasting two (2) weeks or longer. […] It is accompanied by other problems like feelings of guilt, helplessness, or hopelessness, poor concentration, sleep disturbances, lethargy, appetite loss or weight gain, anhedonia, loss of mood reactivity, and thoughts of death. […] Suicide is the most serious complication of major depression. It occurs in nearly 15% of patients with untreated depression. […] There are a number of evidence-based psychotherapeutic treatments for adults with major depressive disorder such as behavioral therapy, cognitive therapy, cognitive behavioral analysis system of psychotherapy, interpersonal psychotherapy, problem-solving therapy, and self-management or self-control therapy.

• #1 Is Depression Common in Seniors?

  https://www.ncoa.org/article/how-common-is-depression-in-older-adults/

  How Common is Depression in Older Adults? […] Older adults have unique risk factors for developing depression. […] Chronic medical illnesses, disability, social isolation, lower income, all of those things can increase the risk for depression as we age, Raue said. […] Depression is a mood disorder and chronic medical condition. Its characterized by feelings of sadness, anxiety, and/or apathy that last for at least two weeks and impact a persons ability to function normally. […] According to the Centers for Disease Control and Prevention (CDC), most older adults are not clinically depressed. However, that doesnt make the issue any less challenging for those who suffer from it. […] Older adults have a higher risk of developing depression, but there is no single, specific cause. […] Some signs and symptoms of depression in seniors include: Apathy, or a sense of not caring about anything, Persistent sadness, Irritability, Fatigue and low energy, Feelings of guilt and worthlessness, A sense of hopelessness, Loss of interest in activities you once enjoyed, Trouble concentrating and other cognitive changes, Insomnia or oversleeping, Overeating or a decrease in appetite, Slower speech or movement, Digestive problems that persist, Physical pains that don’t get better with treatment, Recurring thoughts of death.

• #1 Depression: What It Is, Symptoms, Causes, Treatment, and More

  https://www.healthline.com/health/depression

  Depression can be temporary or long-term. You may find help with mediation or different therapies, such as cognitive behavior therapy. Its important to seek professional help if youre feeling major depression. […] Depression is considered a serious medical condition that can get worse without proper treatment. […] If you or someone you know is in crisis and considering suicide or self-harm, please seek support. […] Depression can be more than a constant state of sadness or feeling blue. […] Major depression can cause a variety of symptoms. Some affect your mood and others affect your body. Symptoms may also be ongoing or come and go. […] Not everyone with depression will experience the same symptoms. Symptoms can vary in severity, how often they happen, and how long they last. […] If you experience some of the following signs and symptoms of depression nearly every day for at least 2 weeks, you may be living with depression: feeling sad, anxious, or empty; feeling hopeless, worthless, and pessimistic; crying a lot; feeling bothered, annoyed, or angry; loss of interest in hobbies and interests you once enjoyed; decreased energy or fatigue; difficulty concentrating, remembering, or making decisions; moving or talking more slowly; difficulty sleeping, early morning awakening, or oversleeping; appetite or weight changes; chronic physical pain with no clear cause that does not get better with treatment (headaches, aches or pains, digestive problems, cramps); thoughts of death, suicide, self-harm, or suicide attempts.

• #1 Depression and Older Adults – Boyd | Nursing & Rehabilitation

  https://www.boydnr.com/depression-older-adults/

  Depression is a serious mood disorder. It can affect the way you feel, act, and think. Depression is a common problem among older adults, but clinical depression is not a normal part of aging. […] Depression is serious, and treatments are available to help. For most people, depression gets better with treatment. Counseling, medicine, or other forms of treatment can help. You do not need to suffer help and treatment options are available. Talk with your doctor if you think you might have depression. […] Depression in older adults may be difficult to recognize because older people may have different symptoms than younger people. For some older adults with depression, sadness is not their main symptom. They could instead be feeling more of a numbness or a lack of interest in activities. […] If you are a health care provider of an older person, ask how they are feeling during their visits. Research has shown that intervening during primary care visits is highly effective in reducing suicide later in life.

• #1 Depression in Older Adults: How to Help Your Loved One – The CareSide

  https://www.thecareside.com.au/post/depression-in-older-adults-how-to-help-your-loved-one/

  Depression in older adults is sadly common, although it is not a normal part of ageing. Between 10 and 15 percent of older people experience depression. […] Depression is sometimes hard to diagnose in older people because its symptoms can be confused with the natural ageing process: less energy, sleep problems, memory and concentration difficulties. Diagnosis is especially difficult if depression coexists with dementia. […] Common causes that can exacerbate the symptoms of depression in older adults include some life events such as bereavement, retirement, social isolation and loss of social relationships. […] Depression can have different causes, but it is now believed that the onset of depression is influenced by a combination of genetics, environmental stress, brain chemistry and personality.

• #1

  https://www.who.int/health-topics/depression

  Depressive disorder, or depression, is a common mental health condition that can happen to anyone. It is characterized by a low mood or loss of pleasure or interest in activities for long periods of time. […] Depression results from a complex interaction of social, psychological and biological factors. People who have lived through abuse, severe losses or other adverse events are more likely to develop depression. […] There are also effective psychological treatments and medications for depression. However, these are often absent or inaccessible, especially in low- and middle-income countries. […] In 2019, an estimated 280 million people, including 5% of all adults, experienced depression. […] Depression can cause difficulties in all aspects of life, including performance at school, productivity at work, relationships with family, friends and community.

• #1

  https://www.aurorahealthcare.org/services/behavioral-health-addiction/depression

  Depression is one of the most common mental health disorders in the U.S. Over an estimated 16% of U.S. adults will experience depression at some point in their lifetime, and two out of 10 people are affected by depression each year. […] Depression can develop at any age but is often developed in adulthood. The risk of hereditary depression increases by 40% for people with first-degree relatives (parents, children and siblings) who have depression. Women are more likely than men to be diagnosed with depression but women are also more likely to seek treatment. […] There is no cure for depression; however, depression is an illness, and it is treatable. A combination of therapy and depression medication, or antidepressants, is often the best treatment for depression. […] Without treatment, depression symptoms can worsen. Avoiding depression treatment can increase the chances of participating in risky behaviors such as drugs and alcohol, increase the risk of developing dementia and possibly lead to self-harm.

