Depending on one’s preference, geriatric psychiatrists can choose between clinical practice, academic research, and clinical educator careers. They may work in private practice, group practices, or long-term care facilities and may work weekends and evenings. With an increasing number of older people, the need for a psychiatrist in this area is on the rise. One of the best things about this career is that the field is growing in scope: more than 100 million people will be 65 or older by 2025.
It is vital to diagnose and treat mental and emotional disorders in the elderly. While these conditions are more common among the younger population, they can still cause significant problems. For example, depression in the elderly is less common than in the younger population. Symptoms of major depression include five of the nine classic criteria. However, many older people exhibit three or four of these criteria. They may also appear sad but complain of physical symptoms.
A physician’s diagnosis of a patient with a mental illness may be challenging for many reasons. The fact that older adults have fewer symptoms of a mental disorder than younger patients may make it difficult to diagnose them. The lack of knowledge may also lead to paternalistic attitudes, leading to the overuse of neuroleptic medications and a general reluctance to refer patients for treatment. The following are some common misconceptions about diagnosing and treating mental disorders in the elderly:
Informed consent has increased the level of patient involvement in treatment decisions. However, obtaining informed consent requires a rigorous assessment of the patient’s competency. Although most authors agree on the need for a structured format, some have been content to omit the assessment altogether if the patient’s decision makes intuitive sense. In fact, two patients with severe, life-threatening illnesses have refused potentially life-extending treatment. The patients later regarded the decision as irrational, highlighting the difficulty of determining a patient’s competence. But the issue of informed consent is not something that can be brushed off as a simple technicality. Even if it seems reasonable, patients with serious illnesses need to be carefully evaluated.
Although many geriatric psychiatrists agree on the importance of IC, few have the capacity to describe the requisite criteria. One study surveyed geriatric psychiatrists in Lebanon and found that only a few were aware that IC is directly related to the disclosure of adequate information. Moreover, only one participant was aware of the relationship between IC and the disclosure of adequate information.
Psychiatrists trained in geriatrics specialize in treating patients suffering from a variety of age-related mental health conditions. Their training includes assessing cognitive and mental functioning and differentially diagnosing patients with various types of dementia, including Alzheimer’s disease.
Cognitive-behavioral therapy is a popular treatment for older adults with a range of mental health conditions. It may help reduce symptoms and replace dysfunctional patterns. Cognitive-behavioral therapy typically involves a manual that helps patients set goals and identify strategies for change. Cognitive-behavioral therapy for older people can help with issues like physical health, spirituality, and family relationships.
Geriatric psychiatrists work primarily in public, non-traditional hospital settings. They see geriatric patients from a variety of backgrounds, including those of minority ethnic groups, working-class populations, and those with psychiatric disabilities. Fellows spend three months on a rotation in a public, non-traditional hospital setting. They will work with people of all ages and take on leadership roles on the treatment team. They will work with multidisciplinary teams, family members, and other health care providers.
Working outside traditional hospital settings for geriatrics varies, from forensic consulting to providing care to veterans. Working in the public sector is increasingly common in geriatric medicine. For example, geriatric psychiatrists are often called upon to consult on cases of elder abuse or neglect. The elderly people in prison also have special needs that geriatric psychiatrists can help with.