Introduction: Effective Communication Approaches in Depression Assessment for Older Adults

In terms of assessing mental ill-health in the seniors and particularly when talking of depression, the facet of interaction is exceptionally significant. Depression in elderly patients is different from young patients in such a way that most of the symptoms develop themselves with other diseases that are common with old age such as dementia or chronic diseases. This implies that the communication strategies that are required to reach this demographic are very complex since the overall world recognizes that this group of people is quite distinct. This work has the following general research questions as which among the communication strategies was most effective in identifying the older adults at risk of depression? Discussing the methods of verbal and non-verbal communication, the importance of empathy, and activity list instead of involving the elderly people during assessments. With this discourse on the different regimes, the paper seeks to highlight approaches that can be used to improve depression diagnosis accuracy of the older population and in turn their well-being (Czaja, Moxley, & Rogers, 2021). The papers of the subsequent sections will offer a brief literature review that will discuss the approach to carrying out the systematic review and will provide recommendations regarding the way communication might be improved in this regard.

Search Strategy

For this study, this paper mainly aims to make a review of the related literature on communication strategies which are used during depression assessment in the older adults. For this, the academic databases PubMed, PsycINFO, and Google Scholar will be searched (Christensen et al. 2020). The studies were retrieved by using peer-reviewed articles, systematic reviews, and clinical guidelines from the last decade in order to obtain recent and highly relevant data.

Another aspect is that the main terms to be invited were chosen to embrace the whole issue. These terms were communication strategies, for older adults. Assessment of mental health, depression, and psychosocial assessment (Lawrence et al. 2020). Different types of boolean operators were applied to narrow the results, for example, typing in terms such as depression and older type of adults, communication strategies, and mental health assessment. The search has detected many papers with over many papers that were reported initially. To refine the search, the articles were limited further to the ones that featured older adults and those containing elaboration on the approaches for interacting with patients during the mental assessment. After the application of these criteria, many articles were considered relevant.

More difficulty was introduced by the scrutiny of abstracts and the process of choosing works to include with attention paid to the findings’ relevance depending on the topic of communication in depression assessment among elderly patients. Many of the highly valuable articles that comprised the final review (Czaja, Moxley, & Rogers, 2021). Each of the following works offers a detailed description of the difficulties, guidelines, and most importantly, communication strategies in mental health assessments among elderly people. These studies are also going to be used in the literature review of the next section towards identifying the most useful communication approaches and its consequences for the proper identification and treatment of the older adults depressed.

Review of the Literature

The review of the literature mainly comes from the research topic of communication strategies used when assessing an older person for mental ill health focusing on depression.

Communication strategies for depression older adults’ assessment

According to Jack, Ridley, & Turner, (2024), interpersonally knowledgeable and skilled, therefore, interacts at the individual level meaning that good communication with older adults is a central function of practice. Wherever communication deteriorates, it leads to negative consequences with a sample for elders, these include in ability, powerlessness as well as helplessness. Older adults need to be heard by Nurses and feel as if their complaints are being listened to without prejudice. One aspect of interpersonal communication is the self-monitoring of the nurse along with their own thoughts and emotions, especially prejudice about the aging process (Jack, Ridley, & Turner, (2024). As mentioned, aging may impose certain communication difficulties in the interaction with older adults. However, many of those barriers can be addressed by the nurses. Another crucial lesson is that people should and must be treated as individuals and that in working with older adults, one should take into account some of the aspects associated with aging. In doing so, the nurses can also assist older people to feel enabled, valued, and capable of keeping independence. Apart from the good delivery of healthcare services, this enhanced care and respect for the patient’s needs and California eldercare makes the elderly happy and makes them interested in taking an active role in their treatment.

The challenges in the adoption of intervention among older people

Figure 1: Social-ecological model for the challenges in participation of intervention

(Source: Pywell et al. 2020)

