Evidence-Based Practice Guideline

Suzanne Fitzsimmons, MSN, ARNP Edited By Deborah Perry Schoenfelder, PhD, RN It is estimated that the incidence of depression in older adults living in long-term care facilities can be as high as 77% and is the most common mood disorder of late life (Steinberg et al., 2008). Unfortunately, depression often goes undiagnosed, and therefore untreated, since older adults may exhibit nonspecific somatic symptoms, rather than symptoms of depressed mood classified in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR) (American Psychiatric Association [APA], 2000; Bekelman et al., 2007; Greenberg, 2007). Minor depression often becomes chronic in older adults but is not a part of normal aging (Lammer, 2007). Depression is a serious mental illness that affects a person’s mood, behaviors, function, thoughts, and physical health. According to the World Health Organization (n.d.), depression is the leading cause of disability for older adults. Depression may be associated with side effects of medications (APA, 2000) or compounded by medical conditions such as a cerebral vascular accident (Roose & Sackeim, 2004), Parkinson’s disease (Ehrt, Brønnick, Leentjens, Larsen, & Aarsland, 2006), diabetes (Egede, Nietert, & Zheng, 2005), dementia (Landes, Sperry, & Strauss, 2005), urinary incontinence (Zorn, Montgomery, Pieper, Gray, & Steers, 1999), and sensory impairment (Capella-McDonnall, 2005).