Getting older can come with a variety of challenges. It can be upsetting to confront the loss of those close to you, limited mobility, or failing memory. When faced with these challenges, it can be helpful to have a trained mental health professional there to guide you through.
Before you can understand geriatric psychiatry, it can be important to learn about psychiatry itself. Psychiatry is the medical study of mental illnesses and disorders, which psychiatrists then attempt to diagnose and treat. It is an area of medicine, much like oncology or cardiology. Because of this, it looks at mental health from a medical standpoint, unlike psychology.
Derived from Greek, the words psykhe and iatreia mean "mind" and "healing" respectively. Psychiatry focuses particularly on identifying and addressing the mental health needs of an individual, with the ultimate goal of “healing” a patient's “mind.”
Psychiatrists use varied treatment methods, from talk therapy to electroconvulsive therapy. However, because they are medical doctors, psychiatrists are mostly known for their ability to prescribe medications to treat disorders like depression, anxiety, and obsessive-compulsive disorder, to name a few.
To diagnose and treat mental illness, a psychiatrist will typically meet with a potential patient to discuss their presenting problem at length. Psychiatrists then may order or conduct a physical examination as well, in an effort to rule out medical conditions as hyperthyroidism, metabolic syndrome, and syphilis that can trigger symptoms that may be otherwise confused with mental illnesses.
After ruling out a medical condition, the psychiatrist then may give the patient a diagnosis and a respective treatment plan.
Specific populations, like the young or the elderly, often need more specialized care. Just as a child and adolescent psychiatrists address the specific needs of young people, geriatric psychiatrists specialize in providing care to elderly patients.
Geriatric psychiatrists understand that certain mental illnesses can appear due to aging, including dementia and anxiety. Additionally, geriatric psychiatrists may have expertise on how to handle other types of mental illness that can evolve and become more pronounced depending on the patient's age and life circumstances, such as depression or substance use disorder.
Not only do geriatric psychiatrists specialize in treating the symptoms of the disorder at hand, but they're also often required to address the underlying issues, just as psychologists and counselors do.
For example, anxiety could arise because of memory loss or a new medical diagnosis. Similarly, the loss of family and friends could make depressive symptoms more pronounced or trigger a descent into substance use. Geriatric patients often have a set of worries that are unique to their age group, like the state of the world, a fear of mortality, or feelings of grief, that can contribute to their mental state. Because of the interconnectedness of these issues, it is important that geriatric psychiatrists understand the problems that may be facing senior citizens.
Mental illness in elderly patients can also be intertwined with physical health. Because geriatric psychiatrists are medical doctors, they can make assessments about their patients that take into account the person's emotional and medical history. A patient's depression, for instance, could be the result of a cancer diagnosis, or an unnoticed interaction of medications. It is a geriatric psychiatrist's job to consider all these factors when making decisions.
With the growing population of older adults in America, the profession of geriatric psychiatry has also continued to grow. This means that geriatric psychiatrists are needed in a large variety of locations.
To some extent, geriatric psychiatrists might practice in the same places as any other psychiatrist. However, geriatric psychiatrists also might practice in facilities that are unique to their specialized fields, such as assisted living facilities, nursing homes, and veterans' homes.
Because of the high concentration of older adults in these types of facilities, geriatric psychiatrists are often included as a part of the care teams in nursing homes and assisted living centers. In facilities like these, psychiatrists also might be on-call throughout the day and night to serve these unique, residential populations.
However, patients do not have to live in one of these specific facilities to receive services from a geriatric psychiatrist. Patients can visit geriatric psychiatrists in their offices and at hospitals, and some geriatric psychiatrists may even make house calls.
Geriatric psychiatrists offer similar treatment options to those presented by a general psychiatrist. Medication, behavior plans, and talk therapy are all options that a geriatric psychiatrist might explore with their clients.
Before treatment can occur, however, geriatric psychiatrists must go through the process of diagnosing their patient. Due to increasing physical ailments in elderly patients, geriatric psychiatrists may have greater difficulty diagnosing and treating patients. Some physical issues present with psychotic or depressive symptoms, and some mental disorders can result in physical symptoms like lethargy. Geriatric psychiatrists must, then, conduct extensive physical assessments and psychological questionnaires to distinguish the causes of certain symptoms.
Before deciding on a treatment plan, geriatric psychiatrists may consider:
- Will the patient remember to take their medication if memory-related issues are present?
- What type of support system does my patient have?
- How will treatment interact with any other medications or medical conditions that my patient has?
- Is the patient living alone, with family, or in an assisted living facility?
- How can the side effects of medication be neutralized?
- Will my patient be open to psychiatric services?
Although attitudes are changing, some geriatric psychiatrists find that older generations may still carry the stigma of receiving psychiatric or psychological care. Some clients may be resistant to treatment or in denial that they require it in the first place. Being respectful while still working through these barriers is another element of the treatment plan that geriatric psychiatrists may need to consider.
Diagnosis and treatment in geriatric psychiatry also must address the interpersonal context of geriatric care. Older adults may have a strong network of support around them, made up of family and other medical practitioners; because of this, geriatric psychiatrists typically work as part of a larger care team.
The client's family also tends to be more actively involved in treatment that would be typical of a psychiatric patient.
Seeking mental health care can be difficult, especially for seniors. Between mobility concerns and potential social stigma, many older adults may have trouble getting the care that they need. Similarly, caretakers of elderly patients can have trouble finding time to receive care themselves.
No matter what your situation, receiving mental health care can be expensive, overwhelming, or inaccessible. If care from a medical doctor is out of reach, there is still a way to seek professional help for your problems.
BetterHelp can set you up with convenient counseling that can give you the care you need. With over 1,500,000 registered users and 2500 licensed counselors, BetterHelp is a service you can trust. With a variety of flexible, digital counseling options, BetterHelp can provide help that is discrete and available on your time. Users of BetterHelp can communicate with their counselors by exchanging messages, instant messaging, talking on the phone, or through video conferencing.
Studies show that online therapy can be particularly helpful to older adults, especially as they may have mobility issues or a worry of leaving the house to seek out therapy in-person. Online therapy has many other benefits, for example, a review of 17 studies showed that e-therapy tends to be more cost-effective than its in-person counterpart.
Once you fill out a short questionnaire, BetterHelp can place you with a counselor who meets your needs. Geriatric counselors are available for you and your family.