• #1 Recommendation: Depression and Suicide Risk in Adults: Screening | United States Preventive Services Taskforce

  https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/screening-depression-suicide-risk-adults

  Adults, including pregnant and postpartum persons, and older adults (65 years or older) The USPSTF recommends screening for depression in the adult population, including pregnant and postpartum persons, as well as older adults. B […] To achieve the benefit of depression screening and reduce disparities in depression-associated morbidity, it is important that persons who screen positive are evaluated further for diagnosis and, if appropriate, are provided or referred for evidence-based care. […] Treatment for MDD in adults includes psychotherapy or pharmacotherapy. Collaborative care is a multicomponent, health care system-level intervention that uses care managers to link primary care clinicians, patients, and mental health specialists to ensure patients receive the best care. […] The USPSTF recommends screening for depression in all adults regardless of risk factors. However, there are some factors that increase risk. These include family history of depression, prior episodes of depression or other mental health conditions, a history of trauma or adverse life events, or a history of disease or illness.

• #1 Depression: What It Is, Symptoms, Causes, Treatment, and More

  https://www.healthline.com/health/depression

  Depression is associated with other chronic medical illnesses. People with heart disease are about twice as likely to have depression as people who dont, while up to 1 in 4 people with cancer may also experience depression. […] You may successfully manage symptoms with one form of treatment, or you may find that a combination of treatments works best. […] Its common to combine medical treatments and lifestyle therapies, including the following: medications, psychotherapy, light therapy, electroconvulsive therapy (ECT), and alternative therapies. […] Psychotherapy has been shown to be an effective treatment in improving symptoms in people with depression and other psychiatric disorders. […] Depression can be treated successfully, but its important to stick to your treatment plan. […] Living with depression can be difficult, but treatment can help improve your quality of life. Talk to your healthcare professional about possible options.

• #1 Collaborative Care for Depression in Older Adults | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0900/lown-right-care-depression-older-adults.html

  A 93-year-old woman has mild cognitive impairment and lives in an assisted-living facility. […] Major depression occurs in 1% to 3% of older adults in the general population (8% to 16% in those with dysthymia). […] However, fewer than 20% of cases are diagnosed or adequately treated because the symptoms of depression are likely to be attributed to comorbid conditions instead of sadness. […] The U.S. Preventive Services Task Force recommends screening all adults for depression. […] Screening is important in older adults because of the likelihood of contributing risk factors, the masking of symptoms by comorbid conditions, and the tendency for depressive symptoms to compromise function and increase general health care utilization and cost. […] Risk factors for depression in older adults include previous depression, loneliness, loss of function, new medical diagnosis, poor health status, bereavement, poor self-perceived health, low self-esteem, helplessness because of racism or ageism, ST-segment elevation myocardial infarction, multiple chronic conditions, certain medications, insomnia, and pain.

• #1 Depression in adults

  https://www.rcpsych.ac.uk/mental-health/mental-illnesses-and-mental-health-problems/depression

  Depression can be triggered by a stressful or distressing event, such as a bereavement, relationship breakdown, or losing a job. […] If your life circumstances mean that you live alone or have no friends or family around, you may be more likely to become depressed. […] Regular heavy drinking or using drugs like cannabis can make you more likely to become depressed in the long-term. […] Most people with depression will get better on their own by doing things to help themselves. […] If trying to get better on your own isnt working as well or as quickly as you would like, then it may be a good idea to speak to your GP. […] Your GP will talk with you to review your symptoms and to find out what treatments will work for you. […] If you are experiencing depression for the first time, you wont normally be offered an antidepressant.

• #1 Adults with Depression or Anxiety More Likely to Have Medical Debt, Delay Care | Johns Hopkins | Bloomberg School of Public Health

  https://publichealth.jhu.edu/2024/adults-with-depression-or-anxiety-more-likely-to-have-medical-debt-delay-care

  The study found that 27.3 percent of adults with current depression and 26.2 percent with current anxiety reported having medical debt going back 12 months […] The inability to pay medical debt has been shown to cause delays to needed care, especially when it comes to seeking treatment for mental disorders: Less than half of U.S. adults with mental disorders receive treatment. […] Medical debt remains common despite insurance coverage: Over 90 percent of individuals in this study were insured, yet 19.4 to 27.3 percent reported having medical debt over the last 12 months. […] Among adults with a lifetime depression diagnosis and medical debt, 29 percent delayed care because of cost, while 29.4 percent did not seek out mental health care at all. […] Health systems have a critical role to play […] The authors note that economic stressors and financial strain are risk factors for both depression and anxiety.

• #1 Depression in Nursing Homes | Nursing Homes Abuse

  https://nursinghomesabuse.org/nursing-home-mental-health/depression/

  Nursing home residents are at risk of developing mental health issues, including depression. If someone you care about lives in a nursing home, it is important to understand why people living in nursing homes get depressed, what are the signs of depression in nursing homes, and what to do to get them the help they might need. […] Research shows that many nursing home residents struggle with a wide range of debilitating mental health issues. One of the most commonly cited mental health struggles is depression, which is marked by overwhelming sadness and a loss of interest in activities that were once enjoyable. […] According to Johns Hopkins Medicine, about one out of every ten adults will experience a major depressive disorder each year. Statistically speaking, women are much more likely to experience depression than men. Unfortunately, it appears that the risk of depression is much higher in nursing homes. One study found that about 30 percent of nursing home residents suffer from depression each year.

• #1 Registered nurses experiences of managing depressive symptoms at care centres for older people: a qualitative descriptive study | BMC Nursing | Full Text

  https://bmcnurs.biomedcentral.com/articles/10.1186/s12912-019-0368-5

  The process of identifying depressive symptoms and performing an appropriate intervention was found to be complex, especially as older people were reluctant to present at the centres and provided obscure reasons for doing so. A nurse-patient relationship that was built on trust and was characterised by continuity of care was identified as a necessary prerequisite. Appropriate nursing interventions afforded the same status as pharmacological treatment are warranted as the first-line treatment of depression. […] Registered nurses (RN) are on the frontline of care. Therefore, they are well placed to identify, assess and intervene (i.e. in accordance with the nursing process) against depressive symptoms among older people. […] A lack of knowledge of depressive symptoms and an absence of confidence in RNs is a plausible explanation as to why RNs don’t readily discuss depression with patients.

