Nursing Homes as Primary Care Sites for Psychological Practice

2006 ◽  
Vol 10 (1) ◽  
pp. 112-114 ◽  
Author(s):  
Victor Molinari
Keyword(s):  
Primary Care ◽  
Nursing Homes ◽  
Psychological Practice

The futility of cardiopulmonary resuscitation attempts in nursing homes and primary care wards

Resuscitation ◽  
2017 ◽  
Vol 118 ◽  
pp. e37
Author(s):  
Heidi Kangasniemi ◽  
Piritta Setälä ◽  
Heini Huhtala ◽  
Antti Kämäräinen ◽  
Ilkka Virkkunen ◽  
...  
Keyword(s):  
Primary Care ◽  
Nursing Homes ◽  
Cardiopulmonary Resuscitation

Psychological practice in primary care settings: Practical tips for clinicians.

2005 ◽  
pp. 95-112 ◽  
Author(s):  
William E. Haley ◽  
Susan H. McDaniel ◽  
James H. Bray ◽  
Robert G. Frank ◽  
Margaret Heldring ◽  
...  
Keyword(s):  
Primary Care ◽  
Psychological Practice ◽  
Primary Care Settings

scholarly journals The prognosis of depression in late life versus mid-life: implications for the treatment of older adults

2005 ◽  
Vol 17 (4) ◽  
pp. 533-538 ◽  
Author(s):  
Hari Subramaniam ◽  
Alex J. Mitchell
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Nursing Homes ◽  
Late Life ◽  
Clinical Excellence ◽  
Late Life Depression ◽  
Medical Settings ◽  
Nice Guidelines ◽  
Primary Care Settings

Depression in late life is extremely common. Of those aged 65 years or older, 2–5% have syndromal depression, but up to 20% of elderly people have depressive symptoms (Horwath et al., 2002). Both syndromal and subsyndromal depression carry a high risk of long-term complications and both are associated with elevated risks of morbidity and mortality (Penninx et al., 1999). Despite repeated alerts, depression is consistently under-recognized in acute medical settings, in nursing homes and in primary care (Volkers et al., 2004). For reasons that are inadequately understood, late-life depression seems to be under-treated to an even greater extent than depression in mid-life (Mackenzie et al., 1999). This issue is particularly important, given that effective and safe treatments for depression are available (Bartels et al., 2003), even though the evidence regarding maintenance therapies in older people is inconsistent (Geddes et al., 2003; Wilson et al., 2003). Recent evidence suggests that a package of care can improve the care of older depressed patients in primary care settings (Bruce et al., 2004) and in nursing homes (Ciechanowski et al., 2004). This has led to the development of several clinical guidelines specifically for late-life depression (Baldwin et al., 2003; Charney et al., 2003; Lebowitzet al., 1997). Yet, in the recent National Institute of Clinical Excellence (NICE) guidelines for the management of depression in primary and secondary care, no distinction was made between early, middle and late-life depression (Malone and Mitchell, 2005).

scholarly journals Case-Finding for Depression in Elderly People: Balancing Ease of Administration With Validity in Varied Treatment Settings

2004 ◽  
Vol 59 (4) ◽  
pp. M378-M384 ◽  
Author(s):  
Karen Blank ◽  
Cynthia Gruman ◽  
Julie T. Robison
Keyword(s):  
Primary Care ◽  
Major Depression ◽  
Nursing Homes ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Epidemiologic Studies ◽  
Diagnostic Interview ◽  
Case Finding ◽  
Late Life Depression ◽  
Cut Points

