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An evaluation of a national program to implement the Cornell Scale for Depression in Dementia into routine practice in aged care facilities

Published online by Cambridge University Press:  05 December 2011

Tanya E. Davison*
Affiliation:
Deakin University, Melbourne, Victoria, Australia
John Snowdon
Affiliation:
Discipline of Psychiatry, Sydney Medical School, Concord Hospital, Sydney, New South Wales, Australia
Nathan Castle
Affiliation:
Deakin University, Melbourne, Victoria, Australia
Marita P. McCabe
Affiliation:
Deakin University, Melbourne, Victoria, Australia
David Mellor
Affiliation:
Deakin University, Melbourne, Victoria, Australia
Gery Karantzas
Affiliation:
Deakin University, Melbourne, Victoria, Australia
Janelle Allan
Affiliation:
Deakin University, Melbourne, Victoria, Australia
*
Correspondence should be addressed to: Dr Tanya Davison, School of Psychology, Faculty of Health, Deakin University, Burwood, Melbourne, VIC 3125, Australia. Phone: +61-(0)3-9244-6505; Fax: +61-(0)3-9244-6858. Email: tanya.davison@deakin.edu.au.

Abstract

Background: Screening tools have been recommended for use in aged care to improve the detection and treatment of depression. This study aimed to evaluate the impact of a program for the routine implementation of the Cornell Scale for Depression in Dementia in Australian facilities, to determine whether use of the instrument by nurses led to further monitoring of depressive symptoms, medical referral, and changes in treatments prescribed for depression.

Methods: A file review was completed for 412 participants out of a total of 867 older people (47.5%) who resided in ten aged care facilities. The review examined Cornell Scale assessment data, medication charts, medical history, nursing progress notes, and resident care plans. Nursing staff who administered the Cornell Scale to each participant were also interviewed, and ten facility managers took part in an interview to determine barriers to the effective implementation of the instrument.

Results: The Cornell Scale had been administered to 46.8% of the sample in the previous 12 months, with 25% of these participants scoring 9–13 and 27% scoring 14 and above. Less than one third of the residents with high scores were monitored by the staff following the assessment. Only 18% of residents with high scores were referred for further assessment of depression, while 10% received a treatment change.

Conclusions: The absence of a protocol for responding to high Cornell Scale scores limited the potential of this program to result in widespread improved treatment of depressed older people. The use of the Cornell Scale by aged care nurses with limited training raised concern.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2011

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