# Assessment Teams Experience of Barriers and Challenges When Assessing Loneliness and Depression Among Home‐Dwelling Elderly: A Qualitative Study

## TL;DR

This study explores how care teams in Norway face challenges when assessing loneliness and depression in elderly home care recipients, highlighting gaps in mental health support.

## Contribution

The study reveals systemic barriers in prioritizing mental health over physical health in home care assessments for the elderly.

## Key findings

- Only three out of 168 home care decisions included mental health support.
- Care teams prioritize physical health over mental health in assessments.
- Municipalities vary widely in their mental health support for elderly home care recipients.

## Abstract

Loneliness and depression in the elderly population are a worldwide challenge. Elderly people receiving home care are very vulnerable, as they often suffer from comorbidity and various other challenges.

The study aim was to explore how care assessment teams experience assessing loneliness and symptoms of depression among home care recipients aged 65 years and older in planned home visits.

This study has a qualitative design. Data were collected during two phases. First, data from documents were collected in seven municipalities on 168 home care decisions made by assessment units during 1 month. Second, 10 caseworkers and 10 case managers from different care assessment teams in 20 municipalities located in four different regions in Norway were individually interviewed. Both data sources were analysed using qualitative content analysis.

Analysis of the documents revealed that only three of the 168 home care decisions described support for mental health. The analysis of the interviews resulted in three themes: (i) ‘Physical health has higher priority than mental health in home care’, (ii) ‘Being diagnosed is essential to receive support from home care’, (iii) ‘Major differences in mental health support between municipalities’.

Caseworkers in care assessment teams find that many home‐dwelling elderly are struggling with loneliness and depression, but barriers on both organisational and administrative levels prevent them from providing appropriate interventions. Mental health is thus not systematically recorded in assessments, which may lead to loneliness and depression being overlooked. There are significant differences between municipalities regarding service offerings and follow‐up procedures for loneliness and depression, and both caseworkers and municipal leadership must ensure a system that provides comprehensive patient care.