Assessment of depression is a matter of gathering relevant information, compiling it into a summary of functioning in various life domains and then comparing this summary to criteria established by the American Psychological Association. When assessing depression in seniors, it is necessary to use good clinical judgment in determining if the assessment indicates depression or normal changes related to aging. In making a clinical decision, the assessment must also consider the possibility that depression has developed as part of a larger clinical problem, such as adjustment disorder, or phase of life problems, which can develop from the stress and changes which occur in the senior years.
Step 1
Complete a clinical interview which focuses on the primary risk factors for depression in the elderly. These factors are disabilities which come with the normal aging process or as part of a new or previously existing medical problem, physical decline associated with aging which may trigger depression in seniors, a sense of a diminished quality of life, and difficult or tense relationships with caregivers.
Step 2
Assess for persistent, significantly impairing or recurring moods associated with depression. Assessment tools such as the Beck Depression inventory are often used to gather this information, and can significantly supplement information gathered in the clinical interview.
Step 3
Assess behaviors including sleep patterns. It is important to establish a baseline for previous activity levels, typical daily activities and sleep patterns as opposed to using a criteria based on these same behaviors in younger people. Look for drastic or rapid changes over short periods of time. If the changes are not related to a medical condition, this could indicate depression.
Step 4
Complete the Geriatric Depression Scale. The GDS is the most widely used assessment tool used to gather information about possible depression in seniors. The scale comes in both a short form (15 items) and a longer form (30 items). It is used to gain understanding of the senior's physical, mental and social well-being. This scale focuses on the senior's own perspective of well-being as opposed to objective clinical standards. Compile the information gathered to develop a full clinical picture. Answers from the Geriatric Depression Scale can be used at this point to gain further clarification for sound clinical judgment.
Step 5
Compare the compiled information to the diagnostic criteria for depression from the American Psychological Association. A careful comparison, along with good clinical judgment, will determine if the senior is having trouble with clinical depression or if depression is present as part of a phase of life problem, the normal aging process or perhaps as part of a reaction to stress.
References
- "Assessing and Treating Late-Life Depression;" Michele J. Karel; 2002
- "Mental Disorders in Older Adults: Fundamentals of Assessment and Treatment;" Steven H. Zarit & Judy M. Zarit; 1998
- "Depression in Elderly People;" Robert Howard; 1996
