ILOTA Communique December 2017 Communique

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 Continued on Page 3