Abstract
Geriatric depression is under-detected in residential care facilities. There is a paucity of Canadian and Alberta-specific research on how this mental health condition is recognized and assessed in residential care settings. The purpose of this exploratory study was to learn about the perspectives and practices of regulated nurse professionals on the recognition of geriatric depression in long-term care (LTC) and designated supportive living (DSL) facilities in Alberta.
The research questions focused on: 1) relevant knowledge, beliefs, and education of participants; 2) the relationship between the level of knowledge and types of facilities; 3) depression assessment process and methods; 4) barriers to the recognition and assessment; and 5) perceived strategies for the effective detection of depression. The study employed a convergent parallel mixed methods design, including a survey (N = 635) and qualitative interviews (N = 14).
Findings suggested a risk for social exclusion of residents with geriatric depression from mental health services in Alberta. While considering the assessment of depression important, participants reported multiple challenges to its identification in facilities. One of the main challenges included specific socio-cultural beliefs about geriatric depression among staff, residents, and public, such as ageism, the normalization and the stigmatization of geriatric depression. Other challenges related to a less than optimal clinical knowledge of participants about geriatric depression, scarcity of resources, complicated and unclear assessment protocols, inconsistent use of assessment methods, poor communication between all stakeholders, and marginalized priority of the mental health care in facilities. These inter-connected structural and agential barriers on micro, mezzo, and macro levels served as constraining conditions in the depression assessment process. The perceived improvement strategies targeted addressing this complex constellation of barriers to enable successful detection.
Recommendations included actions to alter views about geriatric depression, such as public awareness campaigns and enhancing depression-specific education, as well as increasing resources, elevating the priority of mental health in facilities, and advocating for the legislative changes to support effective regulations and policies for mental health provision in these care settings.