• #1 Depression (major depressive disorder) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/depression/diagnosis-treatment/drc-20356013

  Your doctor may determine a diagnosis of depression based on: […] Your mental health professional asks about your symptoms, thoughts, feelings and behavior patterns. You may be asked to fill out a questionnaire to help answer these questions. […] It’s important to get an accurate diagnosis, so you can get appropriate treatment. […] Our caring team of Mayo Clinic experts can help you with your depression (major depressive disorder)-related health concerns. […] Medications and psychotherapy are effective for most people with depression. Your primary care doctor or psychiatrist can prescribe medications to relieve symptoms. However, many people with depression also benefit from seeing a psychiatrist, psychologist or other mental health professional. […] If you have severe depression, you may need a hospital stay, or you may need to participate in an outpatient treatment program until your symptoms improve.

• #1 Detecting and screening for depression in older adults

  https://www.myamericannurse.com/detecting-and-screening-for-depression-in-older-adults/

  After performing a comprehensive physical assessment, review your findings for indicators of a reversible medical condition that might account for depressed mood and signal the need for further medical evaluation. […] The best choice is the Geriatric Depression Scale (GDS, short form), a 15-question, forced-choice tool that includes subjectively identified behaviors and feelings. […] Other effective tools designed for primary-care settings are the Patient Health Questionnaire 2 (PHQ-2) and the Patient Health Questionnaire 9 (PHQ-9). […] As nurses increasingly encounter depressed older people, use of the GDS or PHQ-9 can give direction for referral and more comprehensive evaluation. […] Expert consensus guidelines and nursing resources define the best clinical practices and are available in psychiatric mental health nursing texts and other resources, as well as from geropsychiatric and geriatric nursing competency statements, and the National Institute of Mental Health and National Institute on Aging.

• #1 Depression: Screening and Diagnosis | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/1015/p508.html

  Depression affects an estimated 8% of persons in the United States and accounts for more than $210 billion in health care costs annually. […] The U.S. Preventive Services Task Force (USPSTF) and American Academy of Family Physicians recommend screening for depression in the general adult population. […] All screening should be implemented with adequate systems in place to ensure accurate diagnosis, effective treatment, and appropriate follow-up. […] The two-item and nine-item Patient Health Questionnaires (PHQs) are commonly used validated screening tools. […] Screening all postpartum women for depression is recommended by the USPSTF, American Academy of Family Physicians, American Academy of Pediatrics, and American College of Obstetricians and Gynecologists. […] In older adults, the Geriatric Depression Scale is also an appropriate screening tool for depression.

• #1 Recommendations | Depression in adults: treatment and management | Guidance | NICE

  https://www.nice.org.uk/guidance/ng222/chapter/recommendations

  Be alert to possible depression (particularly in people with a past history of depression or a chronic physical health problem with associated functional impairment) and consider asking people who may have depression if: During the last month, have they often been bothered by feeling down, depressed or hopeless? […] Always ask people with depression directly about suicidal ideation and intent. If there is a risk of self-harm or suicide: assess whether the person has adequate social support and is aware of sources of help, arrange help appropriate to the level of need, advise the person to seek further help if the situation deteriorates. […] If a person with depression presents considerable immediate risk to themselves or others, refer them urgently to specialist mental health services.

• #1 7.5 Applying the Nursing Process to Depressive Disorders – Nursing: Mental Health and Community Concepts

  https://wtcs.pressbooks.pub/nursingmhcc/chapter/7-5-applying-the-nursing-process-to-depressive-disorders/

  Assessing a client with a depressive disorder focuses on both verbal and nonverbal assessments. […] The role of the nurse in caring for clients with depression is related to primary nursing care, as well as collaboration with interprofessional team members. […] The registered nurse uses specific questions during the clients admission process based on agency policy. […] Critical findings that require immediate notification of the provider are bolded with an asterisk. […] The client may exhibit too much sleep (i.e., 14-18 hours daily) or have insomnia (i.e., less than 4 hours of sleep or in intervals of sleep). […] The client may have a slow response with walking, talking, and reacting; may tend to stay put on the couch or in bed. […] The client may exhibit weight loss, insomnia, constipation, and self-care deficits.

• #1 Major Depression: Nursing Diagnoses, Care Plans, Assessment & Interventions | NurseTogether

  https://www.nursetogether.com/major-depression-nursing-diagnosis-care-plan/

  Depression itself is a barrier but the nurse can delve further into the causes of the patients poor self-care. The patient may lack the energy, time, assistance, or may feel the tasks are unimportant. […] Major depression can affect the patients motivation and energy in completing self-care tasks.

• #1 7.5 Applying the Nursing Process to Depressive Disorders – Nursing: Mental Health and Community Concepts

  https://wtcs.pressbooks.pub/nursingmhcc/chapter/7-5-applying-the-nursing-process-to-depressive-disorders/

  For example, the client states, I just dont want to shower today. […] For example, the client states, I have no energy; I cannot get out of bed. […] The client may feel there is no longer any hope for them getting better or for life improving. […] The client may have feelings of guilt regarding themselves and their depression. […] The client does not feel in control of life events. […] Nurses should report new symptoms of depression in clients who have been diagnosed with dementia. […] Evaluation of the clients progress towards meeting expected outcomes occurs continuously throughout the treatment phase.