According to Pywell et al. (2020), the authors have suggested how the mobile-based interventions can be helpful to older people and how can they be adopted to the process. The barriers of the implementation of this process have also represented in this study. The reality is that there is a growing need for mental healthcare treatments for elderly individuals, and at the same time, there is pressure to keep the costs of delivering healthcare low; so, the use of mobile applications emerges as a solution. However, as earlier discussed, the adoption of mobile-based mental health interventions by the older adults remains very low. A review of the literature suggested that psychological barriers are important in the evaluation of such intercessions and acknowledged the gender factor but no previous studies have investigated the level of awareness of older people regarding the applications and the barriers that limit their usage. The purpose of this work is to identify the factors that hinder older adults in using mobile-based mental health interventions. In-depth, semi-directed interviews were carried out with 10 participants aged 50 years or over (7 female; mean age = 68 years; SD = 8.8) who reported experiencing low mood at some time. To engage the participants in the discourses and check the Level of knowledge regarding, the mental health application of mobile based intervention, NHS mental health application were used during the interviews (Pywell et al. 2020). The interviews conducted were analyzed via integrative thematic analysis with the social ecological model used as the theoretical framework. Six distinct barriers to the uptake of mobile-based mental health interventions emerged: low level of e-health literacy, poor play with technology, high attrition rates, the perceived lack of a doctor patient relationship, ambiguity of the general practitioner’s position and issues of privacy and confidentiality. Such barriers included the personal level to the systemic level showing that adoption of such technologies among older adult was not easy. The paper also finds that older adults experience barriers at all levels right from individual level regarding their e-health literacy to the organizational and systems level. These results highlight the need for further interventions to enhance the older adults’ awareness of and engagement with the mobile-based mental health interventions and possible solutions such as educational and informational initiatives.

Efficiency of the one type of intervention in deterioration of depression

According to Reangsing et al. 2021, the mindfulness-based interventions for depression were very comprehensively reviewed for older adults, as also the moderating effects of the participant characteristics, intervention approach, and study design features. Due to the escalation of focus on non-drug approaches for mental disorders in elderly people, MMIs are currently acknowledged as potential approaches for handling depression. This meta-analysis sought to systematically review the literature on the efficacy of MMIs for only older adults aged 65 years and above. A systematic review was done using 15 databases up to June 2019 without restricting to any date. The search keywords were derived from mindfulness, meditation, depression, and older adults. The inclusion criteria were concerned with the primary studies conducted on the responses of adults aged 65 and above with depression as an outcome measure, the studies done with a control group, and the studies done in the English language only (Reangsing et al. 2021). Out of the identified studies, nineteen studies with 1,076 patients in total were included in the analysis, of whom the mean age was evaluated for 71. 8. Cohen’s d was used to assess effect sizes within the studies reported and ‘tau squared’ was used to address variance between the studies. Heterogeneity was tested with the Q statistic and the I² statistic; the effects of the possible sources of moderator were examined. MMIs were typified by a considerable reduction in depressive symptoms in older adults compared to control conditions at moderate “ES =. 65 (95% CI, 0. 035, 0. 094)”. The moderator analysis showed that the outcomes of MMIs depended on the type of intervention and participants’ demographic features. More particularly, Asian participants demonstrated the most significant enhancement on the depression measure, European participants were next (ES = .59), and North Americans were the least (ES = .32). Less times interventions less than 5 weeks were more effective (ES = 1. 47) as compared to a longer program. Uncontrolled meditation SELF = ES 0. 42, and controlled or guided meditation SELF = ES 0. 91. The observed effect size was significantly higher in the primary studies that conducted a power analysis.

Recommendations

Healthcare professionals should mainly prioritize individualized types of communication strategies that ensure they actively listen along with validating older adults' issues. Training in self-awareness along with addressing age-related types of stereotypes is very important. Adapting the methods of communication to overcome barriers posed by aging can allow older adults. This mainly enhances their overall sense of autonomy along with well-being.

Development of communication approaches

The health experts need to adopt the two types of communication which helps in getting of understanding of demands of the older people. With the help of proper and concise language, the complications related to the medical field can be avoided.

Incorporation for active listening and understanding

With the help of describing compassion is crucial during the interaction with the patient. Active listening can be helpful to the patient as they can share their issues more spontaneously and acknowledge their feelings (Tremain et al. 2020). This can also help in reacting with the empathy and help to develop the trust. This can motivate them and assure the older people about a safe environment that feels more comfortable to them.

Involvement of family members

Family members can offer assistance in the different purposes. Caregivers can properly recognize the exact issues by communicating with them. So involvement of them requires more implementation to acquire the best results among older people.

Conclusion

Here mainly conclude that effective type communication is very important in nursing specifically with older adults. Tailored and empathetic type of communication mainly develops empowerment, respect, along with independence. These aspects ultimately enhance outcomes of healthcare. It is important to discuss how depression can be reduced among the older people. This study has evaluated the strategy with the help of different journals and helps in acquiring the knowledge regarding depression. The search strategy has also been presented here to understand from where the articles required to be collected. The different evidences of the different authors have been helped in the description of the literature review which has helped to understand how this can deteriorate the problems of depression among the older people. The preexisting journals have helped to proceed the study in future and how this can be helpful to others. The recommendations are also required to know that which plans are required to be implemented better in the future. So this study has efficiently described how the communication strategies can be helpful to reducing depression among the older people.