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Depression Tele-care for Elderly Patients at Home: Successes and Challenges

Roberts L, Wakefield BJ, Scherubel MN, Sheeran T, Nelson S, Turvey CL, Klobucar TF, Rabinowitz T, Kaboli PJ. Depression Tele-care for Elderly Patients at Home: Successes and Challenges. Presented at: American Telemedicine Association Annual Meeting; 2011 May 3; Tampa, FL.

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The objective of this panel presentation is to describe methods and outcomes related to different technological and methodological approaches in providing mental health services to community-dwelling older adults in their homes. Results of three different studies will be presented, each using different technologies and care delivery approaches, along with implications for future directions. Dr. Sheeran will present the results of a study evaluating the feasibility and effectiveness of a home telemonitor-supported depression care management protocol. This study was conducted in collaboration with three home care agencies in Vermont, New York, and Florida. Completed with 50 patients with research-verified need for depression care, results of this study suggest that this model of service delivery is feasible, accepted by telehealth nurses and patients, and improves depressive symptoms. Dr. Turvey will present results from a study of 130 patients in an illness management program for depression and chronic illness delivered by telephone that included home monitoring of both depressive and chronic illness symptoms. The relation between depressive symptoms on phone-based home monitoring to self report and research diagnosis will be presented. Results indicate that this approach is a valid and reliable method to assess change in depressive symptoms during an intervention. Results on the effectiveness of two interventions in reducing depressive symptoms, one with an enhanced mental health component, the other without, will also be presented. Dr. Rabinowitz will discuss the development and implementation of a pilot project to test the feasibility of a lowcost, Web-based approach to delivering telepsychiatry consultations for depressed homebound elders. Key topics covered will include: 1) making contact with the collaborating home care agency to obtain their support and buy-in for the project, 2) training of research assistants and others in use of the telemedicine equipment and in patient recruitment, and 3) findings of this study including costs, advantages, disadvantages, lessons learned, and ideas for improvement regarding this modality. Objectives 1. Describe key components of depression identification and care using telehealth technology. 2. Identify facilitators

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