Depression and OASIS-C
The OASIS-C dataset will be asking if our patients are depressed. Although no tool is mandatory, the dataset includes a copy of the P2 tool as follows:
In using this tool, it seems that many of our patients will show signs and symptoms of depression. I asked Randy Still, a psychiatric nurse to help us address those patients who were depressed related to their situation and yet not qualified for a psych evaluation. Here is what he said:
- Consult with patient’s MD to see if MD thinks that a short term use of an antidepressant might be indicated.
- Teach patient coping skills to ameliorate situational depression
- Do something. Do something. Get active. Even if it is calling a friend on the telephone. DO SOMETHING.
- Teach patient to take a short walk or sit outside with friends or family (if able…does not mean pt. is not homebound). Get outside in the sun if possible.
- Teach pt to take a warm bath when depressed.
- Teach pt. to talk to friends and family via telephone or in person if they can visit
- Teach pt. positive visual imaging
- Teach pt. to find a way to help someone else, daily. ( to attempt to quit thinking about self continually in home isolation if even just a “how are you” telephone call)
- Teach sleep hygiene (sleep at night, no caffeine, no heavy meals before bed, etc.) if it is a problem
- Teach patients about above subjects using patient handouts (Med-Line is a good free source of handouts via internet, copy them and initial and date what part of the page and when and leave in chart attached to nurses note. Surveyors like that.
Be sure to document anything you teach and also the content of what you taught. That is why I like the teaching handouts. I simply say, “refer to patient handout sheet attached”.
Randy reminds us to always be alert to signs and symptoms of serious depression and to investigate suicide ideation if the patient seems seriously depressed.
Randy Stilly is the administrator of
Star Light Home Health, LLC
In addition to providing home health services in his area he also provides consultation to other agencies who want to offer psychiatric services. If you are interested in adding psychiatric services or improving those you offer, Randy can be reached at email@example.com.
Comments are always welcome below. We can be reached at Haydelconsulting@bellsouth.net.