The Management Of Depression In Older Adults Discussion

The Management Of Depression In Older Adults Discussion

Introduction

The nursing practice problem under analysis is the growing rates of depression in older adults. Using relevant empirical and conceptual evidence, this paper conducts a critique of the selected research materials on whether alternative therapies can be associated with substantial therapeutic benefit in comparison to no intervention among elderly individuals grappling with depression. Research has shown that older patients struggle with a myriad of daily life challenges, anxiety and stress that may be treated using both pharmacological and non-pharmacological treatment interventions. In this discussion, strong emphasis is placed on discussing the key findings on some of the alternative therapies that can be utilized as effective non-pharmacological strategies to improve the management of depression and anxiety in older adults. The PICOT Question under analysis: Among depressed older patients (P), will the use of alternative therapies as adjunct treatment (I), in comparison to standard mental health care (C), prove more effective, acceptable and safe (O), over a 6-month period? (T) The Management Of Depression In Older Adults Discussion

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Background of Studies

The nursing practice problem under analysis is the deteriorating mental health of adults in the wake of the coronavirus disease 2019 (COVID-19). Webb et al. (2022) established that depression and anxiety are some of the most prevalent symptoms witnessed in the geriatric patient populations in the aftermath of the pandemic. In terms of significance to nursing, a better understanding of alternative therapies for treatment or management of depression in elderly adults may mitigate the detrimental effects of mental health problems on the older adult population. Liu et al. (2021) added that the COVID-19 crisis was associated with a myriad of psychological, mental, and physical challenges that had profound implications on the health and wellbeing of the aging population. Webb et al. (2022) identified a number of factors to play a role in heightening the risk of mental illness in older adults during the COVID-19 crisis and they include age group, sex, and socioeconomic status, living circumstances, location, psychiatric and medical comorbidities. According to the CDC (2021), the occurrence of cognitive impairment in the elderly individuals may be accompanied by depression, and in some cases, dementia. Nurhidayati (2022) agreed that whilst pharmacological interventions have so far been employed in managing depressed mood in older adults, the effects of non-pharmacological treatment options (such as cognitive behavioral therapy, art therapy, psycho-education, and others) in older adults must be examined. Therefore, the main findings from the studies focused on a set of non-pharmacological treatments that can be employed to reduce the prevalence and effects of depression among the older adult populations during periods of major crises such as the recent COVID-19 global pandemic. Key Research questions include: The Management Of Depression In Older Adults Discussion

1. What was the impact of COVID-19 pandemic on the mental health of older adults?
2. What is the effectiveness of psycho-education for elderly depression?
3. Can art therapy contribute to improvement in health and wellbeing of elderly people at risk of depression?

How the Four Articles Support the Nursing Practice problem

The identified articles contain relevant conceptual and empirical evidence to address the key issues raised in the PICOT question. First, Webb et al. (2022) attempted to highlight the detrimental effects of mental illness in older adults during the COVID-19 pandemic, with the most notable ones being: social isolation, loneliness, increased stress and depression. Equally, the findings reported that older adults were also confronted with a great deal of distress and stigmatization resulting from the realities and conditions surrounding the COVID-19 crisis.  Whilst the study by Webb et al. (2022) focused on coping interventions and strategies aimed at reducing the risk of mental illness and enhancing the quality of life for elderly adults, the proposed PICOT question solely highlights the effectiveness of alternative therapies in the treatment of anxiety and depression in older adults. The CDC (2021) explained that whilst the younger people reported higher levels of anxiety and depression during the pandemic than older adults, the consequences of mental health problems in the geriatric group proved to be devastating. For instance, older adults with depression are at an increased risk of experiencing functional impairment than their non-depressed counterparts, and are less likely to recover from medical conditions or disorders, implying extended medical hospitalizations and increased risks of morbidity and mortality. In a different study, Liu et al. (2021) revealed that the phenomenon of depression in older adults is associated with poor mental, physical, and psychological health and wellbeing, and hence evidence-based interventions must be adopted within the public health system to boost the diagnosis and treatment of mental health conditions including depression. The study also focused on determining the effectiveness of art therapy in promoting the health and wellbeing of older adults at risk of experiencing anxiety and depression. In comparison, the PICOT question seeks to combine a range of therapeutic methods related to art therapy such has music and drama, psychotherapy and movement/dance.  Equally, the study by Nurhidayati et al. (2022) focused on investigating how the adoption of psycho-education for elderly persons with depression may assist in reducing the depressive symptoms and complications associated with mental illnesses. As a systematic review, the findings from the article indicated that depressed elderly people who participated in psycho-education for elderly depression reported significant improvements in quality of life when compared to their counterparts with no access to psycho-education The Management Of Depression In Older Adults Discussion.