• #1 Major Depression Nursing Care Plans – 9 Nursing Diagnosis – Nurseslabs

  https://nurseslabs.com/major-depression-nursing-care-plans/

  Goals and expected outcomes may include: The client will seek help when experiencing self-destructive impulses. The client will have a behavioral manifestation of absent depression. The client will identify at least two-three people he/she can seek out for support and emotional guidance when he/she is feeling self-destructive before discharge. The client will not inflict any harm to themself or others. The client will identify support and support groups with whom he/she is in contact within one month. The client will state that he/she wants to live. The client will start working on constructive plans for the future. The client will demonstrate compliance with any medication or treatment plan within the next two weeks. The client will identify feelings that lead to poor social interactions. The client will discuss two-three alternative ways to take when feeling the need to withdraw. The client will eventually voluntarily attend individual/group therapeutic meetings within a therapeutic milieu (community or hospital). The client will verbalize that he/she enjoys interacting with others in activities and one-on-one interactions to the extent they did before becoming depressed. The client will state and demonstrate progress in the resumption of sustaining relationships with friends and family members within one month. The client will feel connected with others to share thoughts, feelings, and beliefs. The client will feel connectedness with the inner self. The client will participate in spiritual rites and passages. The client will discuss with the nurse two things that gave his or her life meaning in the past within three days. The client will talk to a nurse or a spiritual leader about spiritual conflicts and concerns within three days. The client will keep a journal tracking thoughts and feelings for one week. The client will state that he/she feels a sense of forgiveness. The client will state that he/she wants to participate in former creative activities. The client will state that he/she gained comfort from previous spiritual practices. The client will demonstrate a zest for life and the ability to enjoy the present. The client will identify one or two strengths by the end of the day. The client will identify two unrealistic self-expectations and reformulate more realistic life goals with the nurse by the end of the day. The client will identify three judgemental terms (e.g., I am lazy) the client uses to describe themself and identify objective terms to replace them (e.g., I do not feel motivated to). The client will keep a daily load and identify on a scale of 1 to 10 (1 being the lowest, 10 being the highest) feelings of guilt, shame, and self-hate. The client will report decreased feelings of guilt, shame, and self-hate by using a scale of 1 to 10 (1 being the lowest, 10 being the highest). The client will demonstrate the ability to modify unrealistic self-expectations. The client will give an accurate and nonjudgmental account of four positive qualities as well as identify two areas he or she wishes to improve. The client will identify two goals he or she wants to achieve from treatment, with aid of nursing intervention, within one to two days. The client will discuss with the nurse two irrational thoughts about self and others by the end of the first day. The client will reframe three irrational thoughts with the nurse. The client will remember to keep appointments, attend activities, and attend to grooming with minimal reminders from others within one to three weeks. The client will identify negative thoughts and rationally counter them and/or reframe them in a positive manner within two weeks. The client will show improved mood as demonstrated by the Beck Depression Inventory. The client will give examples showing that short-term memory and concentration have improved to usual levels. The client will demonstrate an increased ability to make appropriate decisions when planning with the nurse. The client will groom and dress appropriately with help from nursing staff and/or family. The client will regain a more normal elimination pattern with the aid of foods high in roughage, increased fluid intake, and exercise daily (also with the aid of medications). The client will sleep between four to six hours with the aid of nursing measures and/or medications. The client will gain one pound a week with encouragement from family, significant others, and/or staff if significant weight loss is noted. The client will demonstrate progress in the maintenance of adequate hygiene and be appropriately groomed and dressed (shave/makeup, clothes clean and neat). The client will experience normal elimination with the aid of diet, fluids, and exercise within three weeks. The client will sleep between six to eight hours per night within one month. The client will gradually return to weight consistent for height and age or baseline before the illness. The client will engage in self-care activities at his or her own pace. The client will demonstrate improvement in handling the stages of grief at his or her own pace. The client will verbalize a sense of improvement toward the resolution of hope and grief in the subsequent time. The client will express feelings and acceptance of life events over which he or she has no control. The client will demonstrate independent problem-solving techniques to take control over life and does not verbalize or demonstrate suicidality. The client and significant other will verbalize accurate information about at least two of the possible causes of depression, three to four of the signs and symptoms of depression, and the use of medications, psychotherapy, and electroconvulsive therapy as treatment.

• #1 Major Depression Nursing Care Plans – 9 Nursing Diagnosis – Nurseslabs

  https://nurseslabs.com/major-depression-nursing-care-plans/

  Therapeutic interventions and nursing actions for patients with major depression may include: Promoting Safety and Preventing Self-Directed Violence, Promoting Therapeutic Relationship and Enhancing Support Network, Promoting Activities of Daily Living and Self-Care, Providing Emotional Support and Enhancing Self-Esteem, Initiating Patient Education and Health Teachings, Administer Medications and Provide Pharmacologic Support.

• #1 Depression Nursing Care Plan: Diagnosis, Assessment, & Intervention

  https://simplenursing.com/nursing-diagnosis-for-depression/

  Nursing interventions for a patient with depression symptoms may appear as the following: Limit complex words, Identify suicide risk and supervision needs, Initiate one-to-one activities, Initiate group activities, Create a no-suicide agreement, Referral to local support groups, Encourage alternative, healthy ways of expressing feelings.

• #1 Psychiatry.org – What Is Depression?

  https://www.psychiatry.org/patients-families/depression/what-is-depression

  Psychotherapy, or talk therapy, is also often recommended. Cognitive behavioral therapy (CBT), one of the most common forms of psychotherapy, has been found to be effective in treating depression. […] There are a number of things people can do to help reduce the symptoms of depression. For many people, regular exercise helps create positive feeling and improves mood. Getting enough quality sleep on a regular basis, eating a healthy diet and avoiding alcohol (a depressant) can also help reduce symptoms of depression. […] Depression is a real illness and help is available. With proper diagnosis and treatment, the vast majority of people with depression will overcome it. If you are experiencing symptoms of depression, a first step is to see your family physician or psychiatrist. Talk about your concerns and request a thorough evaluation.

• #1 Major Depression Nursing Care Management

  https://nurseslabs.com/major-depression/

  These are the nursing responsibilities for taking care of patients with major depression: […] Provide for patients physical needs. Assist with self-care and personal hygiene. Encourage the patient to eat. […] Educate patient about depression. Explain that depression can be eased by expressing feelings and engaging in pleasurable activities. Emphasize that there are effective methods available for relief of symptoms. […] Stress the need for medication compliance. Review adverse effects with the patient. […] Major Depression is a syndrome of persistently sad or irritable mood accompanied by disturbance in sleep and appetite, lethargy, and inability to express pleasure. […] Here are nursing care tips for children with major depression: Structure and maintain a safe environment. Monitor closely for dangerous or self-destructive behaviors. Develop an agreement or contract with child about seeking a staff whenever he feels desperate or suicidal.

• #1 Depression (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK568733/

  Education plays an important role in the successful treatment of major depressive disorder. This would include the education of the family and the patient. Lack of accurate information and misperceptions of the illness as a personal weakness or failing leads to painful stigmatization and avoidance of the diagnosis by many of those affected. Patients should know the rationale behind the choice of treatment, potential adverse effects, and expected results. The involvement of the patient in the treatment plan can enhance medication compliance and referral for psychotherapy. Engaging family members can be a critical component of a treatment plan. Family members are helpful informants, can ensure medication compliance, be a big source of social support and can encourage patients to change behaviors that perpetuate depression (e.g., inactivity).

• #1 Tackling Depression in The Elderly with Home Care

  https://nurselinecs.co.uk/depression/tackling-depression-in-the-elderly-with-home-care/

  Medication management is one of the primary responsibilities of at-home support workers. […] Home care services bring various benefits to older people, and the following elements of home care can significantly improve older adults emotional well-being: Retaining ones own tenancy and staying in their familiar surrounding, Staying close to your family members, Personal care and assistance with everyday activities, Medication management and support with assistive devices, Emotional companionship, Regular socialisation and fulfilling physical activities, Maintaining a healthy diet, getting nutritious meals and hydration, Maximised independence and participation in the local community. […] Addressing depression is a vital part of home care services. […] Quality home care providers are always available to assist people with physical and mental health struggles. […] Our dedicated support workers deliver high-standard care in your own homes, allowing individuals to stay in their familiar surroundings and close to their loved ones.

