UPMC Bedford Memorial, Community Nursing and Home Nursing Agency Partner to Increase Depression Screenings and Access to Care for Seniors

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UPMC Bedford Memorial Hospital has been awarded a $600,000 grant from the Health Resources and Services Administration (HRSA) Federal Office for Rural Health Policy as part of a comprehensive initiative to improve the health outcomes of Bedford County residents 65 and older with depressive symptoms.

“This consortium leverages the expertise of our UPMC partners to ensure the health and wellness of our rural elders while implementing proven strategies to improve population health,” said Jerry Murray

UPMC Bedford Memorial Hospital has been awarded a $600,000 grant from the Health Resources and Services Administration (HRSA) Federal Office for Rural Health Policy as part of a comprehensive initiative to improve the health outcomes of Bedford County residents 65 and older with depressive symptoms. Efforts are also under way to increase their access to primary care and physician specialist care as deemed as criteria of importance in a 2013 Community Health Needs Assessment.

UPMC Bedford, Community Nursing and Home Nursing Agency will collaborate for three years on a project titled “Bedford County Mental HealthPLUS Senior Outreach.” Designated as a Health Professional Shortage Area and a Medically Underserved Area, Bedford County is one of the state’s most rural counties, with a large and increasing percentage of elderly residents ( 19 percent). Currently, there is no access to geriatric mental health services in Bedford, even though research confirms an increased prevalence of depression in older adults living in rural areas.

Using an evidence-based approach and a standardized assessment tool, care managers at UPMC Bedford Memorial and home health nurses with Community Nursing and Home Nursing Agency have identified multiple points of assessment throughout the county in order to screen for depression. Over the grant period, they will collaborate with the Bedford Area Office on Aging and other health care providers for screening, education, outreach and project sustainability to continue to improve access, diagnosis and treatment of geriatric depression.

“This consortium leverages the expertise of our UPMC partners to ensure the health and wellness of our rural elders while implementing proven strategies to improve population health,” said Jerry Murray, president of UPMC Bedford and UPMC Altoona.

Rates of major depression — a serious mental illness that involves depressed mood or loss of interest or pleasure over a two-week period, along with several other symptoms of impairment — are higher in younger populations, according to the U.S. Centers for Disease Control. But other, less severe conditions, such as minor depression and dysthymic disorder, are more common among older adults. Estimates for the different conditions vary, but about 25 percent of adults age 65 or older have some type of mental health problem, according to the CDC.

“Feelings of grief and bereavement, financial stress and other worries, a loss of identity after leaving the workforce, loneliness or worthlessness, as well as biological and medical factors often contribute,” said Charles F. Reynolds III, MD, director of the Aging Institute of UPMC Senior Communities and the University of Pittsburgh.

According to Reynolds, physical decline and depression also often “travel together,” interacting and making each other worse, and with the increase of disabilities that occurs as people age, the risk of developing depression symptoms increases.

"Depression in older adults is eminently treatable, thereby enhancing health-related quality of life and prolonging health span, as demonstrated by many studies published from the University of Pittsburgh's NIMH Center of Excellence in late life mood disorders. The HRSA-sponsored project is now a superb opportunity to extend the evidence to help older residents living in underserved areas of Pennsylvania,” he said.

UPMC Bedford will screen all inpatient and observation patients 65 and older for depression, as will Community Nursing and Home Nursing Agency. Individuals identified with depression will be directed to the most appropriate and least restrictive level of care, including management by a primary care physician, in-home behavioral health nurse and/or telepsychiatry in the patient’s home or at the Teleconsult Center on the UPMC Bedford campus in partnership with UPMC’s Western Psychiatric Institute and Clinic).

The goal is to evaluate ongoing depression symptoms across the continuum of care at every community visit made by the patient. The effectiveness of the program will be assessed by the number of newly diagnosed patients with depression who would otherwise not have received therapy and other measures. The consortium, which also collaborated with Dr. Reynolds and physicians from the UPMC Aging Institute and UPMC Senior Communities, was one of 60 awardees among 240 applicants nationwide.

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