Risk Factors and Intervention Programs for Depression in Nursing Home Residents: Nursing Home Staff Interview Findings

The in-depth qualitative interviews with 25 nursing home staff members were done to examine (a) their perceptions and experiences of risk factors for residents' depression, (b) current depression intervention programs, and (c) specific needs for staff training. The interviewees identified the residents' sense of loss and grief and feelings of isolation and loneliness as the causes of their depression and in-house activities and contract mental health services as current services aimed at reducing depression. They also pointed out the following barriers to providing effective depression interventions: too much dependence on antidepressant medication, low Medicaid reimbursement rate, staff shortage, residents' attitudes, and nursing home culture. The types of training that the staff members desired were: skills to monitor nonverbal signs and changes and to systematically screen different types of depression; education about antidepressants and their effects, side effects, and interaction effects with other medication; and systematic training in different types of psychosocial and behavioral interventions for late-life depression in residents with various levels of physical disabilities and cognitive impairments.