The immediate goal of any depression intervention in
home health care is recovery from depression and reduction of depressive symptoms. Data from other populations
suggest that treating depression may reduce the risk of
negative functional outcomes as well. Functional outcomes are especially important in home health care, both
because good functional status is critical in allowing older
adults to remain in their own homes and because Medicare’s prospective payment system bases reimbursement
on functional outcomes. Despite the availability of efficacious treatments for depression, however, only nine (12%)
of our depressed home care patients received adequate
antidepressant treatment. This magnitude of untreated
major depression underscores the critical need for effective strategies to reduce the burden of depression in older
home health care patients.