Page 150 - Encyclopedia of Nursing Research

DEPRESSion in oLDER ADULTS n 117

could not manage daily life. Further, feel- prevent depression from becoming a recur-
ings of uncertainty and instability affect rent and chronic illness for the entire family.
the atmosphere within each of these fam- The majority of studies continue to focus D
ilies. Families also described living on the on either the environmental or genetic fac-
edge of the community as they isolated or tors that increase risk for depression in fam-
secluded themselves from the wider commu- ilies, but future studies need to examine the
nity. Daily life was hard because responsibil- relationships between genetic–biological
ities shifted between members, including the predisposition and environment on preven-
children within the family, because the adult tion or treatment of depression (Jaffe & Price,
depressed member could not assume usual 2007; Rutter, 2010). There have been fewer
roles and responsibilities. Finally, families clinical trials validating the effectiveness of
describe that despite everything, the family family interventions in treating depression,
as a unit and individually had ways of coping and future research should develop and test
and finding some kinds of satisfaction. These psychoeducational and support interven-
results support findings from previous stud- tions with families. Although a common con-
ies (Badger, 1996a) and provide perspectives cern with research with families remains the
of family members not normally included in unit of analysis (individual, dyad, or family
depression research. as a whole), research representing all per-
The role of the family in the treatment spectives is needed for nursing to more fully
process has received less attention (e.g., understand and treat depression in families.
Cardemil, Saeromi, Pinedo, & Miller, 2005).
Systematic family interventions are few and Terry A. Badger
are modeled after programs used with peo-
ple with other psychiatric disorders and
their families or after programs used with
people with other illnesses (e.g., diabetes, Depression in olDer aDults
dementia) and their families (Judge, Yarry, &
orsulic-heras, 2010; Rosland, heisler, Choi,
Silveira, & Piette, 2010; Rosland & Piette, Depression is the most common mental dis-
2010). For example, Ryan et al. (2010) found order among older adults in the United States
that the Management of Depression Program and one of the most disabling conditions
was effective in helping patients with diffi- among elderly persons worldwide (Kohler
cult-to-treat forms of depression and their et al., 2010; Sable, Dunn, & Zisook, 2002). it
family members to deal more effectively is estimated that of the 35 million people 65
with persistent depression. The disease years and older, 2 million (approximately 6%)
management approach, which was similar suffer from severe depression and another
to approaches used in cancer or diabetes, 5 million (14%) suffer from less severe forms
improved perceived quality of life and func- of depression (national institute of Mental
tioning, reduced depressive symptoms, and health, 2007; Varcarolis & halter, 2010). The
improved perceptions of family function- prevalence of clinical depression ranges
ing. Families continue to identify the need from approximately 5% to 10% in commu-
for information about how to facilitate com- nity samples (medical outpatients), from 10%
munication, decrease negative interactions, to 15% in medical inpatients, and from 10%
handle stigma, and learn strategies for fam- to 25% in hospice and palliative care patients
ily coping with depression (Ahlström et al., (Blazer, 2003; Djernes, 2006, King, heisel, &
2009; Badger, 1996b). in theory, education, Lyness, 2005). Furthermore, the rates of major
support, and partnering could move family depression among older adults range from
members more quickly into recovery and 20% in nursing home residents and nearly