Clinical Case Studies in Long-Term Care Psychiatry. Navigating Common Mental Health Challenges in Geriatric Care

The mental healthcare of older adults can lead to age specific challenges, however, many healthcare settings have limited access to expert geriatric psychiatric consultation. This compelling book provides a comprehensive compilation of real-life cases involving the psychiatric care of older adults in the long-term care setting. Providing practical guidance for healthcare professionals who work regularly with older adults, the chapters cover key topics such as neurocognitive disorders, mood disorders, anxiety disorders, psychotic disorders, end-of-life mental health care, and sexuality issues in older adults. Offering all the information necessary for the diagnosis and formulation of treatment plans for a wide variety of psychiatric presentations, the book covers pharmacologic and non-pharmacologic options for each disorder to assist healthcare professionals in providing well-rounded care. For all those involved in the prevention, assessment, diagnosis, and management of neuropsychiatric disorders in long-term care populations.

• Provides a case-based approach to all the common problems and diagnoses in geriatric psychiatry, featuring real-life examples of cases to ensure that the information presented is memorable, relatable and usable to clinicians in the field
• Each case study builds upon the understanding and knowledge of assessment and the effective management of neuropsychiatric disorders in long-term care populations, enabling readers to become more confident in providing evidence-based care to their older patients with psychiatric issues
• Offering valuable practical guidance to those who frequently practice in the long-term care setting, the authors incorporate practical, strengths-based individualized psychosocial spiritual and environmental approaches to improve mental health and quality of life of long-term care residents

CONTENTS

Preface
Part I. Neurocognitive Disorders:
1. ‘I’ve fallen…and I can’t get up’: Sundowner syndrome
2. ‘I think I hit my head’: major neurocognitive disorder secondary to alcohol use disorder
3. ‘It’s like she’s a different person’: neuropsychiatric complications of TBI
4. ‘I am tired all the time’: dementia with Lewy Bodies
5. ‘I am okay’: frontotemporal dementia
6. ‘Leave me alone’: agitation in MNCD
7. ‘I am fine’: apathy syndrome
8. ‘Those children are cute’: cholinesterase inhibitors and memantine
9. ‘Those terrible men have left’: agitation in MNCD
10. ‘I saw the heavenly gates’: end of life care in MNCD
11. ‘Leave me alone’: pain control in MNCD
Part II. Mood Disorders:
12. ‘I am in hell and I will die in hell’: treatment resistant depression and electroconvulsive therapy
13. ‘My mom looks like a zombie!’: antipsychotic-related movement disorders
14. ‘My soul is in England’: treatment of depression and anxiety at end-of-life
15. ‘I feel terrible’: SSRIs and treatment resistant depression
16. ‘I don’t care’: SSRIs/SNRIs and bleeding risk
17. ‘I feel very lonely’: depression/Psychogenomic testing
18. ‘I don’t feel right’: bipolar disorder
19. ‘I am feeling great’: secondary mania
20. ‘I am staying here illegally’: major depressive disorder with psychosis
Part III. Psychotic Disorders:
21. ‘That priest is a gossip’: schizophrenia and long-acting injectable antipsychotics
22. ‘He just won’t get up’: catatonia
23. ‘My body is being taken over by a fungus!’: delusional disorder
24. ‘This is humiliating’: clozapine
25. ‘I want to go home’: delirium
26. ‘I am a worrier’: schizoaffective disorder and antipsychotics
27. ‘Get out of my house’: medication induced delirium
Part IV. Anxiety and Related Disorders:
28. ‘My whole life is in there!’: hoarding disorder
29. ‘My vision has been worsening in the last two weeks’: generalized anxiety disorder
30. ‘I am not addicted to Valium’: panic disorder
31. ‘Of course, I worry about him’: generalized anxiety disorder in the setting of MNCD
32. ‘Bombs are falling! Run, run!’: PTSD
Part V. Substance Abuse Disorders:
33. ‘I used to do a bit of everything’: substance use disorders
Part VI. Personality Disorders:
34. ‘No one here is on my level’: narcissistic personality disorder
35. ‘I cannot wait to get out of this miserable place’: borderline personality disorder
Part VII. Miscellaneous Neuropsychiatric Disorders Affecting Patients in Long-term Care:
36. ‘Can I have a hug?’: sexually inappropriate behavior
37. ‘Everyone is just so good to me!’: pseudobulbar affect
38. ‘Why do they say I have dementia?’: ADD in older adults
39. ‘I hate that guy… I can’t get any sleep!’: sleep-wake cycle disorders
40. ‘Just one kiss’: sexuality in long-term care
41. ‘I don’t feel well’: anticholinergic medications, incontinence and overactive bladder
42. ‘I like food’: binge eating disorder
43. ‘I like the way she laughs’: sexuality in long-term care
44. ‘This is so hard’: caring for the caregiver
Index.