![]() To provide insight into the dynamics of activity engagement, this descriptive study examined daily life activities of older adults during a depressive episode using an interactive qualitative assessment method ( Sandelowski, 2000). Without an understanding of clients’ perspectives on how depression affects their daily life activities, practitioners lack the contextual perspective necessary to assess clients with depression and determine interventions that will be most effective for supporting everyday activities and functioning ( Lang, Rieckmann, & Baltes, 2002). Thus, little is known about clients’ perspectives on the functional consequences of depression.Īs experts in ADLs and IADLs, occupational therapy practitioners are uniquely qualified to address the habits and skills clients need to support participation in meaningful daily activities ( Rogers & Holm, 2000). No researchers have examined the dynamics of activity engagement as clients react and adapt to the effects of a depressive episode. Thus, they reported on limitations in basic activities of daily living (ADLs) and instrumental ADLs (IADLs) in the aggregate, revealing little about engagement in individual activities ( Grigsby, Kaye, Baxter, Shetterly, & Hamman, 1998 Ormel et al., 1998). In most studies, however, authors examined activity domains rather than activities. The association between depression and disability has been demonstrated in many studies, as noted in Lenze and colleagues’ (2001) systematic review. ![]() It is associated with greater health care costs, increased medical burden, and longer hospital stays ( Luber et al., 2000). Depression renders negative consequences not only for the individual but also for society and the health care system. Because the number of older adults is projected to increase to 82 million in the United States by 2050, the number experiencing depression will likely increase, adding to existing public health concerns ( Jarvik & Small, 2005). The prevalence of major depression in older adults is 1%, and an additional 15% have depressive symptoms that do not meet full diagnostic criteria ( Alexopoulous, 2005). Moreover, major depression is associated with stress, medications prescribed for other conditions, and severe and traumatic life events such as the death of a spouse or poverty ( Institute of Medicine, 1994). Major depression may be a primary diagnosis, or it may exist comorbidly with medical conditions such as cardiac disease ( Dickens, Cherrington, & McGowan, 2012) or stroke ( Ayerbe, Ayis, Crichton, Wolfe, & Rudd, 2013). ![]() Major depression is characterized by a change in mood or sleeping or eating habits, low energy or fatigue, reduced concentration, feelings of worthlessness or excessive guilt, psychomotor agitation or retardation, or thoughts of death or suicide ( American Psychiatric Association, 2013). Depression is “clinically significant distress or impairment in social, occupational, or other important areas of function” ( American Psychiatric Association, 2013, p. Each theme for activities continued and activities stopped lends itself to intervention strategies.įunctional disability, which includes activity limitations and participation restrictions, is a cardinal symptom of major depression. To guide effective intervention, it is critical for occupational therapy practitioners to complete a client-centered qualitative assessment to understand what and, most important, why activities are continued or stopped. ![]() Some intentionally stopped activities to direct limited energy to their highest priority activities. Older adults maintained many instrumental activities of daily living while depressed, and some actively adapted activities so they could continue them. Six themes emerged that explained activities participants continued while depressed, and four themes described activities they stopped.ĬONCLUSION. Transcripts were coded to identify relevant themes. Each community-dwelling participant ( n = 27) completed one semistructured interview while in recovery for at least 3 mo. We sought to understand activity choices of older adults when they were depressed.
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