Home-Based Program Reduces Senior Depression, Cuts Health Care Costs

A nationwide home-based program is curbing depression among seniors and cutting costs in the process.

The Program to Encourage Active, Rewarding Lives (PEARLS), which started out of the University of Washington in the late 1990s, aims to combat depression among those over 65.

The condition affects more than 6.5 million Americans in that age group, but only about 10% get treatment, according to the National Alliance on Mental Illness. Oftentimes, depression among seniors is associated with social isolation and increased physical illnesses.


“I think this generation views mental health as shameful, so they won’t seek treatment, and a lot of times we see they are not even aware they’re feeling depressed,” Annmarie Franco, PEARLS Program Manager for the Visiting Nurse Service of New York (VNSNY), told Home Health Care News. “They just feel stagnant: ‘I’m at a certain age, this is how I am now.’ ”

The PEARLS program, which is free, helps identify seniors who may be struggling by using community screening. At-risk seniors then receive six to eight in-home sessions to learn behavior techniques to help them combat their depression.

The Visiting Nurse Service of New York (VNSNY) adopted the PEARLS program in 2016 and — along with other NYC-based PEARLS programs — has since delivered care to hundreds of clients across New York City. VNSNY has grown from a serving handful of clients to currently serving nearly 90 seniors across Manhattan and Queens this year.


The results speak for themselves.

NYC residents in PEARLS programs started with an average depression score of 11.5, according to Department of Health data from November 2017. After completing the program, that score lowered by 5 points — to a 6.3 — indicating their conditions improved.

Additionally, VNSNY points to exit survey results to tout the program’s success.

Some responses include, “I’m not so sad all the time and unreasonable about everything,” “I would recommend this program to most people,” and, “it changed my way of thinking,” Franco said.

Beyond social benefits, the PEARLS program can have financial advantages.

“If people take care of their emotional health, they’re more likely to care for themselves physically,” Franco said. “I think a program like this can help individuals be less dependent on the system.”

Research backs up that theory. PEARLS recipients were more likely to have a 50% greater reduction in depression symptoms to achieve complete remission, along with greater health-related quality of life improvements and a trend in decreased hospitalizations.

PEARLS programs are available at select organizations across the country. Still, beyond that, home care companies can employ the concepts behind the program to further improve senior care and reduce costs nationwide, Franco says.

“Train current staff about elderly depression — what the signs and symptoms are,” she said, also encouraging agencies to educate clients about depression. “Care coordination is also very key. It helps ensure that the gaps are closed and supports are in place so the functioning of the individual doesn’t decline after treatment.”

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