1. Meredith Bailey, LCSW Timberlawn Hospital February 26, 2009 1

2. Scope of Problem Number of Caregivers Average Period of Caregiving 2

3. Psychiatric Conditions Complicate Caregiving Issues Getting Appropriate Assessment Making Appropriate Care Plans 3

4. Background Geriatric Mental Health Foundation Estimates 6.5 million older adults are depressed By 2030 the number will be 15 million 4

5. Risk Factors For Late Life Depression Changes in Medications Recent Loss of Loved One Living Alone—Feeling Isolated Serious Medical Problem Severe or Chronic Pain 5

6. Symptom Manifestation in the Elderly Somatization Indecisiveness Lack of feeling or emotion Social withdrawal Feelings of worthlessness Thoughts of death 6

7. Somatic concern Lowered affect Cognitive impairment Feelings of discrimination Impaired motivation Lack of future orientation Lack of self esteem The Geriatric Depression Scale 7

8. Bipolar Disorder Afflicts.5% of elderly population Have proportional number of hospital visits to younger population Hospital stays are longer 8

9. Anxiety Disorders 11.4% of older adults meet criteria Agoraphobia often develops in elderly 9

10. Schizophrenia Afflicts.6% of older adults compared 1.3% in 18 to 55 year olds 10

11. Psychosis 50% of Alzheimer's patients have delusions/hallucinations Suspiciousness Paranoia Combativeness Aggressiveness 11

12. Suicide The elderly are 11% of overall population but represent 17% of suicides 12

13. Suicide Risk Factors Prior history of suicide attempts Lethality of prior attempts Current plan--do they have one and what is it Gender Debilitating medical illness or chronic pain Lack of support system 13

14. Suicide Risk Factors (continued) History of suicide in the family Hopelessness Substance abuse Alcoholism Prescription medications 14

15. Assessment Tools Geriatric Depression Scale Casemanagement Questionnaire 15

16. Geriatric Depression Scale 15 and 30 question versions Scoring and use 16

17. Casemanagement Questionnaire Demographics Activities of daily living Vision and mobility Medical conditions—stable vs. unstable Psychiatric conditions Support availability Financial considerations 17

18. Referrals & Resources Community Area aging resources Medical center—geriatric assessment centers Informal networks Internet Eldercare resources Case managers Facility referral 18

19. Attachments Geriatric Depression Scale Casemanagement Questionnaire Resource list Eldercare website list Bibliography 19

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