Behavioral Health Service Utilization and Preferences of Older Adults Receiving Home-Based Aging Services

Gum, Amber M.; Iser, Lindsay; Petkus, Andrew J.

doi:10.1097/jgp.0b013e3181c29495

Cited by 56 publications

(55 citation statements)

References 33 publications

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“…High satisfaction scores, even in non-remitted patients, may reflect the need for home-delivered treatment in this population [49] who has limited resources. Caregivers’ treatment satisfaction with PATH is consistent with findings that most caregivers find treatment involvement helpful and constructive [50, 51] .…”

Section: Discussionmentioning

confidence: 99%

Problem Adaptation Therapy for Older Adults With Major Depression and Cognitive Impairment

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Problem Adaptation Therapy for Older Adults With Major Depression and Cognitive Impairment

et al. 2015

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“…A complexity of treating depression in low-income older adults is the limited access and acceptability of depression treatment. Low-income older adults prefer counseling-based interventions to medication management (20, 21), and when treated with medications, they show poor adherence (22–24) and have poor outcomes (25). Psychotherapy, although preferred by this population, is limited in its availability and in its ability to address the social needs of people living in poverty (26, 27).…”

Section: Introductionmentioning

confidence: 99%

Effects of Problem-Solving Therapy and Clinical Case Management on Disability in Low-Income Older Adults

Areán

Raue

McCulloch

et al. 2015

The American Journal of Geriatric Psychiatry

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Objective To test the hypotheses that: 1) Clinical case management integrated with Problem Solving Therapy (CM-PST) is more effective than clinical case management alone (CM) in improving functional outcomes in disabled, impoverished patients and 2) Improvement in depression, self-efficacy and problem solving skills mediates improvement of disability. Design RCT with a parallel design, allocating participants to CM or CM-PST at 1:1 ratio. Raters were blind to patients’ assignments. Setting Participants’ homes. Participants 271 individuals were screened and 171 were randomized. Participants were ≥60 years with major depression, had at least 1 disability, were eligible for home-based meals services, and had income ≤30% of their counties’ median. Interventions 12 weekly sessions of either CM or CM-PST. Main Outcome Measure WHO Disability Assessment Scale (WHODAS). Results Both interventions resulted in improved functioning by 12 weeks (t=4.28, df=554, p=0.001), which was maintained until 24 weeks. Contrary to hypothesis, CM was non-inferior to CM-PST (one-sided p=0.0003, t=−3.5, df=558). Change in disability was not affected by baseline depression severity, cognitive function or number of unmet social service needs. Improvements in self efficacy (t=−2.45, df = 672, p=0.021), problem solving skill (t=−2.44, df=546, p=0.015), depression symptoms (t=2.25, df = 672, p=.025) by week 9 predicted improvement in function across groups by week 12. Conclusions Case management is non-inferior to case management augmented with PST for late-life depression in low-income populations. The effect of these interventions occur early, with benefits in functional status being maintained as long as 24 weeks after treatment initiation.

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“…The reasons for this underuse are multi-faceted and include, but are not limited to: transportation challenges, financial limitations, mental health stigma, low confidence about treatment outcomes, and limited knowledge about mental health services and resources (Conner et al, 2010; Gum, Iser, &Petkus, 2010; Robb, Haley, Becker, Polivka, & Chwa, 2003). For healthcare providers, reasons contributing to underuse may include unawareness of, or inexperience with, interventions for late-life anxiety andreluctance to discuss mental health with older adults (Karlin & Duffy, 2004).…”

mentioning

confidence: 99%

Effects of Home-Delivered Cognitive Behavioral Therapy (CBT) for Depression on Anxiety Symptoms among Rural, Ethnically Diverse Older Adults

DiNapoli

Pierpaoli

Shah

et al. 2017

Clinical Gerontologist

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Background: We examined the effects of home-delivered cognitive-behavioral therapy (CBT) for depression on anxiety symptoms in anethnically diverse, low resource, and medically frail sample of rural, older adults. Method: This was a secondary analysis of a randomized clincial trial with 134 rural-dwelling adults 65 years and older with decreased quality of life and elevated psychological symptomatology. Anxiety symptoms were assessed with the anxiety and phobic anxiety subscales of the Symptom Checklist-90-Revised (SCL-90-R). Results: Compared to a minimal support control condition, CBTfor depression resulted in significantly greater improvements in symptoms of anxiety and phobic anxiety from pre-treatment to post-treatment. Conclusion: Home-delivered CBT for depression can be an effective treatment for anxiety in a hard-to-reach older populations.

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Behavioral Health Service Utilization and Preferences of Older Adults Receiving Home-Based Aging Services

Cited by 56 publications

References 33 publications

Problem Adaptation Therapy for Older Adults With Major Depression and Cognitive Impairment

Problem Adaptation Therapy for Older Adults With Major Depression and Cognitive Impairment

Effects of Problem-Solving Therapy and Clinical Case Management on Disability in Low-Income Older Adults

Effects of Home-Delivered Cognitive Behavioral Therapy (CBT) for Depression on Anxiety Symptoms among Rural, Ethnically Diverse Older Adults

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