A Toolkit for Serving Diverse Communities

[Excerpt] This Toolkit provides the Aging Network and its partners with a replicable and easy-to-use method for providing respectful, inclusive, and sensitive services for any diverse community. The Toolkit consists of a four-step process and a questionnaire that assists professionals, volunteers and grassroots advocates with every stage of program planning, implementation and service delivery for older adult communities, their families and caregivers. The core principles of the toolkit include respect, inclusion and sensitivity as the hallmarks of quality service. This Toolkit is an invitation to make a cultural shift in service provision, to learn, to grow and fully appreciate the diverse community of older adults that agencies and their partners serve

Rationale and design: telepsychology service delivery for depressed elderly veterans

<p>Abstract</p> <p>Background</p> <p>Older adults who live in rural areas experience significant disparities in health status and access to mental health care. "Telepsychology," (also referred to as "telepsychiatry," or "telemental health") represents a potential strategy towards addressing this longstanding problem. Older adults may benefit from telepsychology due to its: (1) utility to address existing problematic access to care for rural residents; (2) capacity to reduce stigma associated with traditional mental health care; and (3) utility to overcome significant age-related problems in ambulation and transportation. Moreover, preliminary evidence indicates that telepsychiatry programs are often less expensive for patients, and reduce travel time, travel costs, and time off from work. Thus, telepsychology may provide a cost-efficient solution to access-to-care problems in rural areas.</p> <p>Methods</p> <p>We describe an ongoing four-year prospective, randomized clinical trial comparing the effectiveness of an empirically supported treatment for major depressive disorder, Behavioral Activation, delivered either via in-home videoconferencing technology ("Telepsychology") or traditional face-to-face services ("Same-Room"). Our hypothesis is that in-homeTelepsychology service delivery will be equally effective as the traditional mode (Same-Room). Two-hundred twenty-four (224) male and female elderly participants will be administered protocol-driven individual Behavioral Activation therapy for depression over an 8-week period; and subjects will be followed for 12-months to ascertain longer-term effects of the treatment on three outcomes domains: (1) clinical outcomes (symptom severity, social functioning); (2) process variables (patient satisfaction, treatment credibility, attendance, adherence, dropout); and (3) economic outcomes (cost and resource use).</p> <p>Discussion</p> <p>Results from the proposed study will provide important insight into whether telepsychology service delivery is as effective as the traditional mode of service delivery, defined in terms of clinical, process, and economic outcomes, for elderly patients with depression residing in rural areas without adequate access to mental health services.</p> <p>Trial registration</p> <p>National Institutes of Health Clinical Trials Registry (ClinicalTrials.gov identifier# NCT00324701).</p

Half of Home Care Recipients Are Depressed: How Do We Optimize Their Care

Xiang et al.1 provide us with the estimated prevalence of older adults receiving home care services who also experience major depression or subthreshold depressive symptoms, and their findings are sobering. A key strength of their study is its reliance on data from the 2008–2014 waves of the U.S. Health and Retirement Study, the largest ongoing nationally representative study of older Americans. Of the 811 respondents who self-reported receiving paid home care for one or more limitations in activities of daily living or instrumental activities of daily living, 13.4% met criteria for major depression and another 38.7% met criteria for subthreshold depression (52.1% total)