Reported Needs and Depressive Symptoms Among Older Adults Entering Long-Term Services and Supports

Background and Objectives: Long-term services and supports (LTSS) are vital for older adults with physical and cognitive disabilities. LTSS can be provided in settings such as nursing homes, assisted living, or via community-based services. During the transition to LTSS, older adults are at risk of increased depressive symptoms. In addition, older adults may identify unmet needs despite having access to new LTSS resources. The goal of this study was to examine the factors associated with increased depressive symptoms among a pool of older adults, with a focus on change in reported needs after starting LTSS. Research Design and Methods: This cross-sectional analysis of a cohort study included 352 older adults new to LTSS (R01AG025524). The outcome of depressive symptoms was measured using the Geriatric Depression Scale-Short Form. Reported needs included supportive equipment, devices, transportation, and social activities. Bivariate and linear regression modeling using change in needs 3 months later were performed. Results: Depressive symptoms were present among 40% of the LTSS recipients at enrollment and 3 months. At baseline, 29% of LTSS recipients reported a need for supportive equipment, 30% for transportation, and 23% for social activities. After 3 months, an average of 12% of LTSS recipients' needs were met, 13% of LTSS recipients' needs persisted, and 11% of LTSS recipients reported new needs. Depressive symptoms 3 months later were higher for those who reported persistent unmet needs compared with those who reported no needs at all, controlling for functional status and LTSS type. Discussion and Implications: The transition to LTSS is a vulnerable time for older adults. Assessing the need for equipment, transportation, and social activities during this period may identify opportunities to improve the lives and emotional status of this population. Translational Significance: Depression is common among older adults transitioning to long-term services and supports (LTSS). The need for equipment, transportation, and access to social activities all affect LTSS recipients' emotional status. A focus on assessing these needs more thoroughly from the start of LTSS and trying to meet those needs may have a positive impact on the mental health of older adults.