Method of Studies

The study by Webb et al. (2022) conducted a thematic analysis on the growing rates of depression and anxiety in older adults during the COVID-19 pandemic. Although the thematic analysis acts a flexible research technique for identifying, interpreting and analyzing qualitative data,    lack of coherence and inconsistency in creating themes derived from the data may undermine quality or credibility of findings. Nurhidayati et al. (2022) performed a comprehensive literature review on psychoeducation for elderly. Although the systematic literature review method allows the researcher to scan, analyze, synthesize, and integrate a wide pool of literature on the research topic, some of the key limitations of this method include: reduced rigor and thoroughness and the potential risk of bias including attrition bias, selection bias, selective outcome reporting and inadequate blinding.  The study by Liu et al. (2021) employed a mixed method of qualitative and quantitative analysis comprising of keyword co-occurrence analysis and bibliometric analysis. Mixed method research largely benefits from both the externally-valid, generalized insights of quantitative data and the contextualized, detailed, and integrated insights of qualitative data and information. In the report by the CDC (2021), a content analysis approach was employed to provide detailed information and data on mental health as a pertinent public health problem in the United States. Whilst content analysis provides a cost-effective and reliable approach to gain rich insights into a phenomenon, this research method may be subject to increased error, and hence less generalizability of findings The Management Of Depression In Older Adults Discussion.

Results of Studies

The study by Webb et al. (2022) revealed that enhancing individual coping strategies may assist to reduce depression and its effects on older adults in the wake of the COVID-19 pandemic. The study also indicated that increased usage of helpline resources, optimization of caregiver roles, and enhanced connection to the healthcare team played a major role in tackling depression and other mental health problems in elderly patients, and hence contributing to improvements in quality of care for older adults during strict COVID-19 containment measures. The study by Nurhidayati et al. (2022) revealed that psycho-education is an effective approach that can raise health-related awareness among elderly adults, their family friends and the community. The findings reported that adoption of specific psycho-education programs for elderly depression can prove instrumental in improving therapeutic outcomes and quality of life in depressed adults. In a different study, Liu et al. (2021) established that art therapy can act as evidence-based interventions aimed at promoting health and wellbeing of elderly adults exposed to COVID-19 challenges. The article by the CDC (2021) provided key information on mental health and its implications on the psychological, physical, emotional and social wellbeing and health of individuals. The implications of the selected four studies in nursing practice is based on how they provide key insights into some of the non-pharmacological interventions that can be applied in managing depression and other mental health problems among elderly people. Equally, a number of proposed interventions including psycho-education and art therapy stands out as some of the emerging standards of care in nursing competencies, and hence the core findings of the reviewed articles reinforces the effectiveness of combined therapy in the treatment and management of mental health conditions The Management Of Depression In Older Adults Discussion.

Ethical Considerations

The two ethical considerations in conducting research include obtaining informed consent from study participants and avoiding or reducing potential for harm (non-maleficence). Precisely, whilst the obtaining informed consent from the participants is primarily focused on ensuring voluntary participation, observance of the ethical principle of non-maleficence is based on the greater need to ensure the outcomes or results of the study are beneficial and of no harm to participants and other stakeholders.  The researchers in the four articles focused on ensuring a good deal of objectivity, rationality and professionalism through presenting their core findings in a manner informed by voluntary participation and non-maleficence.

Outcomes Comparison

For the PICOT Question, the anticipated outcomes are significant reduction in depressive symptoms and improvements in quality of life among elderly patients. The outcomes of the four articles are almost similar to my anticipated outcomes since core findings presented in those articles sought to determine the effectiveness of alternative therapies in addressing depression as a common mental health condition affecting the elderly population.

Proposed Evidence-based Practice Change

The connection between the PICOT question, the research articles and the identified nursing practice problem is based the centrality of evidence-based, patient-centered care and support in the treatment and management of depression. The proposed evidence-based practice change for the identified setting includes the adoption of non-pharmacological treatment for depressed older adults The Management Of Depression In Older Adults Discussion.

Conclusion

This paper combines relevant findings from the reviewed research articles on the effectiveness of alternative therapies in the management of depression among the elderly adults. The discussion reveals that a myriad of evidence-based non-pharmacological interventions (psycho-education, art therapy, coping strategies) can be strategically applied to tackle depressive symptoms and complications experienced by elderly people in the midst of difficult circumstances such as the COVID-19 pandemic. Further investigation into the topic is still required to shed more light on the key issues and concerns behind the proposed evidence-based practice change.

References

Centers for Disease Control and Prevention. (2021). About mental health. Centers for Disease Control and Prevention. https://www.cdc.gov/mentalhealth/learn/index.htm#:~:text=Mental%20and%20physical%20health%20are,%2C%20heart%20disease%2C%20and%20stroke.

Liu, Z., Yang, Z., Xiao, C., Zhang, K., & Osmani, M. (2021). An investigation into art therapy aided health and well-being research: A 75-year bibliometric analysis. International Journal of Environmental Research and Public Health, 19(1), 232. https://doi.org/10.3390/ijerph19010232 The Management Of Depression In Older Adults Discussion

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Nurhidayati, T., Pandin, M. G., & Nadya, C. (2022). Systematic review psychoeducation of elderly with depression in Public Health: Philosophical Study. https://doi.org/10.1101/2022.09.27.22280394

Webb, L. M., & Chen, C. Y. (2022). The COVID-19 pandemic’s impact on older adults’ mental health: Contributing factors, coping strategies, and opportunities for improvement. International Journal of Geriatric Psychiatry, 37(1), 10.1002/gps.5647. https://doi.org/10.1002/gps.5647 The Management Of Depression In Older Adults Discussion