Abstract Background. Little is known about the performance of brief and ultrabrief (1- and 2-question) depression screens in older patients across varied treatment sites. This study (1) assesses their validity in clinics, hospitals, and nursing homes and (2) assesses cut-points for optimal clinical application. Methods. 360 patients aged 60 years and older from 2 urban primary care practices (n = 125), 1 general hospital (n = 150), and 8 nursing homes (n = 85) were assessed using the Yale 1-question screen, the 2-question instrument derived from the Primary Care Evaluation of Mental Disorders, and long and short versions of the Center for Epidemiologic Studies Depression (CES-D) scale and Geriatric Depression Scale (GDS). Sensitivity and specificity were calculated for each screen compared with the criterion standard Diagnostic Interview Schedule (DIS) depression diagnosis and receiver operating characteristic curves generated. Results. 9% of patients met DIS criteria for major depression and 7% for subsyndromal depression. Overall, the 10-item CES-D showed the best sensitivity/specificity for major depression in clinics (79%/81%) and hospitals (92%/77%), and the short GDS in nursing homes (86%/82%). Specificity of 1- and 2-question instruments was generally low. Established cut-points generally worked best for the short screens, while modifications were useful for longer versions. Conclusions. Consideration of site of use is important in selecting brief case-finding instruments for late-life depression, with the 10-item CES-D working best in medical settings and the 15-item GDS in nursing homes.

scholarly journals Hip fracture risk in patients with dementia in German primary care practices

Dementia ◽  
2015 ◽  
Vol 16 (7) ◽  
pp. 853-864 ◽  
Author(s):  
Jens Bohlken ◽  
Louis Jacob ◽  
Peter Schaum ◽  
Michael A Rapp ◽  
Karel Kostev
Keyword(s):  
Primary Care ◽  
Hip Fracture ◽  
Nursing Homes ◽  
Fracture Risk ◽  
Antidepressant Drugs ◽  
Hip Fracture Risk ◽  
Dementia Patients ◽  
Fracture Development ◽  
Care Practices ◽  
Primary Care Practices

The aim was to analyze the risk of hip fracture in German primary care patients with dementia. This study included patients aged 65–90 from 1072 primary care practices who were first diagnosed with dementia between 2010 and 2013. Controls were matched (1:1) to cases for age, sex, and type of health insurance. The primary outcome was the diagnosis of hip fracture during the three-year follow-up period. A total of 53,156 dementia patients and 53,156 controls were included. A total of 5.3% of patients and 0.7% of controls displayed hip fracture after three years. Hip fracture occurred more frequently in dementia subjects living in nursing homes than in those living at home (9.2% versus 4.3%). Dementia, residence in nursing homes, and osteoporosis were risk factors for fracture development. Antidementia, antipsychotic, and antidepressant drugs generally had no significant impact on hip fracture risk when prescribed for less than six months. Dementia increased hip fracture risk in German primary care practices.

Improving Primary Care in Nursing Homes

1991 ◽  
Vol 39 (4) ◽  
pp. 359-367 ◽  
Author(s):  
Robert L. Kane ◽  
Judith Garrard ◽  
Joan L. Buchanan ◽  
Alan Rosenfeld ◽  
Carol Skay ◽  
...  
Keyword(s):  
Primary Care ◽  
Nursing Homes

Effects of Depressive Syndromes on the Everyday Competence of Nursing Home Residents with Dementia

GeroPsych ◽  
2012 ◽  
Vol 25 (2) ◽  
pp. 103-109
Author(s):  
Sandra Verhülsdonk ◽  
Sabine Engel
Keyword(s):  
Primary Care ◽  
Nursing Home ◽  
Depressive Symptoms ◽  
Nursing Homes ◽  
Functional Impairment ◽  
Depressive Symptomatology ◽  
Nursing Home Residents ◽  
Cognitive Status ◽  
The Everyday ◽  
Depressive Syndromes

Depression in dementia is very common and has significant effects on the functional impairment of nursing-home residents. This study assesses depression, depression diagnosis, cognitive status, status of medication and functional status in 138 residents. Results: (1) 34.1% of the demented residents had a depressive symptomatology. (2) No diagnosis of “depression” was documented for a high percentage of depressed residents. (3) No correlation between depressive symptoms and treatment with antidepressants was present. (4) There was no correlation between the stage of dementia and the rate of depression. (5) There were significant differences in the everyday competence between depressive and nondepressive residents with dementia. The data suggest the need for an adequate diagnosis and treatment of depressive residents with dementia and underlines the need for improvement in care and treatment in primary care and nursing homes.

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