Mental Disorder in an Elderly Home Care Population: Associations with Health and Social Service Use

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Abstract
BACKGROUND Home care services maintain people in their own households by providing practical help such as with housework, shopping and personal care. In this study associations between mental disorder and health and social service use, demographics and activity limitation are investigated. METHOD A cross-sectional study with random cluster sampling of people over 65 receiving home care in Lewisham. Mental disorder was rated using the GMS/AGECAT system. RESULTS We interviewed 169/177 eligible individuals, a response rate of 96%. Forty-six percent of this population were rated as cases of mental disorder (15% organic and 26% depressive). Most (84%) of those with depression did not appear to be receiving appropriate treatment. Home care provision to those with depression (unlike dementia) was only partially explicable in terms of activity limitation. CONCLUSIONS There is a high level of depressive disorder in this population with little in the way of appropriate primary or secondary care management. Those in sheltered housing seem particularly at risk; depression may lead to increased service use independent of disability.