Integrating Effective Depression Interventions into Geriatric Care Management Practices

Rates of depression among the elderly have been found to range up to 28%. Moreover, 70 to 90% of late life depression goes undiagnosed and therefore untreated. Depression in the elderly has been associated with increased risk of disability, increased mortality, and impaired functioning, as well as with higher service use when compared to a nondepressed sample. As the portion of elderly in our community continues to rise, it becomes more and more critical to find adequate methods of detecting and treating late-life depression.

Kaiser and Partners in Care Foundation collaborated together in order to develop and test an integrated model of geriatric care management based on an effective new depression model developed for the primary care setting. Key elements from Project IMPACT include a stepped care treatment that offers antidepressant medications, psychotherapy (Problem Solving Therapy), or a combination of both. Findings from Project IMPACT indicate a substantial decrease in depression among intervention participants. This project represents an innovative approach by adapting a successful intervention designed to detect and treat depression in primary care settings. Unique features of this proposed intervention include the integration of evidence-based practice models into existing geriatric care management services and the application of a multi modal psychosocial treatment that can be accomplished within a short, defined time period.