Essay ELP5 Sample Assignment

Though there are fewer interventions done to prevent or detect depressive disorders amongst hospitalized old aged patients, certain treatments procedures that are less invasive can be introduced to minimize the chances of depression to occur like introduction of physical activity into daily routine or introduction of any social interaction that may help in social intermingling of these individuals. It has been evidenced that excessive levels of exercise can help elder individuals in lowering the chances of developing continual diseases like diabetes, stroke and heart diseases (Benedict et al., 2013). Whilst it is well established that physical activity results in enormous health benefits, research suggests that the elderly people who connect in forceful exercise can stave off disability, chronic disease and mental impairment for 10 years. It was noted in the research that over the period of decade, those elderly individuals who engaged in the greatest levels of exercising i.e., much more than the prescribed minimum level, had 100 percent more likely to stay protected from chronic illnesses like heart disease, cancers, diabetes, stroke and angina and keep the most favorable mental and physical shape till the end of the period (Benedict et al., 2013).

Apart from physical inactivity, social isolation has also been seen to be associated with causing excessive health disorders as its been found to be a risk-factor for all-cause of mortality and morbidity with results comparable to obesity, smoking and high blood pressure. It has been also noted to be associated with declined immunity, cognitive decline and causing depressive disorders and dementia (Fairhall et al., 2012). It can also be linked to heightened chances of emergency hospitalization, delayed discharges and longer duration of stay. Various researches have shown that social interaction is strongly correlated with health and well-being of elderly patients. Societal associations are continually linked with the biomarker of good physical status. The social interaction may lead to enhanced motivational levels and people may sense some purpose in living and thus be happy to stay active (Fairhall et al., 2012).

Detection of depression as discussed afore was found to be rather complicated. Certain screening tests, however, can be used for the purpose (Dennis, Kadri and Coffey, 2012).The guidelines provided by NICE (National Institute for Clinical Excellence) for depression management amongst primary and secondary care have emphasized the significance to testing at risk populations such as physically ill old aged hospitalized individuals in general hospitals. In the general hospitals, already there are several screening instruments that are commonly used like GDS or Geriatric Depression Scale (Nice.org.uk, 2018). These measures are normally developed within the primary care settings or in community. However, they in it portray their own challenges such as whether the screening tests for depressive disorders function accurately in a particular setting; which instrument would be considered most appropriate and what could be the superlative cut-off score for a chosen scale in the hospitalized patients’ clinical setting (Mann, Adamson and Gilbody, 2012). Among various studies, thirteen different screening instruments for depression have been examined where many studies even implemented more than one tool. Though the most regularly examined instrument was the GDS (Dennis, Kadri and Coffey, 2012). It’s a complete thirty item instrument which is at times completely utilized while in some cases half and in other cases only a smaller fragment is being examined. In the United Kingdom, NICE advocated the screening of populations at extreme chances of depression and those individuals with chronic illness (Nice.org.uk, 2018). Originally NICE suggested the Whooley questions that included only two simple questions (Beauchamp, 2014) (Suija et al., 2012). These were “During ‘During the past month have you often been bothered by feeling down, depressed or hopeless?’ and during the last month have you been bothered by having little interest or pleasure in doing things? (Whooley, et al., 1997) (Beauchamp, 2014).

Conclusion

This review can be concluded saying that the Depression is most likely to occur amongst old aged hospitalized individuals but it’s difficult to diagnose due to similar kind of symptoms that can be associated to other chronic disorders. Depression can lead to adverse physical issues and may accelerate the impact of other chronic illness. Physical activity, cognitive behavioral therapies and social interaction are found to be associated with better health outcomes and treatment plans for old aged people in hospitalized setting. It has been suggested that proper screening for depression should be done in individuals with chronic health issues and those at high chance of depression (Biswas et al., 2009). The most usually used scale for the purpose was GDS and Whooley Questions (Nice.org.uk, 2018). This review thus systematically highlights the issue of depression in elderly people in hospital setting while assessing the treatment and screening procedures for the purpose.

References

Beauchamp, H. (2014). What factors influence the use of the Whooley questions by health visitors? Journal of Health Visiting, 2(7), pp.378-387.

Benedict, C., Brooks, S., Kullberg, J., Nordenskjöld, R., Burgos, J., Le Grevès, M., Kilander, L., Larsson, E., Johansson, L., Ahlström, H., Lind, L. and Schiöth, H. (2013). Association between physical activity and brain health in older adults. Neurobiology of Aging, 34(1), pp.83-90.

Biswas, S., Gupta, R., Vanjare, H., Bose, S., Patel, J., Selvarajan, S., Aaron, J., Nitya, E., Iyer, D., Jacob, N., John, K. and Jacob, K. (2009). Depression in the elderly in Vellore, South India: the use of a two-question screen. International Psychogeriatrics, 21(02), p.369.

Delbaere, K., Close, J., Brodaty, H., Sachdev, P. and Lord, S. (2010). Determinants of disparities between perceived and physiological risk of falling among elderly people: cohort study. BMJ, 341(aug18 4), pp.c4165-c4165.

Dennis, M., Kadri, A. and Coffey, J. (2012). Depression in older people in the general hospital: a systematic review of screening instruments. Age and Ageing, 41(2), pp.148-154.

Fairhall, N., Sherrington, C., Kurrle, S., Lord, S., Lockwood, K. and Cameron, I. (2012). Effect of a multifactorial interdisciplinary intervention on mobility-related disability in frail older people: randomised controlled trial. BMC Medicine, 10(1).

Fiske, A., Wetherell, J. and Gatz, M. (2009). Depression in Older Adults. Annual Review of Clinical Psychology, 5(1), pp.363-389.

Mann, R., Adamson, J. and Gilbody, S. (2012). Diagnostic accuracy of case-finding questions to identify perinatal depression. Canadian Medical Association Journal, 184(8), pp.E424-E430.

Nice.org.uk. (2018). Developing NICE guidelines: the manual | Guidance and guidelines | NICE. [online] Available at: https://www.nice.org.uk/process/pmg20/chapter/introduction-and-overview [Accessed 2 Dec. 2018].

Suija, K., Rajala, U., Jokelainen, J., Liukkonen, T., Härkönen, P., Keinänen-Kiukaanniemi, S. and Timonen, M. (2012). Validation of the Whooley questions and the Beck Depression Inventory in older adults. Scandinavian Journal of Primary Health Care, 30(4), pp.259-264.

Whooley, M., Avins, A., Miranda, J. and Browner, W. (1997). Case-finding instruments for depression. Journal of General Internal Medicine, 12(7), pp.439-445.