The Availability of Psychological Services for Aged Care Residents in Australia: A Survey of Facility Staff

Objective: rates of depression and anxiety are high among older adults in residential aged care facilities (RACFs). This study examined the extent to which psychological services are made available to facility residents in Australia, and investigated barriers to accessing such services. Method: the sample consisted of 90 senior staff from a random sample of RACFs. Participants completed self-report questionnaires regarding their perspectives on the availability of psychological services and potential barriers to access psychological services. Results: access to psychological services was poor. Psychologists were employed at a rate only one third that of other providers of mental health services. Residents were rarely referred to psychologists or to psychological treatments. The most important barriers to access, as perceived by participants, were the low availability of psychologists specialising in treating older adults, lack of government funding for such access, and limited staff training in detecting depression and anxiety. Conclusion: access to psychologists and psychological services remains poor in Australian residential aged care settings. Such access may be improved by developing a workforce of clinical geropsychologists, improving funding mechanisms for residents to access psychological services, and addressing staff knowledge about depression and anxiety

Characteristics of Cognitive Behavioral Therapy for Older Adults Living in Residential Care: Protocol for a Systematic Review

Background: The prevalence rates of depressive and anxiety disorders are high in residential aged care settings. Older adults in such settings might be prone to these disorders because of losses associated with transitioning to residential care, uncertainty about the future, as well as a decline in personal autonomy, health, and cognition. Cognitive behavioral therapy (CBT) is efficacious in treating late-life depression and anxiety. However, there remains a dearth of studies examining CBT in residential settings compared with community settings. Typically, older adults living in residential settings have higher care needs than those living in the community. To date, no systematic reviews have been conducted on the content and the delivery characteristics of CBT for older adults living in residential aged care settings. Objective: The objective of this paper is to describe the systematic review protocol on the characteristics of CBT for depression and/or anxiety for older adults living in residential aged care settings. Methods: This protocol was developed in compliance with the recommendations of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Studies that fulfill the inclusion criteria will be identified by systematically searching relevant electronic databases, reference lists, and citation indexes. In addition, the PRISMA flowchart will be used to record the selection process. A pilot-tested data collection form will be used to extract and record data from the included studies. Two reviewers will be involved in screening the titles and abstracts of retrieved records, screening the full text of potentially relevant reports, and extracting data. Then, the delivery and content characteristics of different CBT programs of the included studies, where available, will be summarized in a table. Furthermore, the Downs and Black checklist will be used to assess the methodological quality of the included studies. Results: Systematic searches will commence in May 2018, and data extraction is expected to commence in July 2018. Data analyses and writing will happen in October 2018. Conclusions: In this section, the limitations of the systematic review will be outlined. Clinical implications for treating late-life depression and/or anxiety, and implications for residential care facilities will be discussed

Additional file 2 of Study protocol for ELders AT Ease (ELATE): a cluster randomised controlled trial of cognitive behaviour therapy to reduce depressive symptoms in aged care residents

Additional file 2: Supplementary Table 1. CONSORT 2010 checklist of information to include when reporting a cluster randomised trial. Supplementary Table 2. Extension of CONSORT for abstracts to reports of cluster randomised trials

Additional file 1 of Study protocol for ELders AT Ease (ELATE): a cluster randomised controlled trial of cognitive behaviour therapy to reduce depressive symptoms in aged care residents

Additional file 1. SPIRIT 2013 Checklist: Recommended items to address in a clinical trial protocol and related documents*