Because major depression can be successfully treated in older patients (3), our finding that depression is not only prevalent but mostly untreated in home health care patients is important for clinical practice. The complex configuration of home care presents a challenge to identifying depression in these patients. Physicians have little opportunity for directly assessing their home health care patients, unlike the patients they see in primary care. The visiting nurse generally serves as the eyes and ears of the physician, thereby playing a key role in establishing the presence of depression and potential need for treatment