Home Health Nurses Lack Training in Geriatric Frailty, Depression

Frailty, chronic disease and depression are three parts of a whole health problem for some home health care patients—and some nurses might not be equipped to help.

Older adults with depression show a greater base level of frailty, according to a American Journal of Geriatric Psychiatry study from 2014 that analyzed the correlation between depression and frailty. Along with those two issues, about 80% of older adults have at least one chronic disease, according to the National Council on Aging (NCOA).

But a new study may suggest that the home health care industry as a whole isn’t prepared to care for those demographics.


Home health care nurses feel unprepared to assess depression and frailty and few home visits incorporate depression and frailty assessments, according to the study, “The Home Health Nurses’ Perspectives and Care Processes Related to Older Persons with Frailty and Depression: A Mixed Method Pilot Study.”

Other studies have found similar results, which led to the development of training on geriatric depression for home health care nurses.

“Up to 35% of our elderly population has a comorbid diagnosis of depression or cognitive deficit,” Susan Northover, SVP of patient care services at Visiting Nurse Service of New York (VNSNY) told Home Health Care News. She noted that VNSNY does train its home care staff in on how to care for depression and cognitive deficits.


Nurses in the study commented on a lack of training despite existing modules and tools, including the standardized depression screening tool in OASIS

From a provider standpoint, these issues are important to be aware of as depression and frailty are factors associated with hospitalization.

“One of the main goals of home health is to keep our clients safe and stable in the community,” Kathryn H. Bowles, VNSNY vice president and director of the Center for Home Care Policy and Research, told HHCN. “Patients who are depressed may not have the will to participate in self-care activities such as exercise or medication management. Those who are frail and weak are at risk for falling. Home health providers can address and prevent the sequelae of both of these conditions.”

For some home health care nurses, depression requires their own research.

“I’ve done some training on my own from the internet,” read one comment in the study.

“As far as geriatric depression and behaviors, usually, it just depends on who the nurse is. Some nurses have a knack for that. Some don’t,” the comment continued.

The report noted that nurses had similar views on the absence of training in frailty.

Written by Kaitlyn Mattson