Among home health patients, depression is a debilitating and treatable psychiatric condition that often remains undiagnosed and reduces quality of life, social interactions, daily functioning, and treatment adherence. Untreated major depression increases functional decline; costly medical, emergency, and mental health visits; and reliance on disability or welfare. In the worst case, many patients decide that life is not worth living and attempt suicide. Screening and careful assessment are the keys to the detection and evaluation of depression. Scant literature exists to guide the evaluation and management of depressive disorders in home care. This article illustrates the evaluation and management of depression. The home care provider is in a key position to detect, evaluate, and intervene with depression and monitor its complications such as suicide risk. Evaluating depression is a professional nursing responsibility requiring judgment and the ability to understand subtle dynamics of loss, hopelessness, and emotional pain.
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