This essential guide is designed for mental health practitioners and primary care providers without advanced training in geriatric psychiatry. Leading physician and educator Gary J. Kennedy sets forth a clear framework for understanding the interplay of medical, psychological, and social factors in frequently encountered problems among older adults. Clear guidelines are delineated for assessing and treating such conditions as depression and anxiety, dementia, psychosis and mania, sleep disturbances, personality and somatoform disorders, substance abuse, and suicidality. Throughout, Kennedy focuses on ways to sustain seniors' independence and overall quality of life while enhancing their adaptive capacities. Psychopharmacological principles are presented with an emphasis on safety, simplicity, and effectiveness, and the beneficial applications of individual, marital, family, and group psychotherapies are also addressed. Other topics covered include sexuality in old age, problems of elder abuse and neglect, collaborating with family members and other caregivers in medical and nonmedical settings, and legal and ethical issues in treatment.

Gary J. Kennedy, MD, is Professor of Psychiatry and Behavioral Science at Albert Einstein College of Medicine and Director of the Division of Geriatric Psychiatry and the Psychogeriatric Fellowship Training Program at Montefiore Medical Center in Bronx, New York. He is also Supervising Psychiatrist of the Geriatric Unit at Bronx Psychiatric Center. More than 30 psychiatrists have completed geriatric training under his direction. Dr. Kennedy's research and teaching have focused on cardiac arrhythmias, the epidemiology of depression and dementia, and mental health care in nursing homes and in the community.

Introduction to the Geriatric Imperative

1

(18)

Core Concepts from Sociology and Clinical Sciences

2

(8)

The New Psychopharmacology: Burdens and Benefits

10

(5)

Attributes of Successful Geriatric Practice

15

(1)

References

16

(3)

Depression and Anxiety

19

(25)

Assessment

19

(1)

Symptom Identification, Screening for the Disorders

20

(1)

Geriatric Syndromes, Depression, and Anxiety

21

(1)

Comorbidity of Mental and Physical Disorders

22

(1)

Anxiety Disorders

23

(2)

Suicide

25

(1)

Comprehensive Treatment of Depression and Anxiety Disorders

25

(13)

References

38

(6)

The Dementias

44

(40)

Dementia Defined

44

(1)

Epidemiology

45

(1)

Genetic and Other Risk Factors

45

(1)

Diagnostic Criteria and Procedures

46

(1)

Differential Diagnosis

47

(5)

Cognitive Assessment

52

(3)

Assessment of Functional Impairment

55

(1)

General Treatment Considerations

56

(1)

Medications to Palliate Cognitive Impairment

57

(5)

Environmental Modifications

62

(1)

Management of Behavioral and Psychological Signs and Symptoms

63

(1)

Specific Problem Behaviors and Symptoms

64

(7)

Medications to Lessen Behavioral and Psychological Disturbances

71

(2)

Caregiver Burden and Dysfunctional Family Dynamics

73

(1)

Practitioner as De Facto Guardian and Other Medical-Legal Issues

74

(1)

Management of Financial Resources

75

(1)

Preparations for End-of-Life Care

76

(1)

Summary

76

(1)

References

77

(7)

Psychosis and Mania

84

(19)

Achieving and Sustaining the Alliance

84

(5)

The Schizophernias

89

(2)

Delusional Disorder

91

(1)

Mania

91

(3)

Antipsychotics and the Avoidance of Movement Disorders

94

(5)

Electroconvulsive Therapy for Mania or Psychosis

99

(1)

Summary

99

(1)

References

100

(3)

Sleep Disturbances

103

(11)

Assessment

103

(4)

Treatment

107

(5)

Summary

112

(1)

References

112

(2)

Personality, Somatoform, and Pain Disorders

114

(13)

Personality Disorders

114

(7)

Somatoform and Pain Disorders

121

(4)

References

125

(2)

Individual Psychotherapies for Older Adults

127

(28)

Arguments for Psychotherapy in Late Life

127

(3)

Assessment for Psychotherapy

130

(1)

Brief Psychodynamic versus Supportive Therapy

131

(2)

General Principles of Cognitive-Behavioral Therapy

133

(8)

Interpersonal Therapy for Late-Life Depression

141

(2)

Life Review or Reminiscence Therapy

143

(1)

Problem-Solving Therapy

144

(1)

Treatment of Caregiver Burden and Depression

144

(4)

Bereavement Therapy

148

(3)

Summary

151

(1)

References

151

(4)

Adapting Principles of Marital, Group, and Family Therapy to the Needs of Older Patients

155

(20)

Marriage or Couple Therapy with Older Adults

155

(2)

Models

157

(3)

Group Therapy with Older Adults: General Considerations

160

(5)

Family Work

165

(3)

Work with Ethnic Elders, Emigres, and Religious Minorities

168

(1)

Preparing for Genetic Counseling

169

(1)

Summary

170

(1)

References

170

(5)

Sexuality

175

(17)

Myths about Sex and Aging

175

(1)

Realities

176

(3)

The Genesis of Late-Life Sexual Dysfunction

179

(2)

Evaluation

181

(1)

Management of Sexual Dysfunction

182

(6)

Sex in the Nursing Home

188

(1)

Summary

188

(1)

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Geriatric Mental Health Care A Treatment Guide for Health Professionals

9781572305922

1572305924

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