Because of their social isolation imposed by chronic illness and functional limitations, homebound older adults are more vulnerable to depression than their mobility-unimpaired peers. Indeed, aging-service providers in Central Texas have identified depression as one of the most significant unmet need among older adults, especially among low-income older adults (Final Report of the Greater Austin Initiative on Depression in Older Adults, 2008). Previous research showed the effectiveness of in-home, short-term problem-solving treatment/therapy (PST) for reducing depressive symptoms among medically ill older adults (Areán, Hegel, Vannoy, Fan, & Unützer, 2008; Ciechanowski et al., 2004; Gellis, McGinty, Horowitz, Bruce, & Misener, 2007). However, due to the lack of trained service providers and budget constraints, aging-service providers in Central Texas have overlooked screening and treatment of depression in low-income older adults.
The tele-PST project is a community services project that provides active psychotherapy for depressed homebound older adults in the local community while collecting research data to inform future program needs. Funding from the St. David’s Foundation (SDF) will enable low-income homebound older adults to access evidence-based depression treatment, which will, in turn, improve their quality of life and reduce healthcare costs for these vulnerable older adults. Community partners-referral sources are the MOWAM, Area Agency on Aging of the Capital Area, Family Eldercare’s Elders Living Well Program, Austin Groups for the Elderly (AGE), and the H.A.N.D.
This project extends access to services and builds on previous research conducted by Dr. Choi with support from NIH/NIMH, St. David’s Foundation and the Mitte Foundation. In this PST project, we collect data on the subjects’ healthcare use before and after their participation in PST. In collaboration with a health economist at Cornell Medical School, we also plan to conduct preliminary cost-benefit analysis of PST.