meredith bailey, lcsw timberlawn hospital february 26, 2009 1
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Meredith Bailey, LCSWTimberlawn HospitalFebruary 26, 2009
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Scope of Problem
Number of CaregiversAverage Period of Caregiving
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Psychiatric Conditions Complicate Caregiving Issues
Getting Appropriate Assessment
Making Appropriate Care Plans
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Background
Geriatric Mental Health Foundation Estimates6.5 million older adults are depressedBy 2030 the number will be 15 million
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Risk Factors For Late Life Depression
Changes in MedicationsRecent Loss of Loved OneLiving Alone—Feeling IsolatedSerious Medical ProblemSevere or Chronic Pain
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Symptom Manifestation in the ElderlySomatizationIndecisivenessLack of feeling or emotionSocial withdrawalFeelings of worthlessnessThoughts of death
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Somatic concernLowered affectCognitive impairmentFeelings of discriminationImpaired motivationLack of future orientationLack of self esteem
The Geriatric Depression Scale
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Bipolar Disorder
Afflicts .5% of elderly populationHave proportional number of hospital visits to younger population
Hospital stays are longer
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Anxiety Disorders
11.4% of older adults meet criteria
Agoraphobia often develops in elderly
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Schizophrenia
Afflicts .6% of older adults compared 1.3% in 18 to 55 year olds
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Psychosis
50% of Alzheimer's patients have delusions/hallucinationsSuspiciousnessParanoiaCombativenessAggressiveness
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Suicide
The elderly are 11% of overall population but represent 17% of suicides
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Suicide Risk FactorsPrior history of suicide attemptsLethality of prior attemptsCurrent plan--do they have one and what is it
GenderDebilitating medical illness or chronic pain
Lack of support system13
Suicide Risk Factors (continued)
History of suicide in the familyHopelessnessSubstance abuse
AlcoholismPrescription medications
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Assessment Tools
Geriatric Depression ScaleCasemanagement Questionnaire
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Geriatric Depression Scale
15 and 30 question versionsScoring and use
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Casemanagement QuestionnaireDemographicsActivities of daily livingVision and mobilityMedical conditions—stable vs. unstable
Psychiatric conditionsSupport availabilityFinancial considerations
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Referrals & ResourcesCommunity
Area aging resourcesMedical center—geriatric
assessment centersInformal networks
InternetEldercare resourcesCase managersFacility referral
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AttachmentsGeriatric Depression ScaleCasemanagement QuestionnaireResource listEldercare website listBibliography
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Bibliography
“Caregiving in the US” National Alliance for Caregiving and AARP 2004 “Geriatrics and Mental Health” American Association for Geriatric Psychiatry AAGP Health Care Professionals “Stroke and Depression: Frequently Asked Questions” Robert Robinson, MD Division of Psychiatry University of Iowa Hospitals and Clinics “Suicide Prevention Training” Diamond Health Care Staff Training 2007 “Suicide in the Elderly” CEU Units at Home 2004 “Suicide in Older Adults: How do we detect risk and what do we do about it?” Psychiatric Times Nov 2006 Vol. 13 No. 13
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