Old Age Psychiatry
Nature of the work
Old age psychiatrists provide assessment, treatment and
continuing care for older adults with organic (dementia syndromes)
and functional (e.g. depression in schizophrenia) mental
disorders. Due to change in demographics and the demands of
an aging population, patients requiring the attention of old age
psychiatry are often within acute general hospitals in addition to
a number of community settings, including residential and nursing
facilities. Patients who suffer from concurrent organic and
functional mental disorder present particular management
challenges. Younger adults who develop dementia are usually
cared for by old age psychiatry services. There has been an
expanding demand for early memory assessment and anti-dementia drug
treatment which is now an important part of the work of old age
psychiatrists. The increase in patients over the age of 65
anticipated in the next 20 years is likely to create an increasing
demand for old age psychiatry services.
Working in old age psychiatry
Old age psychiatrists have an opportunity to
work with both functional and organic mental disorder often in the
context of medical illnesses and the physical, social and
psychological changes associated with increasing age. Old age
psychiatrists work closely with primary care and agencies such as
social services. Specialty training in old age psychiatry
recognises the need to have a good understanding of the effect of
co-morbid physical health problems on patients’ mental
health. Specialists work closely with patients’ families who
often have an informal role in patient care which is an important
aspect of the consultant role.
Common procedures / interventions
Old age psychiatrists initiate and
monitor psychotropic medication and are involved in the
introduction and monitoring of anti-dementia treatments for
Alzheimer’s disease per the current NICE guidance. Specific
issues around the changes in drug metabolism in later life are
important considerations in the specialty. Competency in the
assessment and delivery of specific psychotherapies to treat
patients is required of old age psychiatrists in addition to
specialist skills in cognitive assessment. A proportion of
patients will be subject to the legal framework provided by the
Mental Health and the Mental Capacity Acts.
Further information
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