Combining Nursing Home and Day Cares to Decrease Depression for the Elderly


Over the past years longevity has been increased in the society, which explains why there are a high number of elderly people. Although they are seen as the foundation of the society, they face many challenges. The common challenges are the health concerns, which include senility, general physical weakness, mental illness, diabetes and blood pressure. Such challenges facilitate the need of coming up with various ways of helping the elderly in the society remain healthy and happy. Healthy people can be described as those with complete physical, mental and social well-being and not merely the absence of disease or infirmity. Happiness is described as a conceptual or emotional comfort that is well-defined by positive feelings ranging from satisfaction to joyfulness (Loberg & Brogan 75). Nursing home attendants have to ensure that all the residents in the facility are healthy and happy. Elderly people are less likely to be happy all the time, hence need more support from the care givers in ensuring that they avoid all habits that make them unhappy. Children on the other hand are always happy unless someone deliberately tries to make them unhappy. It is evident that being happy can help in promoting a person’s health and reducing  chances of getting preventable diseases like depression and blood pressure ailments. Therefore the idea of combining child care with nursing homes will help in reducing the rate of depression levels among the elderly people in the facility.

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Many elderly people are likely to suffer from depression, though it is not an inevitable part of aging, many things can be done to avert it at an early age. It is important for the care givers at the nursing homes to have routine checkups on them, with the aim of detecting any signs of illnesses including depressions. The disease many a times progresses to its serious stages which can lead to one committing suicide because it is often being overlooked as a minor disease. The major signs and symptoms of depression include sadness, hopelessness, social withdrawal and lonesomeness, loss of appetite and having sleep disturbances. The common causes of depression among the elderly include health problems, loneliness and seclusion, reduced sense of single-mindedness, fear of dying and loss of financial stability. The other contributing factor that is almost inevitable is specific hormone levels in the body (Sorell 44). For example, the thyroid hormones produced and regulated by the thyroid glands, can be a contributing factor to depression. Hormones are substances produced by the endocrine glands and are released into the body to help in regulating processes like the reactions to stress. People suffering from depression have abnormal levels of hormones in their blood. These hormonal imbalances are due to the symptoms of depressions like loss of appetite and sleeping disorders. The increased level of stress of hormones is explained form the perspective that when a person contemplates in a negative manner, one creates emotional arousals that promotes the release of more stress hormones into the blood stream. Children can help in reducing the level of hormones in the blood since they provide sense of joy and cheerfulness to the elderly hence averting any chances of them developing any negative thoughts.

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Literature review

Nursing homes are places of residences for people who have difficulties in doing daily activities necessary for one to live well, they therefore need continual nursing and they do not have to be in a hospital setting. The affected individuals include the elderly in the society and young adults with mental or physical disabilities. Nursing homes offer all the services an individual can get outside the hospital, including custodian services like bathing, eating and helping in dressing well. Skilled services are offered by registered nurses like monitoring on a person’s health and recommending for any treatments when necessary (NIMH & Edison 59). Day care entails the care given to children during the day typically by people who are not their legal custodians. It can take a formal structure constituting education, development of the child and discipline. It has been documented that non-profit day care organizations are more likely to produce suitable environments for children to have quality life and experiences compared to profit making organizations.

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Depression is mainly a common but severe mood disorder that causes signs and symptoms that affects one’s way of thinking and ways of handling daily activities like eating and sleeping. The symptoms must be persistent for a period of two weeks for one to be diagnosed with depression. Several factors have a role in the development of depression in an individual. These include life occasions like trauma, losing of a loved one, difficult affiliations and stressful living conditions. Other factors which are difficult to control include one’s genetics, biology and chemistry of the brain, and unfavorable early childhood experiences. It has been noted that depression have the possibility of concurring with other chronic diseases like cancer, cardiac diseases, diabetes and Parkinson’s diseases which are also very common among the elderly people (NIMH et al 66). These aliments are worsened by the development of depressions. On the other hand, sometimes the medications taken for the illness may have side effects that might contribute to one developing depression.

