Project summary
Swinburne University of Technology in partnership with Silver Chain Group Ltd has been awarded an ARIIA grant for their project ‘An innovative digitally enabled intervention to reduce depression in home-based aged care’.
With a growing number of Australians receiving aged care at home and an increase in depression rates in this population, innovative approaches to address depression are urgently required. Australia faces critical shortages in the aged care and the mental health workforce. Depressed home care recipients have poor access to evidence-based treatments.
Digital technologies offer an opportunity to deliver interventions at scale to reach the rapidly increasing number of depressed older Australians receiving aged care at home. While there has been enormous growth in digital mental health programs recently, they have nearly always been designed for younger people. Yet, many older adults are interested in and engage with a range of digital technologies. Our research addresses the gap in availability of effective digitally enabled interventions for depression designed specifically for aged care.
Building on previous work, we will co-design and pilot an innovative intervention for depression for older adults living at home and evaluate its feasibility and acceptability. The intervention will comprise psychological strategies with proven efficacy for older adults, delivered using digital technologies.
This project will assist the aged care workforce to use digital technologies to deliver best practice interventions to older Australians living at home with depression.
Project outcomes
Background and Aims
With a growing number of Australians receiving aged care at home and an increase in depression rates in this population, innovative approaches to address depression are urgently required. This project aimed to fill this gap, by co-designing a digitally enabled psychological intervention for older adults experiencing depression symptoms receiving in-home aged care; evaluating this program; and producing a tool to facilitate tailoring of digital resources and support for older adults receiving digital interventions.
What We Did
We completed a range of activities to meet our aims:
- We developed a digitally enabled psychological intervention (E-EMBED) based on our prior research regarding in-home aged care client needs and preferences, and then sought validation and further co-development with additional in-home aged care clients to ensure that the digital intervention was appropriate for this population.
- We developed a tool (E-TECH) to enable in-home aged care providers to tailor digital technologies to meet the needs of their clients, and to guide the type of training and support that is required for individual older people.
- We then piloted E-EMBED and E-TECH with 13 in-home aged care clients experiencing symptoms of depression.
Outcomes
This project had two outcomes:
The first outcome of the project was a piloted digital intervention to treat depression designed specifically for the home care sector. We co-designed a digital client platform to enable older people to engage with a digital mental health program designed to reduce symptoms of depression. This program was called E-EMBED. We the conducted a pilot evaluation E-EMBED with 13 Silverchain clients. Results of the pilot indicate that E-EMBED is feasible within the in-home aged care setting, and acceptable to in-home aged care clients. There are also initial indications that the E-EMBED digital intervention may be effective at reducing symptoms of depression and anxiety in this cohort.
The second outcome of the project was a tool for the aged care workforce to digitally customise their home care mental health programs. We developed and tested a tool to assist aged care providers to customise digitally enabled interventions for mental health and wellbeing in the home.
The E-TECH tool or protocol includes four steps:
Step 1: Ensure the technology design is appropriate for the in-home aged care population.
Step 2: Preliminary checks to determine client eligibility (e.g., access to a device and internet, any sensory limitations, physical or cognitive impairments that may make the technology unsuitable for some clients).
Step 3: Introduce the technology; explore how it might meet the client’s goals and check if the client is willing to trial the technology.
Step 4: Client assessment to tailor implementation. Further pilot testing is required on the protocol before it is ready for use by the broader aged care sector.
Impact on Aged Care and Workforce
The success of the E-EMBED program demonstrates not only that psychological interventions can be successfully delivered within the in-home aged care setting, but also that doing so in a digitally enabled manner is acceptable and feasible for aged care clients. This is a significant challenge to current perceptions that older people are not interested in using digital technologies.
Resources
The E-TECH protocol will undergo further refinement and will be provided once this process has been completed. For further information, please contact Prof Sunil Bhar: Sbhar@swin.edu.au.
Next Steps
The digital intervention will be trialled further as part of a large clinical trial taking place at Silverchain, where further refinement of the E-TECH protocol will take place.