• #1 Depression: Collaborative Care | The Community Guide

  https://www.thecommunityguide.org/findings/mental-health-and-mental-illness-collaborative-care-management-depressive-disorders.html

  The Community Preventive Services Task Force (CPSTF) recommends collaborative care for the management of depressive disorders based on strong evidence of effectiveness in improving depression symptoms, adherence to treatment, response to treatment, and remission and recovery from depression. […] Collaborative care for the management of depressive disorders is a multicomponent, healthcare system-level intervention that uses case managers to link primary care providers, patients, and mental health specialists. […] Collaborative care models typically have case managers, who support primary care providers with functions such as patient education, patient follow up to track depression outcomes and adherence to treatment, and adjustment of treatment plans for patients who do not improve. […] Primary care providers are usually responsible for routine screening for and diagnosing of depressive disorders, initiating treatment for depression, and referring patients to mental health specialists as needed.

• #1 Recommendations | Depression in adults: treatment and management | Guidance | NICE

  https://www.nice.org.uk/guidance/ng222/chapter/recommendations

  Offer referral to specialist mental health services for people with depression with psychotic symptoms, where the treatment should include: a risk assessment, an assessment of needs, a programme of coordinated multidisciplinary care, access to psychological treatments, after improvement of acute psychotic symptoms. […] Consider electroconvulsive therapy (ECT) for the treatment of severe depression if: the person chooses ECT in preference to other treatments based on their past experience of ECT and what has previously worked for them or a rapid response is needed or other treatments have been unsuccessful. […] Consider collaborative care for people with depression, particularly older people, those with significant physical health problems or social isolation, or those with more chronic depression not responding to usual specialist care.

• #1 Collaborative Care for Depression in Older Adults | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0900/lown-right-care-depression-older-adults.html

  Older patients generally respond to the same treatments as other adults. […] A PHQ-9 score greater than 15, accompanied by the DSM-5 additional criteria, is suggestive of major depression and generally warrants treatment with medication. […] Cognitive behavior therapy and problem-solving therapy are supported by evidence and can be combined with medication. […] Collaborative care may be the ideal primary care model for older adults with depression because of comorbid conditions, risk factors, and loneliness. […] Collaborative care doubles the effectiveness of depression treatment for older adults in primary care settings. […] When older patients do not respond to initial treatment (medication titration, medication changes, or behavior interventions alone), clinicians should have a shared decision-making discussion with the patient about adding a complementary approach.

• #1 The Effectiveness of the Integrated Care Model among Community-Dwelling Older Adults with Depression: A Quasi-Randomized Controlled Trial

  https://www.mdpi.com/1660-4601/19/6/3306

  The interventions for decreasing depression include social support, exercise and physical activities, reminiscence therapy, aid in daily activities, and adequate social resources. Social support may protect older adults against worsening depression, and mitigate psychosocial stressors through emotional and tangible support. Healthcare professionals educate the elderly to help them adopt positive behaviors and strategies to manage depression so that patients can cope with stress, reduce negative thinking and depression, maintain mental health, and promote life adaptation. […] To sum up the above literature, the Integrated Care Model (ICM) combines case management, community care, and home care to provide intervention to older patients with depression and their families. The ICM emphasizes patient-centered care and involves collaboration with families and professional healthcare providers to achieve better health.

• #1 The Effectiveness of the Integrated Care Model among Community-Dwelling Older Adults with Depression: A Quasi-Randomized Controlled Trial

  https://www.mdpi.com/1660-4601/19/6/3306

  The results of this study indicate that the ICM can effectively decrease depression, psychological symptoms, and suicide ideation, as well as improve life satisfaction among older patients with depression living in communities. Additionally, the ICM has a long-term influence, even after the end of the intervention, on depression, psychological symptoms, and life satisfaction. In contrast, participants experienced worsening of conditions in the control group. […] Providing the ICM for the older adults with depression can promote their health. Therefore, the integrated care of this study was related to the development and promotion of a prevention and treatment system for depression, the early screening of the elderly with depression in the community, provision for appropriate care, and preventive measures to reduce the incidence of suicide so that the elderly can „age healthy and prevent disability.”

• #1 Tackling Depression in The Elderly with Home Care

  https://nurselinecs.co.uk/depression/tackling-depression-in-the-elderly-with-home-care/

  Several medical challenges can lead to depression in older adults. […] Access to humanised home care services can help seniors with depression lead fulfilling lives and bring peace of mind to their whole families. […] Quality home care strategies tackle the physical and mental health needs of older adults with depressive episodes. […] Therefore, care workers should take a comprehensive approach to supporting older people with depression, including emotional companionship, exercise regimens, and transportation to community events. […] Regular physical activity and exercise can bring various benefits to older people with physical or mental health challenges. […] Following a healthy diet is a crucial step towards improving an older adults mental well-being. […] By opting for live-in care, older adults can receive professional support in their own homes 24 hours a day, seven days a week.

• #1 Treatment – Depression in adults – NHS

  https://www.nhs.uk/mental-health/conditions/depression-in-adults/treatment/

  Treatment for depression usually involves a combination of self-help, talking therapies and medicines. […] The treatment recommended will be based on the type of depression you have. […] If you have mild depression that’s not improving, you may find a talking therapy helpful. […] A GP can refer you for talking therapies, or you can refer yourself directly to an NHS talking therapies service without a referral from a GP. […] If you have more severe depression, which includes moderate or severe depression, the following treatments may be recommended. […] Antidepressants are medicines that treat the symptoms of depression. […] A GP may recommend that you take a course of antidepressants plus talking therapy, particularly if your depression is quite severe. […] If you have severe depression, you may be referred to a mental health team made up of psychologists, psychiatrists, specialist nurses and occupational therapists.

• #1 Treatment – Depression in adults – NHS

  https://www.nhs.uk/mental-health/conditions/depression-in-adults/treatment/

  Cognitive behavioural therapy (CBT) aims to help you understand your thoughts and behaviour, and how they affect you. […] CBT is available on the NHS for people with depression or any other mental health problem it’s been shown to help. […] Counselling is a form of therapy that helps you think about the problems you’re experiencing in your life so you can find new ways of dealing with them. […] Antidepressants are not addictive, but you may get some withdrawal symptoms if you stop taking them suddenly or you miss a dose. […] Mindfulness involves paying closer attention to the present moment, and focusing on your thoughts, feelings, bodily sensations and the world around you to improve your mental wellbeing. […] Brain stimulation is sometimes recommended by a specialist to treat severe depression that has not responded to other treatments.

