I'm providing a link that I read when researching the role of geriatric psychiatric care for dementia patients.
http://www.ncbi.nlm.nih.gov/pubmed/23636988
The article seems to say that there is some greater benefit to the dementia patient other than medication. I'm trying to figure that one out, since the dementia patient can't recall the visit, right?
I read a lot of comments on this site about getting dementia patients to a geriatric psychiatrist. I would like to hear from those who have experience as to how it works. For example, if the patient has severe dementia, has no short term memory, and little orientation to time and place, how do the visits with the psychiatrist go?
If the patient can't answer any question or recall anything, how does the doctor interact with them? Do they talk to the family member or long term care staff only?
Since the patient would have no memory of going to the visit, how are they benefited?
Is the psychiatrist's role to prescribe and monitor medications?
Is consult with the geriatric psychiatrist only for those patients who have acting out, aggressive, depressed, or having other behavior that is even extreme for dementia patients? Or is it recommended for all dementia patients?
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.
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.
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 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.
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.