Depression and anxiety are major health issues among patients receiving home care, but are under-diagnosed and under-treated ... causing negative health outcomes. Your patient may be anxious and/or depressed because illness prevents participation in activities. While anxiety or depression is an understandable response to illness, it is not inevitable. With support and counseling a patient can cope with the blues.
Home healthcare clinicians are well positioned to help patients manage anxiety depression PROACTIVELY. Facilitate this effort for improving depression care with enhanced learning.
- Excessive worry about several events or activities for more than half a day.
- Trouble controlling anxious feelings
- The presence of three or more of the following symptoms, some of which are present for over half a day:
- Feeling restless, edgy, keyed up
- Tiring easily
- Trouble concentrating
- Increased muscle tension
- Trouble sleeping (initial insomnia or restless, unsatisfying sleep)
- The anxiety and worry aren't suggestive of another mood disorder
- Depressed or irritable mood most of the day—nearly every day
- Loss of interest or pleasure in activities (such as hobbies, work, sex, or being with friends) most of the day—nearly every day
- A sudden change in weight (weight loss without dieting, gaining more than 5% of body weight in 1 month) or a change in appetite
- Inability to sleep or sleeping too much nearly every day
- Agitation or restlessness (observed by others) nearly every day
- Constant fatigue or loss of energy nearly every day
- Frequent feelings of worthlessness or inappropriate guilt nearly every day
- Difficulty concentrating or making decisions nearly every day
- Frequent thoughts of death or suicide (or a suicide attempt or plan)
Coping with anxiety and depression
- Counsel the patient to avoid making major life decisions until s/he is effectively coping with depression or anxiety.
- Instruct the patient to avoid alcohol
- Encourage exercise even if it is only with a few body parts. Mild exercise 30 minutes a day may have a positive effect on depression or anxiety. If s/he misses a day, tell her/him not to worry and to simply do it the next day.
- Encourage the patient to be around people, even if s/he is not feeling up to it. The illness may make the patient feel withdrawn, but counsel them to not let it govern their behavior. Encourage the patient to call or visit a friend.
- Help the patient gain a sense of control by encouraging her/him to care for her/himself as much as possible and make daily decisions such as what to wear
- Encourage the patient to express feelings and Listening attentively an make no judgments.
- Take the patient seriously if s/he shows signs of injuring her/himself or talks of suicide. Remove sleeping pills, guns and razor blades.