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There are different types of depression, the first one is known as major depression, which entails all the symptoms that interferes with one’s ability attend to daily activities like working, eating, sleeping, studying and enjoying life. This episode can occur once or severally. The second type is persistent depressive disorder, in which a person develops depressive moods and that can last for a minimum of two years. Individuals diagnosed with this disorder may develop several episodes of major depression accompanied with less severe symptoms but lust for a period of two years. Other forms include psychotic depression, which is characterized by a person having severe depressions accompanied by some practice of psychosis. For example, one may develop the habit of seeing or hearing things which are not seen or heard by other people in the same environment (Sorell 101). The next one is postpartum depression, which is more to women after giving birth as a result of the physical and hormonal changes and having new responsibilities. Seasonal affective disorder is characterized by the development of depression during winter when there is little natural sunlight. Individuals with this type of depression can be treated with light therapy. Another important aspect to note about depression is that it affects different people in different ways. Tagging on that is the fact that the severity and regularity of symptoms and how they will last will depend on the individual health and wellness and the stage of the illness the person is experiencing. It is also necessary to keep in mind that, having depression for a longer period is not a normal part of growing old or aging. It is difficult to diagnose depression among the elderly because they show less obvious symptoms and many of them are satisfied with their lives despite of having chronic diseases or physical problems.

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Treatment of depression

Depression can be treated if detected earlier to prevent development into serious stages of the disease. It can be done by either taking medications prescribed by one’s doctor or through talk therapies. Since two people cannot be affected in a similar manner, there is no specific treatment that fits all people at the same time. There are different types of talk therapy; the first one is cognitive-behavioral which helps persons with depressions to change their negative ways of thinking. It assists in the interpretations of the surroundings and interactions in a realistic and positive way. This kind of therapy also helps one to recognize things that might be contributing to depression and ways of letting them go, also helps in changing behaviors that worsen the depression (NIMH & Edison 77). The second example is interpersonal therapy, which is intended for individuals with difficult relationships that might lead to depression or make existing conditions worse. It helps one in exploring major issues that might add to one’s depression problems like times of tough transition and grief. The other type is problem solving therapy, which is meant to improve an individual’s ability to cope with stressful life experiences. This is the most effective treatment option for the elderly people in the society with depression. With the use of set up process and procedures, one may identify problems affecting the elderly, and come up with sustainable and realistic solutions. This type of therapy can be conducted in an individual or a group format. One of the examples of the solutions, as will be explained in this paper, is the combination of nursing homes and child care services in one facility.


The facility will combine both the nursing home and the day care as planned, in Bergan County, New Jersey. There are various models that will be used in ensuring that all the residents in the facility get adequate protection and care. The first model entails the creation of a more resident focused environment, in such a manner that the facility is more of a home rather than an institution or hospital. The facility will have small rooms, which contain a common living room and kitchen that can be used by all the residents. Care givers are then assigned to each of the planned households. This idea is different from those used in other nursing homes because they are mainly made of units, similar to any other institution. In this category, residents have the freedom to do what pleases them as long as they are guided by the caregivers. They can choose their daily schedules, waking up time, types of meals and when to take them and have access to pets of their choice (Loberg & Brogan 231). This is done with the aim of introducing different cultures or habits that the residents might not have experienced during their early life; hence promoting development of sense of belonging among the residents. The children from the day care facility can also access the facilities in the common living room in each household. With these, there will be sharing of traits like happiness in both the elderly and the children. Children are always happy and cheerful, therefore there is high possibility that the presence of children in the living rooms will make the elderly happier, an aspect that will reduce the level of stress hormones in the blood, and eventually reduces depression.

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The second model entails the use of chore oriented care in the facility which is characterized by team nursing. This type of model will suit residents with disabilities and those who have difficulties in attending to their daily activities like eating, bathing and sleeping problems. A patient or resident in the facility is attended to by a group of nurses or care givers. It is composed of a team leader whose is tasked with responsibility of supervising all team members and coordinating the care services provided. This type of model requires that there is effective communication between all the health care providers to ensure smooth running of the facility. It promotes a sense of unity because all the staffs are required to work as a team.

The third model entails the use of resident oriented care, whereby the residents in the facility are free to make decisions about their way of life. In this type of care, the families of the residents in the facility are involved in care giving (Sorell, 54). The facilities and the resources respond very well to the physical, emotional, social and financial needs of the residents. In this category, all the members in the facility are required to provide care to the residents, staring from the managerial team to the non-managerial team like nurse aides. All the measures are put in place to ensure that the health and safety of the residents are given the first priority, and that their demands are fulfilled immediately. The fourth model entails the provision of all inclusive health care services, which can be applied to all residents. The other advantage is that it can be used in different nations, this shows that it is adaptable in different cultural settings. This model promotes a sense of unity since all the residents are addressed in the same manner and receive same attentions from the care givers. All the four models will be used in the nursing home, which is sharing the same facility with the child day care. This was done with the aim of increasing the social interactions among the children and the elders.

