Nursing home resident Sarah Gillis said she started to live again once her depression was treated. (CBC)

Nearly half of seniors living in long-term care homes in Canada show signs of depression, according to a report that points to ways of improving their quality of life.

The Canadian Institute for Health Information released its report Thursday finding 44 per cent of seniors in residential care have symptoms of depression.

The study is based on information from 49,089 people aged 65 and older living in long-term care and nursing homes in Nova Scotia, Ontario, Manitoba, Saskatchewan and the Yukon. It is the first survey of this size to measure the prevalence of depression in long-term care in Canada.

"Identifying those who are at risk or are showing symptoms of depression is the first step to developing a care plan that will help improve quality of life," said Brent Diverty, one of the authors of the report and director of continuing and specialized care information services at the Canadian Institute for Health Information in Ottawa.

The researchers used an assessment tool that looked at residents' physical health, nutrition, hearing, communication and cognitive skills.

What's important, Diverty said, is that the study found that 18 per cent of residents had symptoms of depression but didn't have clinically diagnosed depression.

"Through this standardized assessment, we have an opportunity to detect earlier the signs and symptoms of depression and change the care plan to help manage that," Diverty said.

In nursing homes, signs of depression include:

• Lack of sleep.
• Aggressive behaviour.
• Conflict with family and staff.

'I wanted to start living again'

Sarah Gillis, 73, a resident at Garden Court Nursing Home in Toronto, recalled crying for no reason. Everything changed after she was diagnosed and started antidepressant treatment, she said.

"It wasn't long I started to get dressed again, put my makeup on. I wanted to start living again," said Gillis, who also has Parkinson's disease.

The assessment tool does help identify depression in residents sooner, said nursing home director Kathy Turnbull.

"We can tell from the flags, the trigger when we do the assessment, that there's a risk there," said Turnbull. "So we start digging deeper. It alerts us a lot sooner so they're not suffering with that depression for nearly as long."

Other measures to fight depression include group therapy sessions and exercise.

Using the assessment tool often helps identify people with depression symptoms that would have previously gone undetected, said Cynthia Fraser, a licensed practical nurse at Cooper Ridge Place in Whitehorse. Care providers at the facility have used the tool since 2007 to understand residents and provide more focused care plans.

Ontario has mandated use of the tool, which will be implemented in the province's 620 long-term care homes by September, according to the province's Health Ministry.

Other provinces and territories have either mandated or strongly recommended its use, Diverty said.