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.

Recognizing Anxiety

• 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
• Irritability
• Increased muscle tension
• Trouble sleeping (initial insomnia or restless, unsatisfying sleep)
• The anxiety and worry aren't suggestive of another mood disorder

Recognizing Depression

• 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 The illness may make the patient feel withdrawn, but counsel them to not let it govern their behavior.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.

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