Healthcare Areas

Information in this chart comes from the Depression Rating Scale (DRS) (Burrows et al., 2000). This scale shows the prevalence of continuing care – type A (formerly long term care) residents with potential depression and depressive symptoms of mood distress.

This scale assesses the frequency of a range of symptoms displayed by residents. The symptoms assessed include:

• Use of negative statements,
• Persistent anger with self and others,
• Expression of unrealistic fears,
• Repetitive health complaints,
• Repetitive anxious complaints,
• Sad or worried facial expressions, and
• Tearfulness (crying or close to crying).

The frequency of each symptom is calculated, resulting in an overall score that ranges from 0 to 14. A higher value indicates that a resident has more numerous and/or frequent depressive symptoms of mood distress and that a resident may be angry, frustrated, anxious, or lonely. A score of 3 or greater may indicate a potential or actual problem with depression. This is not a diagnosis, but a prompt for further assessment. Further assessment is required to confirm that the symptoms are due to depression. Depression is a serious condition and if left untreated, is associated with significant morbidity, functional decline and unnecessary suffering by the person, family and caregivers.

This chart shows the percentage of residents with no depressive symptoms, 1-2 depressive symptoms, and 3 or more depressive symptoms.

The information in this chart can best inform system-level planning for quality improvement, program development, and resource allocation. This is because this data, when reported at an aggregate level, provides a description of the population that requires services in relation to potential depression. It does not describe the quality of care or services provided at a site.

When thinking about this information, providers and leaders can consider a number of things to better understand these results. Some questions they should consider before taking action include:

• How would you describe the prevalence of continuing care home – type A (formerly long term care) residents in Alberta living with symptoms of depression or potential depression? What might the proportion of residents with potential depression mean for program planning? Quality improvement? Resource allocation?
• What are some challenges staff face to identifying depression and underlying reasons for symptoms of mood distress, such as pain? How can cognitive impairment make this more difficult? What about communication, sensory, and expressive barriers?
• What types of care, supports, and services are appropriate for residents with potential depression and who show signs of mood distress, to ensure quality of life and safety? How might an interdisciplinary team work together to consider possible contributing factors, trial supportive interventions, and assess for improvement?

The Health Quality Council of Alberta uses the Alberta Quality Matrix for Health as a way of organizing information and thinking around the complexity of the healthcare system. This measure can be used as input to assess long term care’s performance in these dimensions of quality: Acceptability, Appropriateness, Effectiveness, and Safety.

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