Table 2 Interprofessional nurse-led mental health promotion intervention versus usual home care services
Characteristics | IP Nurse-Led mental health promotion intervention | Usual home care |
|---|---|---|
Home Care Service Providers | Dedicated team of RNs and PSWs with specialized training in depression care for community-living older adults. RN and PSW dyad work collaboratively with the interprofessional (IP) team, which includes the Home Care Case Manager, the Primary Care Physician, and other home care providers in delivering the intervention. | No dedicated team of home care service providers with expertise in depression care for older adults |
Continuity of Care Provider | Continuity of home care service provider through the use of a dedicated team of RNs and PSWs | Continuity of care provider not assured |
Depression Risk Factor Assessment Tools | In-home assessment of depressive symptoms, and risk factors for depression using validated tools. | No standardized assessment tools across disciplines |
Depression screening, early identification, and management | Implementation of evidence-based strategies for screening, early identification and management of depression. During the home visit, the RN and PSW dyad screens the client for depressive symptoms and depression risk factors, and provides problem-solving therapy, social and behavioural activation, medication review and antidepressant medication management, education about depression, and intensive support to both the client and their family caregiver | No evidence-based practice standard specific to the assessment and management of depression in home care for older adults |
Access to Home Care Services for Mental Health Promotion | Monthly in-home visits by RN and PSW over six months for older adults with depressive symptoms. | Delayed or minimal access to professional home care services directed toward mental health promotion. Eligibility for home care services is based on physical/medical needs; not mental health needs |
Mechanisms for Team Communication and Collaboration | Monthly case conferences involving the unique RN and PSW dyad assigned to each study participant | Limited communication and collaboration among team members and lack of inclusion of the PSW in the care team |
Information Systems | A single evidence-based depression care management plan among members of the IP team | No formal mechanisms for shared record keeping across disciplines |