Identifying elderly depression using the Depression Rating Scale as part of comprehensive standardised care assessment in nursing homes

Abstract

Objectives: This study used data from the SHELTER (Services and Health for Elderly in Long TERm care) project to explore the benefits of using the Depression Rating Scale (DRS) as part of a standardised needs assessment in UK nursing homes, including a statistical method of effectively identifying characteristics linking to residents’ depression.

Method: About 499 residents in nine nursing homes in south-east England were assessed with interRAI Long Term Care Facilities (interRAI LTCF), a standardised assessment tool containing the validated DRS residents who scored 3 or more on the DRS were considered ‘might suffer from depression’. A list of characteristics associated with depression was then examined using bivariate analysis and logistic regression.

Results: Among the 499 residents assessed, 67.5% were not depressed (DRS < 3) and 32.3% might suffer from depression (DRS ≥ 3). The final logistic model showed ‘never married’ (p = 0.019), ‘diagnosis of COPD’ (COPD, chronic obstructive pulmonary disease) (p = 0.015), ‘feelings of pain’ (p = 0.015) and ‘trouble sleeping’ (p < 0.001) were significantly associated with reporting of DRS score of 3 and more.

Conclusion: The article argued that DRS has distinctive advantages for using in UK nursing homes where a preponderance of residents is cognitively impaired, the procedure of screening depression is not regulated and resources to treat depression is relatively scarce. This article also demonstrated how using the DRS as part of a comprehensive standardised needs assessment facilitates analysis of characteristics linking to depression, which has significant policy implications in improving care quality and management.

Keywords:

• nursing home
• Depression Rating Scale
• routine assessment
• interRAI LTCF

Acknowledgements

The SHELTER (Services and Health for Elderly in Long TERm care) project is financed by the EU Seventh Framework Programme for Research and Technological Development in the area of Health. The aim of the study is to identify a standardised assessment instrument to be used on a large scale for older people in residential facilities in Europe. The study involves eight countries: Czech Republic, Finland, France, Germany, Israel, Italy, The Netherlands and the United Kingdom.