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Geriatric Psychiatrists: How Can We Help You?

I am a geriatric psychiatrist. Um, what is that? An older psychiatrist who is ready to be put out to pasture? Nope. A psychiatrist that has an extra comfy couch so that older patients can lie down and tell me about their mother? Also, nope (although I do enjoy comfortable furniture).

A geriatric psychiatrist is:

  • A medical doctor (4 years of medical school after college).
  • With four years of general psychiatry training (internship/residency).
  • And an extra (1-2 years) of sub-specialty training (geriatric psychiatry fellowship).

Our goal is to maximize quality of life and functionality for the older patient.

We evaluate, diagnose and treat mental and cognitive health issues in older adults such as depression, anxiety and dementia.

Caring for older adults requires a special understanding of their physical, emotional and social needs. We manage patients with careful evaluation and assessment, medications (knowing when they can help and when they can't is key) and psychotherapy (mostly focused on the here and now, and no lying on couches).

We maintain close linkage with the older adult's other healthcare professionals and family caregivers, as well as community resources.

I was drawn to this profession for several reasons:

  • Like many other geriatric psychiatrists, I had a very positive experience with an older adult growing up, my grandmother. Late in her life, after she had a stroke, she also experienced depression. I saw the way it impacted our family when this strong, vibrant woman changed before our eyes. With treatment, she was able to recover; this experience made a big impact on me.
  • I love the challenge of integrating the knowledge of psychiatry, neurology and medicine that is critical to understanding the mental and cognitive health problems of the older patient. For example, symptoms of depression can be triggered by life events (like loss of a spouse or a move), stroke (which can interrupt the pathways that impact mood and behavior), medical issues like anemia and thyroid problems (both of which can cause extreme fatigue and affect motivation) and medication side effects. Each patient's issues are different and present a puzzle for me to solve.
  • Whether or not they have previously experienced mental or cognitive health issues, the common feature of older patients is a lifetime of accumulated experience. So with help, they can adapt to change and improve their level of functioning.
  • I enjoy the teamwork of working together with the patient's other doctors or health professionals and the family to help the patient get better. Caregivers are my best partners. Ideally, we tailor care to the older adult and their particular circumstances. The caregiver is a key player who can provide an understanding of what is "old" and what is "new." For example, has the older adult always had an explosive temper or is this a completely new symptom? Caregivers offer a window to the older patient's past personality, their likes and dislikes, and home functional abilities that would be difficult for me to get in an office visit alone. We can then work together to come up with tailored strategies to help improve the older adult's function, which can benefit the entire family.

A unique program

At the University of Michigan, we have the unbelievable good fortune of having 10 geriatric psychiatrists on our faculty in our Program for Positive Aging. However, since there are only 1,600 of us geriatric psychiatrists in the entire nation, and with an aging "tsunami" upon us, we know that we need to find ways to reach older adults and their caregivers beyond our walls.

Thus, we are very excited about partnering with AgingCare.com to provide expert information that will help caregivers link with the right information at the right time.

In the coming months, look for posts from our Program for Positive Aging multidisciplinary expert faculty including geriatric psychiatry, nursing, social work and psychology.

We also very much look forward to hearing from you about topics that you as caregivers would be most interested in seeing us address, so please don't hesitate to let us know in the comments section below!

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Helen Kales, M.D., is professor of psychiatry and Director of the Section of Geriatric Psychiatry at the University of Michigan. She is the Director of the Program for Positive Aging (PPA), which focuses on emotional wellness, aging well and improving life for those with later-life depression or dementia and their caregivers.
 






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