Practical Strategies in Geriatric Mental Health

Cases and Approaches

Laura B. Dunn, Erin L. Cassidy-Eagle, Laura B. Dunn, Erin L. Cassidy-Eagle

• Publisher: American Psychiatric Association Publishing
• Year: 2019
• Print ISBN: 9781615371488
• eBook ISBN: 9781615372577
• Topic: Medicine
• Subtopic: Psychiatry & Mental Health

The experienced editors of Practical Strategies in Geriatric Mental Health: Cases and Approaches recognize that older patients can pose unique challenges to general practitioners working outside this specialty, and that the shortage of geriatric mental health specialists makes the creation of trustworthy, user-friendly resources more critical than ever. In response, they produced this book to be accessible not only to physicians and mental health practitioners, but also to a broader audience of care and service providers for older adults, such as social workers and nurses. From the depressed patient who has not responded to one or more trials of antidepressants and is now losing weight and rarely leaving home, to the patient with major neurocognitive disorder whose behavior has become increasingly difficult for caregivers, older adults frequently present with complex diagnostic and treatment challenges.

Each chapter focuses on a specific symptom or disorder (e.g., depressive symptoms/syndromes, anxiety, neurocognitive disorder with behavioral disturbance, grief) and begins with a "chief complaint, " borrowed from common real-world clinical scenarios. A brief clinical vignette portrays how the chief complaint is often presented, followed by relevant discussion of practical approaches to assessment, diagnosis, and treatment. These cases bring the material to life and illustrate relevant clinical applications, as well as the nuances of common presentations. • Chapters are consistent in structure, flowing from the case illustration to diagnostic and assessment tools to treatment options, and ending with a return to the case to integrate the material presented.• Clinical guidelines and assessment tools suitable for both nonexperts and experts are provided for use in clinical encounters to assess functioning and treatment effectiveness.• Easy-to-follow algorithms, brief behavioral interventions, additional resources (e.g., organizations, websites, books to recommend to patients and families), and clear, take-home pearls are also included, making this text a valuable repository of usable information.• The text acknowledges the reality that the patient belongs to a family system. Family members, who are often also caregivers, have questions and fears -- and their own medical and mental health conditions. Accordingly, the authors carefully consider family input and influence on the clinical situation.

Comorbid medical conditions, the increased likelihood of medication interactions, and the presence of cognitive changes all can complicate and confuse the clinical picture. Practical Strategies in Geriatric Mental Health: Cases and Approaches brings the geriatric psychiatrist's knowledge base and armamentarium to the reader, who will find its guidance essential and empowering.

Table of contents

• Cover Page
• Title Page
• Copyright Page
• Contents
• Contributors
• Preface
• Acknowledgments
• 1: Late-Life Depression I – “I Can’t Keep Up With My Grandkids”
• 2: Late-Life Depression II – “My Guilt Is So Intense, I Think of Ending My Life Every Day to Get Relief”
• 3: Working With Depressed Caregivers: Behavioral Activation – “I Can’t Find the Energy or Time to Leave the House”
• 4: Diagnosis and Treatment of Generalized Anxiety Disorder – “Getting Old Is Not for Wimps!”
• 5: Somatic Complaints and Anxiety – “I Wish the Doctor Would Figure Out What’s Wrong With Me”
• 6: Pain and Psychological Factors – “I Need More Pain Medication, Not Less!”
• 7: Primary Sleep Disorders – “My Wife Says I Snore Loudly and Sometimes Stop Breathing While I’m Asleep”
• 8: Evaluation and Management of Insomnia – “My Sleeping Pill Isn’t Working Anymore”
• 9: Bipolar Disorder – “What’s Wrong With Mom—Is It Dementia?”
• 10: Posttraumatic Stress Disorder – “My Stomach Hurts”
• 11: Evaluation and Treatment of Substance Use Disorders – “I Just Have One Drink With Dinner, Doc”
• 12: Mild Cognitive Impairment – “I’m Forgetting Things. Is This Normal for My Age, or Do I Have Dementia?”
• 13: Neuropsychological Testing – “I Sometimes Forget Things”
• 14: Behavioral and Psychological Symptoms of Dementia – “Little Soldiers Are Invading My Backyard”
• 15: Delirium – “My Mother Is Not Herself”
• 16: Inpatient Issues: Behavioral and Pharmacological Interventions – “He Tried to Kick a Staff Member and Fell”
• 17: Post–Intensive Care Syndrome – “He’s Just Not Himself”
• 18: Physical Activity – “I Can Only Go About a Block Before Running Out of Breath”
• 19: The Social Worker in Geriatric Outpatient Care – “Can You Help Me With This Patient?”
• 20: Initial Evaluation and Management of Frontotemporal Dementia – “My Wife Seems Different”
• 21: Legal Issues in Cognitive Disorders – “Mom Changed Her Will”
• 22: Driving – “My Husband Can Be Absent-Minded When He’s Driving, That’s All”
• 23: LGBT Issues – “I’ve Been a Woman My Whole Life”
• 24: Practical Strategies for Approaching Grief – “When You Don’t Know What to Do, Just Be Human”
• Index