October / November / December • Issue 4 • 2017
communiqué
THE
Illinois Occupational Therapy Assocation
Mara Chiocca, OTR/L
In This Issue Post-Stroke Depression
Finding Purpose
through Occupational
Engagement,
Motivation, and
Coffee!
Pages 4-5. Stroke patients with post-stroke
depression not only have higher mortality
rates, but improve less in rehabilitation
programs; consequently, they have worse
functional outcomes and quality of life (Altier,
2011). Early recognition and treatment of
depression not only improves the emotional
mood of the survivor but aids in their physical
and cognitive recovery (Stroke Association,
2010). According to American Stroke
Association Clinical Guidelines (2016) post
stroke depression is estimated to be at 33%.
(Towfighi 2016). Early identification and
utilization of screening tools for clinicians
can assist in appropriate interventions that
can be utilized to target depression helping
to promote participation in ADLs, mobility
and returning to leisure activities. People
who have aphasia post stroke are even more
vulnerable to have depression. Hyunsoo
(2015) identified that 10-38% of patients
with Aphasia continue to have aphasia.
Additionally, 38% of people who have
aphasia demonstrate decreased participation
in hobbies. It has also been identified that
depression is 62% higher in people who have
Aphasia following a stroke. Identifying and
implementation of tools that can be utilized
to detect depression in all levels of care early
following stroke allow for early intervention
to promote quality of life and functional
outcomes. Occupational Therapist can play an
intricate role in helping to identify depression
in stroke. Often the rehabilitation setting
and level of functioning of patients assists in
deciding which assessments are ideal. It is
vital to find screening tools that are reliable,
UIC’s Geriatrics
Workforce
Enhancement
Program “ENGAGE-IL”
Leads to Educational
Opportunities for
Occupational Therapy
Practitioners
Pages 6-7.
Opinion: The Distinct
Value of OT as MH
Team Members
Pages 7-8.
ILOTA Wrap-Up
Pages 10-11.
quick and easy to administer.
The
PHQ-9
(Patient
Health
Questionnaire) has been identified as a quick
and sensitive tool that can be utilized to screen
for depression in the stroke population. This
tool is helpful in identifying level of depression
and can be re-administered at different points
within the rehabilitation process. Based on
the score this assessment identifies mild,
moderate, and severe symptoms associated
with depression.
Recognizing which
assessment tool is the best fit based on the
level of care, documentation constraints, as
well as resources that are available for patients
and families assists with streamlining the
process to detect and address depression.
When patients have communication
deficits following a stroke this can make
administering standardized assessments more
challenging. Patients who have Aphasia are
at a very high risk for depression, especially
if impaired communication is sustained. It
may be helpful to collaborate with speech
therapists to assist in determining the
most appropriate assessment, which can
be incorporated into the plan of care early
within the rehab process. One tool that is
available to be utilized with this population
is the Aphasic Depression Rating Scale
(ADRS). This assessment utilizes observation,
collaboration with family, and conversation
with patients when appropriate. The ADRS
can also be administered at multiple points
during the rehabilitation process to assess for
depression. For patients who have aphasia
collaboration with speech therapy can assist
in determining which assessments may be
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