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A home‐delivered intervention for depressed, cognitively impaired, disabled elders
Author(s) -
Kiosses Dimitris N.,
Teri Linda,
Velligan Dawn I.,
Alexopoulos George S.
Publication year - 2011
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.2521
Subject(s) - intervention (counseling) , depression (economics) , psychology , cognition , population , cognitive impairment , activities of daily living , psychiatry , gerontology , clinical psychology , medicine , environmental health , economics , macroeconomics
Objective Problem Adaptation Therapy (PATH) is a new home‐delivered intervention designed to reduce depression and disability in depressed, cognitively impaired, disabled elders. A new intervention is needed in this population as antidepressant treatment is effective in only a minority of these patients. Methods PATH focuses on the patient's ecosystem, which includes the patient, the caregiver, and the home environment, to address the needs of depressed, cognitively impaired, disabled elders. It builds on the therapeutic framework of Problem Solving Therapy (PST), which has been efficacious in decreasing depression and disability in cognitively intact depressed elders. To address the needs of depressed elders with advanced cognitive impairment, PATH incorporates environmental adaptations and invites caregiver participation. Results To illustrate the administration of PATH, two case studies with varying degrees of cognitive impairment and caregiver participation are presented. Both patients were administered 12 weeks of PATH at their home. At the end of treatment their depression and disability was significantly reduced. Conclusions PATH is a new home‐delivered intervention for depressed elders with cognitive impairment and disability focusing on reducing depression and disability by employing environmental adaptations and inviting caregiver participation. This intervention may provide a treatment alternative for a population with limited success of antidepressant treatment. Copyright © 2010 John Wiley & Sons, Ltd.