First digital intervention to support mental health in home care

A university and aged care provider have teamed up to reduce the growing rate of older Australians facing depression while living at home.

It's estimated up to half of older Australians receiving home care services are experiencing symptoms of depression.

The Swinburne University of Technology and home care provider Silverchain have partnered to design and test a digital program, e-EMBED, to deliver psychological support to home care recipients. 

Professor Tanya Davison, Silverchain's Director of Research Discovery, said it'd be the first digital mental health intervention designed for home aged care settings.

"Depression is a significant problem among older people receiving home care, but not enough treatment options are available," professor Davison said.

The 12-month pilot received funding from Aged Care Research and Industry Innovation Australia (ARIIA) earlier this year.

Tune into Aged Care Insite's conversation with professor Davison about how to make the technology accessible and easy-to-use for older people to improve their mental health.

ACI: How prevalent is depression among older Australians receiving in-home care?

TD: Unfortunately, we have some indications that depression is a significant problem among older people receiving home care, but we don't have Australian data to confirm this. 

There has also been a lack of structured approaches to address that problem. 

Our best guess is that up to half of home care recipients experience depression, but we can't be certain.

However, an international literature review found home care recipients are twice as likely as other older people to experience mental health disorders, including depression.

It also found that home care patients' mental health disorders were more intense than those not receiving aged care services at home.

Regarding data available in Australia, the best information we have is from 2015, which reported 36 per cent of people receiving a home care package were depressed. 

We suspect that that figure is an underestimation of the actual rate of depression among home care recipients. 

Especially since we anticipate an increase in depression rates among older people following the Covid-19 pandemic. 

What major factors do you suspect are playing a role in the growing rate of depression among this cohort?

Several factors, including physical health, social isolation, and psychological factors influence depression.

Multiple medical conditions, declining day-to-day functioning, or increasing frailty can all put someone at greater risk of depression.

Especially in the home care population, we see greater clinical and medical complexity. 

Social isolation and loneliness are also common in older people, and losing loved ones or having distant family members can contribute to depression. 

Additionally, many older people report feeling a lack of purpose or meaningful activities in their daily lives and feeling undervalued or not contributing to society. 

These psychological factors may also contribute to depression.

It's a complex issue, but these are the types of factors that we see in the literature associated with depression.

How do you hope this program will help reduce the rate of depression? 

So, we're taking a proactive approach and have designed an innovative model of care to address depression. 

Currently, older people in Australia have limited access to psychological treatments, despite their high effectiveness with this population. 

Accessing a psychologist can be difficult for older people living at home, especially in rural or remote areas, as they may not have local options or difficulty travelling. 

That's why we are developing a digital platform that will enable older people to access mental health clinicians and a range of resources to improve their mental health. 

The platform will also allow clients to communicate with their clinicians and access the necessary support they need. 

We believe that digital technology has the potential to bridge the gap in access to psychological treatments and improve the mental health of older people living in the community.

It involves training our frontline staff to recognise signs of depression and set up treatment. 

In this project, we are developing a digital approach to enable older people to access psychological treatment for depression. 

We're using technologies, including telehealth, and developing a digital client platform to help older people access psychological treatments and resources to improve their mental health regardless of where they live.

How will you make the technology accessible and easy to use for older people?

Of course, some older people are very experienced in using technology and have very high levels of digital literacy, but not all. 

So, what we need to do first is look at how to design the technology that's most accessible. 

We'll be working with older people throughout the development and piloting of our approach so that we have that input from the get-go, designed with older people in mind. 

The other thing that we need to think about is what level of support people might need. 

We're working with our partners at Swinburne University to develop a tool to help aged care providers determine what support people might need.

For example, we have a big aged care workforce, and our frontline staff may be able to assist clients in engaging the technology. 

In this project, we will look to understand that and tailor our approaches.

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