Managing Psychosocial Issues in Clinical Geriatrics

Questions (contin

  What are possible o
intervene?

  Depression deepen
  Nutrition negatively
  Continued poor adh

so health status wo
sugars, hypertensio
  More socially isolat
traveling outside th
others, tv, radio
  Deconditioning, red
of exercise

nued)

outcomes if MD does not

ns
y impacted without IADL support
herence to medical treatment
orsens with unstable blood
on
ted as result of difficulty
he home and inability to hear

duced health status due to lack

Case Study: Sec
(Scenario 2)

  Patient returns for sched
  Husband died suddenly
  Son’s business not go

  Son and his 2 teena
to help her and to re

  Patient lost 15 pounds
  Appears withdrawn; unti

senior center/exercising;
problems concentrating
  Records reveal patient m
and did not refill prescrip
  Blood sugars low; blood
functioning; complains o
  Patient reluctant to take
of falling or getting lost

cond Visit

duled appointment 2 months later
of MI 7 weeks ago
oing well.
age boys moved in with mother
educe his monthly costs

idy appearance; not frequenting
; complains of poor memory,
and fatigue
missed last medical appointment
ption medications as needed
d pressure low; hearing aid not
of arthritis pain flare-ups
bus/walk in neighborhood for fear

Questions

  Any psychosocial is

  Depression
  Reduced social sup
  Transportation conc
  QOL negatively in

conditions

ssues evident?

pport/ social isolation
cerns
nfluenced by crowded living

Questions

  What psychosocial
exploration?

  Assess for increased A
  If has increase ADL/IAD

concern is loss of indep
  Assess abuse/neglec

  See G-PSST Questio

  Assess social supports
  Assess financial ability/

care.
  Assess alcohol/drug us
  Screen depression/suic

l domains need further

ADL/IADL dependence
DL dependence, another psychosocial
pendence
ct

ons/AMA Guidelines

s
/desire to pay for increased home

se.
cidal ideation and anxiety

Questions (contin

  How does MD work
assessment into th

  Make sure interview
  Accept time intensi

assessment: This c
  Be prepared: Learn

advance to improve
needed

nued)

k an elder abuse
he medical visit? Consider:

w patient privately
ive nature of elder abuse
conversation may take time
n assessment questions in
e discussion with patients when

Questions (contin

  What medical interv
employ?

  Treat depression/su
  Address anxiety
  Address arthritis/pa
  Refer to audiologist
  Anything else?

nued)

ventions would you

uicidal ideation

ain
t for hearing aid needs

Questions (contin

  What psychosocial
employ (depending

  Empathy regarding her
  Information about abu

safety
  Proper documenta

  Referral to social worke
depression (e.g., grief c
group); anxiety; assista
transportation issues; e
  Including help for

  Encourage attendance
  Psychosocial handouts

anxiety, transportation,
independence; abuse/n

nued)

l interventions would you
g on assessment findings)?

r losses
use/neglect, including planning for

ation
er psychosocial interventions for
counseling; referrals for support
ance with ADLs/IADLs; help with
elder abuse
son
e at senior center
s (possibilities include depression,
, loss of spouse; loss of
neglect)

Questions (contin

  What are possible outcomes of
  Decreased depression
  Reduction in arthritis pain
  Social supports increased d
center
  Improved health status due
adherence
  Nutrition and hygiene needs
  QOL/social engagement im
addressed
  Mobility within the communi
appointments
  Increased safety

nued)

f these interventions?

due to reengagement with senior
e to improved medication
s met
mproved with hearing aid problem
ity, ability to travel to MD

Questions (contin

  What are possible outcom

  Depression deepens
  Nutrition negatively im
  Continued poor adhe

health status worsen
hypertension
  More socially isolated
outside the home and
  Imperiled financially
son
  Physical injuries
  Increased mortality

nued)

mes if MD does not intervene?

s
mpacted without IADL support
erence to medical treatment so
ns with unstable blood sugars,

d as result of difficulty traveling
d inability to hear others, tv, radio
y if supporting grandkids and

y risk

Wrap-Up