Dementia and depression are very common disorders among older people and their presence, both isolated and specifically combined, results in a decreased quality of life in the well-being of the aged. As the population ages, more patients are being diagnosed with dementia and depression. An abundance of patients in long-term care facilities (LTCFs) exist who have dementia and accompanying depression that largely goes undetected and untreated. After a careful review of the literature and anecdotal evidence gathered by the principle investigator (PI), sufficient evidence existed that linked undetected depression in patients with dementia in LTCFs to lack of knowledge among nurses regarding detection of depression in patients with dementia. Patients with dementia who reside in LTCFs are a vulnerable population. These patients are most often frail and in some instances cannot speak for themselves. Depending on the severity of dementia, they are unable to even recognize depression in themselves and thus unable to communicate to their providers that they have depression. The purpose of this Capstone project was twofold: first, to increase awarenes and knowledge level of nurses regarding detection of depression in patients with dementia who reside in the LTCF, and second, to implement the clinical practice guideline (CPG) for detection of depression in older adults with dementia. For this Capstone, the PICO framework was used to identify the clinical question. Rogers Diffusion of Innovations provided a systems/theoretical perspective. The Johns Hopkins Nursing Evidence-Based Practice Model was the selected evidence-based practice framework used throughout this Capstone. A teaching session was conducted at a selected LTCF. All 15 nurses who work at this facility were encouraged to participate in the educational intervention. A total of 13 nurses participated. A pre-test was conducted using the established tool, Detection of Depression in Older Adults with Dementia Knowledge Assessment test. Immediately following the teaching intervention, a post-test was conducted to determine whether there was a change in awareness of knowledge level of the participants. A one-month follow-up was completed using the same test to evaluate the nurses’ level of understanding regarding the implementation of the guideline. Findings suggest that nurses, once educated on the prevalence and lack of treatment of depression in patients with dementia in the LTCF, became better advocates for these patients. The results demonstrated that once nurses were taught how to detect depression in this population, they were better prepared to implement the clinical practice guideline and detect depression in patients with dementia in the LTCF. The PI found that patients with dementia often have unrecognized depression mostly because of a lack of knowledge of nurses regarding the detection of depression in these patients with depression. Results showed that once empowered with heightened awareness and increased knowledge level, nurses implemented the clinical practice guidelines. As a result of continuing education in this practice setting, more patients with dementia were diagnosed with depression; prompt treatment was started with anticipation of an improved quality of life for this vulnerable population.