• #1 Major Depressive Disorder in Adults – Diagnosis and Management – Province of British Columbia

  https://www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/bc-guidelines/depression-in-adults

  Continue patients on antidepressants for at least 6 months after full remission of symptoms or achievement of treatment goals. […] Consultation with a psychiatrist is recommended for: Bipolar disorder, psychotic symptoms and/or a substance use disorder; Risk of suicide or harm to others; Severe co-morbid psychiatric or medical illness; History of treatment resistance; Failed to respond to standard treatment (at adequate dosage and time-period); An unclear diagnosis that needs a more comprehensive evaluation; and Therapeutic relationship has broken down.

• #1 Depression in adults

  https://www.rcpsych.ac.uk/mental-health/mental-illnesses-and-mental-health-problems/depression

  If your depression is moderate or severe or goes on for a long time, your doctor may suggest a course of antidepressants, usually one that is a selective serotonin reuptake inhibitor (SSRI). […] If your depression is severe or needs specialist treatment, you may need to come into hospital to receive treatment. […] Electroconvulsive therapy (ECT for short) is mostly used as a treatment for severe depression if the person’s life is at risk and they need urgent treatment. […] If you are concerned about someone then its important to talk to them about suicidal thoughts and feelings and to take them seriously.

• #1 Adolescent & Adult Depression Treatment Center | Minneapolis, MN

  https://prairie-care.com/treatment/depression/

  It is possible to manage depression and there can be relief. […] The appropriate treatment plan depends on the type and severity of the persons depressive thoughts and feelings. […] Treatment methods for depression include: Psychotherapy or talk therapy once a week or more, depending on the patient; Medication management to rebalance the brain chemistry issues that contribute to depression; Brain stimulation such as Transcranial Magnetic Stimulation for adults with treatment-resistant depression; Outpatient services with programming levels to fit the needs of the patient, including full-day programs, after school, and specialty tracks; Inpatient hospitalization for short-term care to stabilize symptoms following a mental health crisis; Residential care is a long-term treatment for intensive psychiatric needs.

• #1 Depression and Older Adults – Elliott | Nursing & Rehabilitation

  https://www.elliottnr.com/depression-older-adults/

  Depression is a serious mood disorder. It can affect the way you feel, act, and think. Depression is a common problem among older adults, but clinical depression is not a normal part of aging. […] Depression is serious, and treatments are available to help. For most people, depression gets better with treatment. Counseling, medicine, or other forms of treatment can help. […] There are several types of depression that older adults may experience: Major Depressive Disorder includes symptoms lasting at least two weeks that interfere with a person’s ability to perform daily tasks […] Persistent Depressive Disorder (Dysthymia) a depressed mood that lasts more than two years, but the person may still be able to perform daily tasks, unlike someone with Major Depressive Disorder […] Depression is common in people with Alzheimer’s and related dementias.

• #1 Depression – Canadian Coalition for Seniors’ Mental Health

  https://ccsmh.ca/areas-of-focus/depression/

  Up to 20% of older adults have symptoms of depression and these rates increase up to 40% for those in hospitals and long-term care homes. Depression is not a typical part of aging. There are many ways to treat depression including by improving lifestyle and social supports, counselling, and medication.

• #1 Older Adults and Depression | NCDHHS

  https://www.ncdhhs.gov/divisions/mental-health-developmental-disabilities-and-substance-use-services/mental-health-services/older-adult-mental-health/older-adults-and-depression

  Depression is a true and treatable medical condition, not a normal part of aging. However older adults are at an increased risk for experiencing depression. […] Depression is not just having „the blues” or the emotions we feel when grieving the loss of a loved one. It is a true medical condition that is treatable, like diabetes or hypertension. […] Someone who is depressed has feelings of sadness or anxiety that last for weeks at a time. […] Older adults who deny feeling sad or depressed may still have major depression. […] Older adults are at increased risk. We know that about 80% of older adults have at least one chronic health condition, and 50% have two or more. Depression is more common in people who also have other illnesses (such as heart disease or cancer) or whose function becomes limited. […] Older adults are often misdiagnosed and undertreated. Healthcare providers may mistake an older adult’s symptoms of depression as just a natural reaction to illness or the life changes that may occur as we age, and therefore not see the depression as something to be treated.

• #1 Depression and Aging | Healthy Aging | CDC

  https://www.cdc.gov/healthy-aging/about/depression-aging.html

  Older adults often do not seek help for depression. […] They may think their symptoms are a normal part of getting older. […] They may feel stigma or shame about feeling depressed. […] They may not understand that they could feel better with the right treatment. […] Older adults may also face barriers to treatment, including: […] Difficulty getting care because of costs, problems with transportation, or a lack of mental health services. […] Healthcare professionals may not adequately diagnose or treat depression in older adults. […] Most older adults see an improvement in their symptoms when treated. […] Effective treatments are available, including: […] Medication for depression. […] Psychotherapy. […] A combination of both.

• #1 Symptoms and causes of depression and its diagnosis and management | Nursing Times

  https://www.nursingtimes.net/mental-health/symptoms-and-causes-of-depression-and-its-diagnosis-and-management-30-03-2020/

  Depression is a common condition. It presents differently in each person, but common symptoms include feelings of hopelessness, loss of interest in things previously enjoyed, and reduced motivation and energy. […] It is important that nurses can recognise patients presenting with depression. […] Nurses work at the forefront of patient interaction and care. It is, therefore, essential that they understand depression, along with its signs, symptoms and clinical, social and economic impacts to be able to provide effective person-centred care. […] Treatment options vary, depending on the severity of the episode, and a stepped-care approach is recommended. […] Core interventions for nurses working with people with depression include: Psychological approaches; Psycho-education; Medications management; Monitoring.

• #1 Symptoms and causes of depression and its diagnosis and management | Nursing Times

  https://www.nursingtimes.net/mental-health/symptoms-and-causes-of-depression-and-its-diagnosis-and-management-30-03-2020/

  Nurses from all fields can learn to recognise depression in their patients and ensure further assessment and interventions can be offered. […] These findings emphasise the importance of careful psychological assessment and treatment of people with a long-term physical condition, even in the critical stages of a disease. Nurses in all fields should consider the mental health of people in their care. […] A significant part of sustained recovery from depression is being able to avoid or cope with relapse risk factors. […] Depression is common and often chronic and recurrent. Its symptoms and outcomes are marked by persistent suffering, poor overall health and negative effects on several areas of life, including psychosocial, academic and work life. […] This article has provided a general overview of depression, its treatment, outcomes and significance when providing nursing care and assessment.

