Geriatric Depression Scale

The Geriatric Depression Scale

Eden Balbas, Melanie Doi, and Alyssa HirataStanbridge University

Eden Balbas, OTS• University of California, Irvine

• Degree: BA in Social Ecology• Minor: Education

• Stanbridge University• Degree: MS in Occupational Therapy

• My experience with geriatric clients includes...

Melanie Doi, OTS• University of California, Riverside

• Degree: BS Sociology

• Stanbridge University• Degree: MS Occupational Therapy

• My experience with geriatrics clients include...

Alyssa Hirata, OTS• California State University, Long Beach

• Degree: BA Psychology

• Minor: Chemistry

• Stanbridge University• Degree: MS Occupational Therapy

• My experience with geriatrics clients include...

Today’s Agenda1.Introduction2.Agenda3.Objectives4.Key Terms5.Lecture 6.Community Resources Available7.Activity: Case Study8.Summary

9.Quiz

ObjectivesBy the end of this presentation, the attendees will be able to:

• Define occupational therapy

• Identify the populations that work with occupational therapists (OTR)

• Discuss the symptoms of depression

• Distinguish how occupational therapy (OT) benefits individuals with depression

• Identify how to assist individuals with depression

Objectives (cont.)• Discuss the causes of depression

• Identify the function of the Geriatric Depression Scale (GDS)

• Discuss how to administer the GDS

• Describe how the GDS is scored

• Describe how the results of the GDS is interpreted

• Discuss community resources available to individual with depression, and their family and friends

Key Terms 1.Clients = individuals receiving occupational

therapy (OT) services

2.Depression= decrease in energy or drive to participate in the things important to an individual; it’s a medical diagnosis

3.Geriatrics= the study of the issues and processes of aging

4.Geriatric Depression Scale= survey screening tool used to identify depression in older adults Opp, Ashley. (2017). Occupational therapy and depression: Reconstructing lives. In The American Occupational Therapy Association. Retrieved from https://www.aota.org/about-occupational-therapy/professionals/mh/articles/depression.aspx

Key Terms (cont.) 5. Life events= a change in an individual’s typical

routine, leading to major changes or adjustments to their life

6. Occupation= everyday activities that have meaning to an individual and “occupies” their time

7. Occupational therapist (OTR)= the practitioners who deliver OT services and are responsible for the safety and efficacy of the OT services

8. Occupational therapy (OT)= a client-centered medical profession that revolves around the use of occupations to enable and empower an individual, to participate in life

American Occupational Therapy Association (AOTA). (2014). Occupational therapy practice framework: Domain and process (3rd ed.). American Journal of Occupational Therapy, 68(Suppl. 1), S1- S48. http://dx.doi.org/10.5014/ajot.2014.682006

xXJEashXx. (2010, March 22). Favorite Pixar's Up scene ever: Ellie and Carl's relationship through time, sad scene. [Video file]. Retrieved from https://www.youtube.com/watch?v=F2bk_9T482g

http://youtube.com/v/F2bk_9T482g

What is Occupational Therapy? • occupation= everyday, meaningful activities

• Therapeutic use of everyday, meaningful activities (occupations) across the lifespan

• Holistic approach to treatment using occupations to facilitate growth or change in the client

• Enable clients by adapting or modifying the environment

American Occupational Therapy Association (AOTA). (2014). Occupational therapy practice framework: Domain and process (3rd ed.). American Journal of Occupational Therapy, 68(Suppl. 1), S1- S48. http://dx.doi.org/10.5014/ajot.2014.682006

Client Populations of Occupational Therapy

Occupational therapists (OTR) work with all populations throughout the lifespan.

CHECKPOINT:

Depression is a normal

part of aging.

FALSE

What is Depression?• Decrease in energy or drive to participate in the things that are

important

• Emotional symptoms:• Extreme sadness and hopelessness• Anxiety to leave the house• Emotional withdrawal

• Physical symptoms: • Headaches• Stomachaches• Bowel and bladder complaints

• Symptoms must be present for at least two weeksOpp, Ashley. (2017). Occupational therapy and depression: Reconstructing lives. In The American Occupational Therapy Association. Retrieved from https://www.aota.org/about-occupational-therapy/professionals/mh/articles/depression.aspx

Baycrest Health Sciences. (2010, June 10). Story of Don: A story of late-life depression after unexpected retiremen.. [Video file]. Retrieved from https://www.youtube.com/watch?v=jupO4O0Fg0w&list=LL1x5Tdt3d6ER5Pi3vjRCnYA

http://youtube.com/v/jupO4O0Fg0w

Occupational Therapy and Depression

• OTRs can assist people with depression by:• Examining client roles and helping them

engage and gain feelings of accomplishment from them

• Discovering what factors are preventing clients from engaging in their responsibilities

• Helping rebuild the client’s self-esteem and identity

• Assisting with finding balance between their work, relationships, and leisure activities

