The Christiana Care Visiting Nurse Association now provides psychiatric care in New Castle County, focusing first on homebound geriatric patients who are experiencing clinical depression or anxiety.
According to Connie McKelvey, MSN, RN, clinical nurse specialist for the Behavioral Health Program, depression and anxiety are the most prevalent disorders affecting the elderly and those with chronic illness.
“Studies indicate almost 25 percent of patients in general medical practices exhibit depressive symptoms,” McKelvey says. “Almost 50 percent of patients with chronic illness are experiencing depression. The elderly are more vulnerable to depression because of things such as social isolation, loss of loved ones, acute and chronic illness, and limited access to medical care. In addition, the elderly population has the highest risk for successful suicide.”
Depression can worsen chronic diseases like diabetes, heart failure, rheumatoid arthritis, hypertension, COPD, dementia, and Parkinson’s disease, at a cost of tens of billions of dollars annually. And worsening disease symptoms can lead to worsening depression.
McKelvey says the new program aims to improve medication adherence, increase quality of life, return the patient to the community, decrease hospitalizations and lower levels of depression and anxiety.
“We will remove the barriers for homebound patients to receive psychiatric care and provide a bridge to available services,” she says.
The program’s first patients will probably enter through Christiana Care’s geriatric practices and the Acute Care for the Elderly hospital-based program. Psychiatric nurses and consulting psychiatrists will provide a best-practice, evidence-based set of interventions, including evaluation and assessment, cognitive behavioral/ interpersonal therapy, family and patient education, medication management, crisis intervention, relapse prevention techniques and recommendations for further treatment.
The VNA expects to first focus on the elderly community and later expand in to include treatment to other age groups and illnesses such as dementia, bipolar disorder and schizophrenia.