In-Home Depression Treatment May Lower Hospitalization Risks

Treating older adults for depression through home health care could reduce the risk of hospitalization, according to a Dartmouth College study published in the Journal of the American Geriatrics Society.

In fact, treatment lowered the hospitalization risk by 35% within 30 days of starting home health care, and 28% lower within 60 days for older adults who participated in a depression intervention program called CAREPATH, researchers found.

CAREPATH is an intervention program aimed at helping nurses assess and manage depression in Medicare recipients.


For seniors referred to home health agencies directly from a hospital, the risk of being readmitted was about 55% lower with CAREPATH.

“The hospitalization findings were surprising because they demonstrated an almost immediate impact of the intervention on patient outcomes,” Dr. Martha Bruce, a study author and professor in the Geisel School of Medicine at Dartmouth, told Home Health Care News in an email.

CAREPATH utilizes weekly symptom assessments, medication management, care coordination, patient education and goal-setting to help older adults understand and manage their depression.


Homebound seniors who suffer from depression normally have a “significantly higher” risk of hospitalization during the first month of care, according to the study.

“I think that having nurses pay attention to depression (acknowledging it as real, talking with doctors and family, helping patients set self-care goals) helped activate patients, families and clinicians, perhaps engaging them in addressing patients’ wellbeing, psychosocial needs and overall care,” Bruce said. “Maybe it gave hope.”

In-home applications

Home health agencies could potentially benefit from the intervention program. CAREPATH is designed to scale, meaning it can be tailored for agencies of different sizes. Furthermore, adding the CAREPATH intervention program to home health did not increase number of nurse visits, length of stay or average minutes per visit, the study showed.

“Besides the training and any agency infrastructure changes…it should not add to the cost of care,” Bruce said.

So far, feedback on the program from clinicians and administrators has been fairly positive.

“They report that the CAREPATH gives them tools to work more effectively with depressed patients, and it gives them guidance in how to talk with physicians about depression,” Bruce said. “And it gives them guidance in how to talk with physicians about depression.”

The intervention also recently won the 2017 Innovative Research on Aging Award from Mather LifeWays Institute on Aging, the research service arm of Evanston, Illinois-based senior housing provider Mather LifeWays.

Written by Tim Regan

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