From DECISIONS HEALTH
Train clinicians how to ask whether patients have lost interest in activities or if they have been feeling sad. These questions will lead to more accurate assessments and better depression treatment that can lower your rehospitalization rates and improve your star ratings.
Because some clinicians may feel uncomfortable asking patients about emotional health, have clinicians practice asking and answering the inquiries on the depression scales so they can become more at ease with the questions and learn how to speak more naturally to patients, says Katherine J. Vanderhorst, vice president at C&V Senior Care Specialists, Inc., a behavioral health consulting firm in Williamsville, N.Y.
Patients identified in depression screening as having a potential mental health issue and who suffer from diabetes, congestive heart failure or chronic obstructive pulmonary disease are prone to rehospitalization so it’s important to identify this early on, Vanderhorst adds.
Another way to rephrase questions to encourage patients to open up is to ask if their condition has ever made them feel overwhelmed, Vanderhorst says. And ask if patients have ever been treated for depression. These questions might help patients open up about a difficult topic.
Use a depression screening tool that has been scientifically tested in a population with characteristics similar to the patient being assessed. Different tools are better for patients depending on their ages. The PHQ-9 is the better tool for adults under age 65, Vanderhorst says. She says her agency prefers the Geriatric Depression Scale — Short Form (GDS) for their patients over age 65. The questions that require more than a yes or no response are difficult for adults with cognitive problems, Vanderhorst explains. The GDS has 15 questions that ask seniors questions about whether they are satisfied with life or are in good spirits.
The Geriatric Depression Scale (GDS) can be used to assess whether a patient has depression and needs further evaluation and interventions. This tool is among several provided by the Visiting Nurse Associations of America’s (VNAA) Blueprint for Excellence training module on depression screening for home health.
|Score 1 point for each bolded answer. A score of 5 or more suggests depression.|
|1||Are you basically satisfied with your life?||Yes||No|
|2||Have you dropped many of your activities and interests?||Yes||No|
|3||Do you feel that your life is empty?||Yes||No|
|4||Do you often get bored?||Yes||No|
|5||Are you in good spirits most of the time?||Yes||No|
|6||Are you afraid that something bad is going to happen to you?||Yes||No|
|7||Do you feel happy most of the time?||Yes||No|
|8||Do you often feel helpless?||Yes||No|
|9||Do you prefer to stay at home, rather than going out and doing things?||Yes||No|
|10||Do you feel that you have more problems with memory than most?||Yes||No|
|11||Do you think it is wonderful to be alive now?||Yes||No|
|12||Do you feel worthless the way you are now?||Yes||No|
|13||Do you feel full of energy?||Yes||No|
|14||Do you feel that your situation is hopeless?||Yes||No|
|15||Do you think that most people are better off than you are?||Yes||No|