Opp, Ashley. (2017). Occupational therapy and depression: Reconstructing lives. In The American Occupational Therapy Association. Retrieved from https://www.aota.org/about-occupational-therapy/professionals/mh/articles/depression.aspx

How Depression Relates to You • You may have loved ones who are older adults

(family members or friends 65+ years or older)

• You may observe subtle signs of depression in older loved ones

• You can discuss how they’re feeling and what they’re thinking, without using the terms depressed, drugs, therapy, or other terms that may make them defensive

• Participate in loved one’s medical care if your loved one gives permission

Depression in the elderly: 7 ways to help. (n.d.). Retrieved from http://www.health.com/health/gallery/0,,20518814,00.html

How Depression Relates to You (cont.) • Inform their physician of your

observations and concerns

• Ensure they’re getting the assessment/ care they need

• Help, but don’t take over your loved one’s life

• Divide tasks into small steps• Praise them for attempts at tasks

Depression in the elderly: 7 ways to help. (n.d.). Retrieved from http://www.health.com/health/gallery/0,,20518814,00.html

What Causes Depression?• Life events

• Lack of satisfaction from their relationships• Death of a loved one• Loss of independence• Retirement• Admission to nursing home or hospital• Co-occurring illnesses

• Decreased neurotransmitters in the brain- may be genetic

Opp, Ashley. (2017). Occupational therapy and depression: Reconstructing lives. In The American Occupational Therapy Association. Retrieved from https://www.aota.org/about-occupational-therapy/professionals/mh/articles/depression.aspx

CHECKPOINT:

Think of a time where an older adult in your life may

have experienced depression.

Would anyone like to share?

Statistics• More than two million Americans age 65

and older suffer from some form of depression.

• Individuals aged 65 and older account for 20% of all suicide deaths.

• Approximately 68% of adults aged 65 and over know little or almost nothing about depression.

• Less than 3% aged 65 and older receive treatment from mental health professionals.Depression in older adults: More facts. (2017). In Mental Health America. Retrieved from http://www.mentalhealthamerica.net/conditions/depression-older-adults-more-facts

What is the Geriatric Depression Scale (GDS)?• Self-report screening tool to identify depression

in older adults • Originally developed as 30-item measure

(Geriatric Depression Scale- Long Form: GDS-L) by J.A. Yesavage and others

• Newer shortened form is 15-item measure (Geriatric Depression Scale- Short Form: GDS-S) developed by J.I. Sheikh and J.A. Yesavage in 1986

American Psychological Association (APA). (2017). Geriatric Depression Scale (GDS). Retrieved from http://www.apa.org/pi/about/publications/caregivers/practice-settings/assessment/tools/geriatric-depression.aspx

What is the Geriatric Depression Scale (GDS)? (cont.) • Research shows the GDS-L and GDS-S are both successful in

recognizing depressive symptoms • Used with healthy, medically ill, and mild to moderately cognitively

impaired older adults • Used in any setting: community, acute and long-term care• Easy to administer and score

○ “Yes/No” format○ Takes approximately 5-7 minutes to administer

American Psychological Association (APA). (2017). Geriatric Depression Scale (GDS). Retrieved from http://www.apa.org/pi/about/publications/caregivers/practice-settings/assessment/tools/geriatric-

depression.aspx

Greenberg, S. A. (2007). How to try this: The Geriatric Depression Scale: Short Form. The American Journal of Nursing. 107(10), 60-69. https://doi.org/10.1097/01.naj.0000292204.52313.f3

Questions on the Geriatric Depression ScaleQuestion Yes No

1. Are you basically satisfied with your life? 0 1

2. Have you dropped many of your activities? 1 0

3. Do you feel that your life is empty? 1 0

4. Do you often get bored? 1 0

5. Are you in good spirits most of the time? 0 1

6. Are you afraid that something bad is going to happen to you? 1 0

7. Do you feel unhappy most of the time? 0 1

8. Do you feel helpless? 1 0

Questions on the Geriatric Depression Scale (cont.)Question Yes No

9. Do you prefer to stay at home, rather than going out and doing new things? 1 0

10. Do you feel you have more problems with memory than most? 1 0

11. Do you think it is wonderful to be alive now? 0 1

12. Do you feel pretty worthless the way you are now? 0 1

13. Do you feel full of energy? 0 1

14. Do you feel that your situation is hopeless? 1 0

15. Do you think that most people are better off than you are? 1 0

How to Administer the Geriatric Depression Scale• Can be completed before clinical visit or

during provider interview, in-person or by telephone

• Administer in private, quiet room• Speak slowly and clearly• Eye contact • Introduce the GDS and provide instructions

• “I’m going to ask you some questions about your mood. Please answer “yes” or “no” based on how you have felt over the past week.”