• #1 Detecting and screening for depression in older adults

  https://www.myamericannurse.com/detecting-and-screening-for-depression-in-older-adults/

  In older adults, depression signs and symptoms often differ from those in younger people. Nearly half of depressed older adults don’t report symptoms that match the DSM-IV-TR criteria. Instead, they may report dysthymia, anxiety, or subclinical depression (depression masked by bodily complaints). […] Older adults are less likely to self-identify problems, seeking care instead from primary-care physicians, nurse practitioners, or medical specialists when they experience anxiety, depression, or cognitive or physiologic changes. This may stem from the belief that depression and anxiety signify weakness or poor character. With continuing stigmatization of mental health problems, many older persons are reluctant to acknowledge mood or cognitive changes. […] Depression can accompany or stem from serious physical problems, such as heart disease, stroke, diabetes, cancer, endocrine disorders, infections, or Parkinson’s disease. And depression can delay recovery from these illnesses or worsen outcomes.

• #1 Depression Remission or Response for Adolescents and Adults (DRR-E) – NCQA

  https://www.ncqa.org/report-cards/health-plans/state-of-health-care-quality-report/depression-remission-or-response-for-adolescents-and-adults-drr-e/

  Depressive disorders are common mental disorders that occur in people of all ages. Major depressive disorder (MDD) is a leading cause of disability worldwide, affecting an estimated 120 million people. Depression is associated with other chronic medical conditions and increased morbidity and mortality. The mortality risk for suicide in depressed patients is more than 20-fold greater than in the general population. Depression adversely affects the course, complications and management of other chronic medical illnesses. Numerous studies have demonstrated the effectiveness of screening and treatment for depression. Literature has focused on the care processes needed to treat and manage depression in primary care settings, where the majority of depression cases first present. Studies have found that patient outcomes improve when there is collaborative care between a primary care doctor, case manager and a mental health specialist to screen for depression, monitor symptoms, provide treatment and refer to specialty care as needed.

• #1 Depression in the nursing home: a cluster-randomized stepped-wedge study to probe the effectiveness of a novel case management approach to improve treatment (the DAVOS project) | Trials | Full Text

  https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-019-3534-x

  The intervention is initiated by a screening applied to the participating residents using a modified version of the Depression Monitoring List (DeMoL) with integrated Patient Health Questionnaire (PHQ-D) assessment. […] The prevalence of depressive disorders and the severity of depression symptoms (or any change in them) among nursing home residents are the primary outcomes of DAVOS. […] Collaborative and multiprofessional treatment concepts are an effective and efficient means of providing appropriate health care for old and very old persons and have recently been recommended for the treatment of depression in nursing home residents. […] The program addresses important reasons for the health-care deficits related to the adequate treatment of depression in German nursing homes.

• #1 Depression: Collaborative Care | The Community Guide

  https://www.thecommunityguide.org/findings/mental-health-and-mental-illness-collaborative-care-management-depressive-disorders.html

  These mental health specialists provide clinical advice and decision support to primary care providers and case managers. […] The U.S. Preventive Services Task Force (USPSTF) recommends screening for depression in adults in outpatient primary care settings when adequate systems are in place for efficient diagnosis, treatment and follow-up for depressive disorders. […] The evidence from this economic review suggests that collaborative care for the management of depressive disorder is both cost-effective and cost-beneficial. […] Based on updated evidence, results are applicable to adults (20-64 years) and older adults (65 years and older), women and men, and a diverse range of organizations and settings. […] Nurses served as case managers in most of the included studies. […] The effect estimate from studies using masters-level mental health workers was smaller than the overall estimate. More skills development is likely needed for those serving as case managers.

• #1 Detecting and screening for depression in older adults

  https://www.myamericannurse.com/detecting-and-screening-for-depression-in-older-adults/

  Because older people of all ethnic groups tend to turn to primary-care practitioners rather than specialists, nurses and general medical physicians are well situated to intervene. […] Interpersonal interventions by trained nurses have brought symptom relief to some older women. […] With severe depression that resists treatment, brain stimulation in the form of electroconvulsive therapy or transcranial magnet stimulation may be helpful. […] For some patients, arranging for environmental intervention may be important. […] Today, depression commonly is assessed and treated in primary-care and general medical settings, and nurses are assuming new roles as generalists and specialist practitioners to increase outreach and make treatment more widely available to older adults. Nurses need to know how to identify signs and symptoms of depression in these patients and should be able to screen for depression.

• #2

  https://www.who.int/news-room/fact-sheets/detail/depression

  Depression is a common mental disorder. […] There is effective treatment for mild, moderate and severe depression. […] Depression can cause difficulties in all aspects of life, including in the community and at home, work and school. […] There are effective treatments for depression. These include psychological treatment and medications. Seek care if you have symptoms of depression. […] Psychological treatments are the first treatments for depression. […] Effective psychological treatments for depression include: behavioural activation, cognitive behavioural therapy, interpersonal psychotherapy, problem-solving therapy. […] Health-care providers should keep in mind the possible adverse effects associated with antidepressant medication, the ability to deliver either intervention (in terms of expertise, and/or treatment availability), and individual preferences.

• #2

• #2 Depression Remission or Response for Adolescents and Adults (DRR-E) – NCQA

  https://www.ncqa.org/report-cards/health-plans/state-of-health-care-quality-report/depression-remission-or-response-for-adolescents-and-adults-drr-e/

  The PHQ-9 is widely used by clinicians in the U.S. and commonly accepted in the behavioral health field as well. Furthermore, the PHQ-9 is quick to complete, score, and is recommended by the International Consortium for Health Outcomes Measurement (ICHOM) as the tool to be used to track depression symptoms in their standard set of outcome measures for depression and anxiety.

