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Treating depression in disabled, low-income elderly: a conceptual model and recommendations for care
- Authors:
- AREAN Patricia A., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 25(8), August 2010, pp.765-769.
- Publisher:
- Wiley
Ten percent of older people in the United States live at or below the poverty line, and the treatment of depression within this group is complicated by several factors, where poor access to resources, disability, and mild cognitive impairment are the main factors that moderate treatment effects. Interventions that not only address the depressive syndrome but also manage social adversity are needed to help this patient population recover from depression. This paper presents a literature review of correlates of depression in late life. In the review the authors propose a treatment model that combines case management to address social adversity with problem solving treatment to address the depressive syndrome. The case of a male patient is outlined – living in poverty, depressed, and physically disabled. The authors’ illustrate how the combination of case management and problem solving treatment can work together to ameliorate depression. In conclusion, the paper suggests that the combination of age, disability, and social adversity complicates the management and treatment of depression. Case management and problem solving treatment are interventions that work synergistically to overcome depression and manage social problems.
Coordination and Advocacy for Rural Elders (CARE): a model of rural case management with veterans
- Authors:
- RITCHIE Christine, et al
- Journal article citation:
- Gerontologist, 42(3), June 2002, pp.399-405.
- Publisher:
- Oxford University Press
Describes a pilot initiative sponsored by the Veterans Health Administration (VHA) to improve the health and community tenure of frail older veterans living in rural counties 50-100 miles from two host VHA medical centers. Problems identified for each patient, included risk, social needs, pain, and needs related to disability. As a result of initial assessment, two thirds of CARE (Coordination and Advocacy for Rural Elders) participants received referral/linkage to formal services, more than half to medical providers.