How to Score the Geriatric Depression Scale• The answers of “1” emphasize

significance to depression• Max score= 15• Add up the total points from yes or no

responses


How to Interpret Results • A score of:

• 0- 4= Normal• Depending on age, education, and

complaints• 5- 8= Mild depression• 9- 11= Moderate depression• 12- 15= Severe depression

• Scores > 5 suggests depression and indicates a complete assessment should follow the GDS

• Scores ≥ 10 typically indicates depressionGreenberg, S. A. (2007). How to try this: The Geriatric Depression Scale: Short Form. The American Journal of Nursing. 107(10),

60-69. https://doi.org/10.1097/01.naj.0000292204.52313.f3

Community Resources for Help- LA County• LA Department of Mental Health

• Older Adults Prevention and Early Intervention Programs

• Coping skills• Problem Solving Therapy

• LA County Elder Abuse Hotline: (877) 477- 3646

• Suicide Prevention Lifeline: (800) 273- 8255Websites:

• http://dmh.lacounty.gov/wps/portal/dmh/our_services/older_adults

• Service area listing:• http://file.lacounty.gov/SDSInter/dmh/

239132_SERVICEAREAOAProvlist1-25-16.pdf

Los Angeles County Department of Mental Health. (n.d.). Older adults. Retrieved from http://dmh.lacounty.gov/wps/portal/dmh/our_services/older_adults

Community Resources for Help- Orange County• OC Health Care Agency: Adult and Older Adult

Behavioral Health• Services:

• Assessment, evaluation, individual and group therapy, substance abuse treatment, plan development, crisis intervention, inpatient services

• Call 866-830-6011 or 714-517-6353 for services

• Suicide Prevention Line: 877-7-CRISIS or (877) 727-4747

• Deaf and Hard of Hearing Text Line: TEXTME

• Website: • http://www.ochealthinfo.com/bhs/about/

aoabh

OC Health Care Agency. (n.d.). Adult and older adult behavioral health. Retrieved from http://www.ochealthinfo.com/bhs/about/aoabh

Case StudyYour 70-year-old widowed grandmother has planned to move to a nursing home because she is unable to live on her own. She is no longer able to drive due to the gradual visual loss she is currently experiencing. Before she became ill, she loved taking her dog on walks, however, the nursing home she will be moving to does not allow pets.

1. What are some of the anticipated challenges your grandmother might experience?

2. How will you deal with this issue?

Summary• We discussed:

• What is occupational therapy?• Client population of OT• What is depression?• How OT relates to depression • How depression relates to you• Causes of depression• What is the Geriatric Depression Scale (GDS)• How to administer and interpret results• Community resources available • Take home brochure of today’s lecture

Quiz Time

ReferencesAmerican Occupational Therapy Association. (2014). Occupational therapy practice framework: Domain and process (3rd

ed.). American Journal of Occupational Therapy, 68(Suppl. 1), S1- S48. http://dx.doi.org/10.5014/ajot.2014.682006 American Psychological Association. (2017). Geriatric Depression Scale (GDS). Retrieved from

http://www.apa.org/pi/about/publications/caregivers/practice-settings/assessment/tools/geriatric-depression.aspxBaycrest Health Sciences. (2010, June 10). Story of Don: A story of late-life depression after unexpected retirement. [Video file]. Retrieved from https://www.youtube.com/watch?v=jupO4O0Fg0w&list=LL1x5Tdt3d6ER5Pi3vjRCnYA

Conradsson, M., Rosendahl, E., Littbrand, H., Gustafson, Y., Olofsson, B., & Lovheim, H. (2013). Usefulness of the Geriatric Depression Scale 15-item version among very old people with and without cognitive impairment. Aging & Mental Health, 17(5), 638-645. http://dx.doi.org/10.1080/13607863.2012.758231

Depression in older adults: More facts. (2017). In Mental Health America. Retrieved from http://www.mentalhealthamerica.net/conditions/depression-older-adults-more-facts

Depression in the elderly: 7 ways to help. (n.d.). Retrieved from http://www.health.com/health/gallery/0,,20518814,00.html Greenberg, S. A. (2007). How to try this: The Geriatric Depression Scale: Short Form. The American Journal of Nursing, 107(10),

60-69. https://doi.org/10.1097/01.naj.0000292204.52313.f3 Los Angeles County Department of Mental Health. (n.d.). Older adults. Retrieved from

http://dmh.lacounty.gov/wps/portal/dmh/our_services/older_adultsOC Health Care Agency. (n.d.). Adult and older adult behavioral health. Retrieved from

http://www.ochealthinfo.com/bhs/about/aoabh

References (cont.)Opp, Ashley. (2017). Occupational therapy and depression: Reconstructing lives. In The American Occupational Therapy Association.

Retrieved from https://www.aota.org/about-occupational-therapy/professionals/mh/articles/depression.aspxxXJEashXx. (2010, March 22). Favorite Pixar's Up scene ever: Ellie and Carl's relationship through time, sad scene. [Video file].

Retrieved from https://www.youtube.com/watch?v=F2bk_9T482g