• #2 Depression: Screening and Diagnosis | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/1015/p508.html

  If screening is positive for possible depression, the diagnosis should be confirmed using Diagnostic and Statistical Manual of Mental Disorders, 5th ed., criteria. […] Major depression is one of the most common mental health disorders in the United States. […] The U.S. Preventive Services Task Force, American Academy of Family Physicians, American Academy of Pediatrics, and American College of Obstetricians and Gynecologists recommend screening all postpartum women for depression. […] The USPSTF recommends screening for depression in the general adult population. […] Older adults can be screened for depression using an instrument such as the PHQ-2, PHQ-9, Cornell Scale for Depression in Dementia, or Geriatric Depression Scale. […] When screening is positive for possible depression, the diagnosis should be confirmed using criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th ed. […] The incidence of depression is higher in patients with chronic medical conditions. […] Physicians should consider screening patients with chronic medical conditions for depression.

• #2 Recommendation: Depression and Suicide Risk in Adults: Screening | United States Preventive Services Taskforce

  https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/screening-depression-suicide-risk-adults

  Adults, including pregnant and postpartum persons, and older adults (65 years or older) The USPSTF recommends screening for depression in the adult population, including pregnant and postpartum persons, as well as older adults. B […] To achieve the benefit of depression screening and reduce disparities in depression-associated morbidity, it is important that persons who screen positive are evaluated further for diagnosis and, if appropriate, are provided or referred for evidence-based care. […] Treatment for MDD in adults includes psychotherapy or pharmacotherapy. Collaborative care is a multicomponent, health care system-level intervention that uses care managers to link primary care clinicians, patients, and mental health specialists to ensure patients receive the best care. […] The USPSTF recommends screening for depression in all adults regardless of risk factors. However, there are some factors that increase risk. These include family history of depression, prior episodes of depression or other mental health conditions, a history of trauma or adverse life events, or a history of disease or illness.

• #2 Major Depression Nursing Care Management

  https://nurseslabs.com/major-depression/

  These are the nursing responsibilities for taking care of patients with major depression: […] Provide for patients physical needs. Assist with self-care and personal hygiene. Encourage the patient to eat. […] Educate patient about depression. Explain that depression can be eased by expressing feelings and engaging in pleasurable activities. Emphasize that there are effective methods available for relief of symptoms. […] Stress the need for medication compliance. Review adverse effects with the patient. […] Major Depression is a syndrome of persistently sad or irritable mood accompanied by disturbance in sleep and appetite, lethargy, and inability to express pleasure. […] Here are nursing care tips for children with major depression: Structure and maintain a safe environment. Monitor closely for dangerous or self-destructive behaviors. Develop an agreement or contract with child about seeking a staff whenever he feels desperate or suicidal.

• #2 Tackling Depression in The Elderly with Home Care

  https://nurselinecs.co.uk/depression/tackling-depression-in-the-elderly-with-home-care/

  Several medical challenges can lead to depression in older adults. […] Access to humanised home care services can help seniors with depression lead fulfilling lives and bring peace of mind to their whole families. […] Quality home care strategies tackle the physical and mental health needs of older adults with depressive episodes. […] Therefore, care workers should take a comprehensive approach to supporting older people with depression, including emotional companionship, exercise regimens, and transportation to community events. […] Regular physical activity and exercise can bring various benefits to older people with physical or mental health challenges. […] Following a healthy diet is a crucial step towards improving an older adults mental well-being. […] By opting for live-in care, older adults can receive professional support in their own homes 24 hours a day, seven days a week.

• #2 Depression: Collaborative Care | The Community Guide

  https://www.thecommunityguide.org/findings/mental-health-and-mental-illness-collaborative-care-management-depressive-disorders.html

  These mental health specialists provide clinical advice and decision support to primary care providers and case managers. […] The U.S. Preventive Services Task Force (USPSTF) recommends screening for depression in adults in outpatient primary care settings when adequate systems are in place for efficient diagnosis, treatment and follow-up for depressive disorders. […] The evidence from this economic review suggests that collaborative care for the management of depressive disorder is both cost-effective and cost-beneficial. […] Based on updated evidence, results are applicable to adults (20-64 years) and older adults (65 years and older), women and men, and a diverse range of organizations and settings. […] Nurses served as case managers in most of the included studies. […] The effect estimate from studies using masters-level mental health workers was smaller than the overall estimate. More skills development is likely needed for those serving as case managers.

• #2 Recommendations | Depression in adults: treatment and management | Guidance | NICE

  https://www.nice.org.uk/guidance/ng222/chapter/recommendations

  Consider using competence frameworks developed from treatment manual(s) for psychological and psychosocial interventions to support the effective training, delivery and supervision of interventions. […] For people with less severe depression who do not want treatment, or people who feel that their depressive symptoms are improving: discuss the presenting problem(s) and any underlying vulnerabilities and risk factors, as well as any concerns that the person may have. […] For people with chronic depressive symptoms that significantly impair personal and social functioning and who have not received previous treatment for depression, treatment options include: CBT or SSRIs or SNRIs or TCAs or combination therapy with CBT and either an SSRI or a TCA. […] Do not withhold treatment for depression because of a coexisting personality disorder.

• #2 Psychiatry.org – What Is Depression?

  https://www.psychiatry.org/patients-families/depression/what-is-depression

  Psychotherapy, or talk therapy, is also often recommended. Cognitive behavioral therapy (CBT), one of the most common forms of psychotherapy, has been found to be effective in treating depression. […] There are a number of things people can do to help reduce the symptoms of depression. For many people, regular exercise helps create positive feeling and improves mood. Getting enough quality sleep on a regular basis, eating a healthy diet and avoiding alcohol (a depressant) can also help reduce symptoms of depression. […] Depression is a real illness and help is available. With proper diagnosis and treatment, the vast majority of people with depression will overcome it. If you are experiencing symptoms of depression, a first step is to see your family physician or psychiatrist. Talk about your concerns and request a thorough evaluation.

• #2 Major Depressive Disorder in Adults – Diagnosis and Management – Province of British Columbia

  https://www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/bc-guidelines/depression-in-adults

  This guideline provides recommendations on how to diagnose and manage major depressive disorder (MDD) in the primary care setting for non-pregnant patients aged 19 65 years. It does not include recommendations for MDD subtypes (e.g., postpartum depression, seasonal affective disorder, psychotic depression, atypical depression and melancholic depression), other depressive disorders (e.g., disruptive mood dysregulation disorder, persistent depressive disorder (dysthmymia), premenstrual dysphoric disorder, treatment resistant/induced depression), psychosis, bipolar disorder, anxiety disorders, or substance abuse disorders. […] Screen for MDD with two quick question method. […] Use the Patient Health Questionnaire-9 (PHQ-9) to aid in diagnosing and monitoring patients. […] Assess suicide risk in all depressed patients.

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