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The facility is expected to host 150 residents from the Actors Fund Nursing home and 200 children from YWCA Early Learning Centre; it will also have 30 health care providers and twenty teachers for the children. Therefore the total number of people in the facility adds up to 400.It provides boarding facilities for the elderly while the children will be available only during the day. Intensive medical treatments are not available for the children, as compared to what are offered for the elderly. However, their health status are well monitored and checked by the nurses, and in case of any abnormalities, the parents are informed earlier for treatments to be effected immediately (Sorell 80). The money spent by the elderly and children will be calculated separately with the aim of creating sense of transparency among the stakeholders. Since the organization is a nonprofit making, it will raise funds from various sources so as to ensure that the interests of both the children and the elderly are addressed without any challenges arising due to insufficient funds. The following is monthly estimates spent in the facility.




Catering services$20000$10000
Boarding services$10000None
Playing equipment$5000$2500
Salaries for staff$50000$35000
Transport expenses$5000$2500
TOTAL COSTS$105,000$51000

Since it is very costly managing the elderly, members of the residents in the facility are encouraged to raise funds from various in institutions like churches, Mosques or other non-governmental organizations like UNICEF, WHO and World Bank. It is important for the facility to have extra funds for any emergencies that might arise. One of the challenges faced apart from the high management costs, are the fluctuating medication expenses. Sometimes the elderly require special treatments which might incur charges than was planned in the budget. This will lead to cases of reducing the expenditures in other essential areas like the playing facilities, which eventually affects the production of quality services in the facility.


The idea of combining of nursing homes and day care for the children came as a result of many concerns. The first one is the increasing level of depression among the elderly in America. Data collected by CDC Behavioral Risk Factor Surveillance indicated that among adults at the age and above, 7.7% of them had depression while 15.5% had lifetime diagnosis of depression. The figures are shocking to those at the nursing homes. It is known that depression can cause physical, social and mental impairments to an individual if not treated at an early age. The effects of depression are detrimental not only to the individuals affected but also the society at large. States are also becoming aware of the burdens of depressions on their residents and are coming up with measures of trying to reduce the chances of its occurring at an early age. Some of the programs enacted include Improving Mood Promoting Access to Collaborative Treatment  (IMPACT), Program to Encourage Active Rewarding Lives for Seniors (PEARLS), and Healthy Identifying Depression, Empowering Activities for Seniors (IDEAS).These three programs have a common agenda, that of reducing depression among the senior citizens of a nation. It is from this agenda that the idea of combining the children and the elderly in one facility in order to help them live a healthier life came into existence (NIMH et al. 56).

The next question is how children assist in the reduction of depression among the elderly. The children help in creating a counterbalance of the loneliness and boredom that are always present in nursing homes. The random social interactions between the children and the elderly in the facility will reduce the rate of loneliness by the elderly, which will eventually have positive impacts in their health. It is linked to reduce cases of mental decline; blood pressures are lowered, and reduced cases of ill health and death. Japanese study also indicate that that socialization across varying generations increases the amount of smiling and positive conversations among the elderly, this will eventually reduce chances of one developing depression (Kaplan  & Stork 112). This kind of relationship between the young and the elderly has benefits to both parties. For example, children who have early interactions with elderly are less likely to discriminate them in any way; instead they will view them as role models in the society and give them the respect they deserve. It also promotes a child’s personal and social developments, the children are able to cope with different personalities in the society, including those with disabilities and mental impairments. This aspect promotes the values and ethics instilled in a child in the future, since they had good values just from the very beginning.

The plan was organized in such a manner that the children and the senior citizens also interact together through planned activities like story telling sessions, art activities, dancing competitions and having meals together . During such periods, the elderly are seen to be full of life and happy, these reduces the level of loneliness, stress and fatigue, which are all signs of depression. It therefore is very clear that such events help in reducing depression. The idea of combining a nursing home and the child care facility has been applauded in many societies. This is because apart from assisting the residents live a happy life, the existence of human nature is promoted (NIMH & Edison 87). In the past, moral conducts and customs were passed from the elders to the young people, but it has been left to the professional who do not consider the basic moral values in the society when training the children. Parents have also been encouraged to take their children to such day care services so that they can get better foundations.

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