What is the role of the Geriatric Psychiatrist with dementia patients?

Correction: floor was not top secret.

Mom was crying non stop suddenly. Her Dr suggested having her evaluated on the Geriatric Psych floor of our hospital. What?!? We had no idea it was there! The whole family had been patients in the wonderful Hospital at some point in our lives. Visited friends family often. This floor was top secret but was not public either. Mom loved it there. She didnt want to leave. Moms short term memory was already gone but they talked to her about what was going on in her "present". Then they talked to me a couple times to get her background. The NH she was in later had a geriatric phych contracted that made visits as needed. I would suggest checking with hospitals to see if they offer these services and just not advertised by the hospital. In my case if a person were to get off the elavator accidently on this floor it appeared to be administrative offices behind glass doors which were locked. You had to be buzzed in.

I see. I think that often with families, they are hesitant to admit that a loved one is to the point that they cannot be left unattended. It's just something they tend to deny, until often there is a crisis. I suppose that if the doctor confirms it, they are more apt to comply.

We have a family friend who was having hallucinations and his family took him to his primary. Afterwards, they said it was due to some cold medication that he was taking too much of. I had my doubts, but the family just seemed to be in such denial about it. Later, he fell down, due to leaving the house, because he saw unruly children inside. (There were no children in his house.) He fell and fractured his hip and is not doing well. Now he goes between the hospital and the NH.

I suppose we do the best we can, but sometimes, I do wonder why people who are caring for seniors seem to be in such denial and slow to accept that safeguards are necessary.

My mom had brief " check ins" with the geriatric psychiatrist at her IL facility. They were for the MD to make sure the meds were doing their job. This was not therapy, it was medication management .

It was the geripsych who told us to have a cognitive assessment done for mom. Mom and family were resistant. The results showed that mom had had a stroke and had significant cognitive loss, and should no longer be on her own.

That is interesting. I take it that you mom was able to convey some information to the doctor and the family supplemented it. Did the psychiatrist actually have sessions with your mom or did he refer her to a therapist for that? Did your mom have dementia at the time?

One reason I ask that is that I went with my father to a psychiatrist. He did not have dementia then or now. She wasn't a geriatric psychiatrist, but one of the few psychiatrist in that area. (Very booked up and hard to see.) I was impressed that she diagnosed my dad pretty quickly. Granted, I provided her with a lot of family information that my dad wasn't likely to divulge. My dad had been through a series of medical tests and doctors including, GP, cardiologists, ENT and neurologists. I had done my own research and took notes, keeping my mouth shut. Finally, when they could not figure out the cause for his spells/seizures/blindness, I begged his Primary for a psych consult and he was happy to comply. As it turns out he had Conversion Disorder. He went on meds, and had a couple of visits of talk therapy with the psychiatrist. I went as well and begged my mom to come. My dad is old school, but he handled it great. I kept telling him, Dad, this is an illness that is treatable! Thank goodness we have discovered the problem and it can be treated! He did so well and has only one incident in over a year! So, that was a good outcome. A psychiatrist was definitely the answer there.

Babalou, if you had a great experience with your family, then that's a great thing and I would absolutely spread the word. We need all the help we can get.

I often think of myself of little miss " has your parent been seen by a geriatric psychiatrist " on this board. I guess that's because they've made SUCH a difference in my mom's life. It's a long story, but to cut to the chase, in my world view, psychiatrists are often the only md.s left who look at the whole person. Their living environment. Their clothing. Whether they are groomed. What their mood and eye contact is like. What their relatives think. Does your LOSS cardiologist ask you about what her neighborhood is like, or if she cooks for hersel? The psychiatrist sees the whole person, body and mind together. They tease out pre-existing mental illness (after my mom professed her love and devotion to Sarah Palin, the Psych raised an eyebrow at my brother and me and says "always"?. "My brother replied "always slightly more conservative that Atilla the Hun". Extreme political views that develop suddenly can be symptoms; if they are lifelong, strongly held beliefs, they are just that.

I'm bumping this up in case someone has information or experiences with geriatric psychiatrist and dementia patients.

I can see how a geriatric psychiatrist might be quite helpful for people who have suffered with mental illness before they got dementia and they are already on psych meds, or for those dementia patients who are able to communicate and answer questions, or for those patients who are violent, uncooperative and out of control. I'm just trying to determine how other patients who don't fit into those categories benefit.

I hope we will get some responses on how it works for those type of patients.

I appreciate the comments from the post upthread about how everyone should have a consult, but I'm just not seeing how or why that is necessary.

I will add - I sought one out after I went to see my own PCP for my stress. He recommended it saying his wife takes her father to one and it's helped a great deal. I had to get a referral from moms PCP. From what I was told when making the appointment there are two kinds of first time type visits. One does the neuro work up and determines the type/stage etc. the other is for medication and medication review. Evidently the wait for the neuro work up is long - but I was able to get the med appt within a week of calling. I guess the Gods we smiling on me (or they looked at moms file) cause they called me back saying they would do a mini diagnosis type of appointment during the same visit. The appointment is 90 minutes long. I too, wonder all the things you do - I mean, my mom can put on a good show, how will they know when she's lying through her teeth? I'm imagining one of those mirrors where I can see/hear them but she can't see me - and they'll be some kind of button I push every time she makes something up, lol! Regardless -I just thankful for any extra help I can get!

Thank you for your question - the timing is perfect! I'm taking my mom to see one Monday. I'll let you know how it goes.

The role of a geriatric psych is non-existent in most of the United States. Unless you live in a metro area w/medical research universities. And your elder concedes that he/she has issues that need to be evaluated and addressed. And your elder has time to wait 7 months for his/her first appointment. And your elder has unlimited transportation to unlimited appointments (that's code for you having no life and no income).

If you ask me, there should be a geriatric psych on every corner. Enrolling in Medicaire/Medicaid should include a geri-psych evaluation. Then each enrollee is assigned to a geri-psych and has guaranteed access -- including house calls if necessary.

Not saying that this entity should be breathing down our elders' necks in a Big Brother capacity. Just saying that ALL seniors should have abundant and efficient access to geri-psych care -- not just elders in NYC, D.C., LA, Miami and Chapel Hill who have top-tier health insurance and on-demand chauffeurs.

The "access-to-all" concept would eliminate the stigma associated with psych care, too. Instead, geri-psych care would be an accepted health routine for a certain life stage -- the same way we view orthodontics, birth control, pap smear, mammogram, prostate exam, colonoscopy, bone density screening, etc.