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Oxford Assess and Progress: Psychiatry$
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Gil Myers, Melissa Gardner, Katharine Boursicot, and David Sales

Print publication date: 2014

Print ISBN-13: 9780199665662

Published to Oxford Scholarship Online: November 2020

DOI: 10.1093/oso/9780199665662.001.0001

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PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press, 2021. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use. date: 29 November 2021

Psychiatry of Old Age

Psychiatry of Old Age

(p.261) Chapter 10 Psychiatry of Old Age
Oxford Assess and Progress: Psychiatry

Clare Wadlow

Oxford University Press

This chapter of practice exam questions aims to put you, albeit briefly, in the seat of an old age psychiatrist dealing with important aspects of psychiatric disease in older adults. Our population is ageing and this, in addition to wider public understanding and earlier diagnoses of dementia, is leading to an increasing burden of disease. Furthermore it is acknowledged that the incidence of affective and psychotic disorders unexpectedly peaks again as we reach old age and can be devastating if not recognized and managed effectively. The unique challenge of psychiatry of old age is the need for a sound grasp of general medicine and neurology to tackle unusual presentations of illness and possible multiple co-morbidities, in addition to a ground–ing in psychiatric theory. There remains a great need for lateral think–ing, particularly in liaison work on the medical and surgical wards where delirium is rife and can masquerade as everything psychiatric. Within the specialty, true collaboration exists as allied health professionals and psy–chiatrists work together at problem solving to improve patients’ quality of life beyond simply offering medication. An understanding of the pathology, epidemiology, diagnosis, and treat–ment of mental illness and dementia in older adults is an essential skill for any doctor at the coalface. Working with older adults is incredibly rewarding and never stops being educational to the clinician. These patients and their carers will continue to challenge and impress you throughout your career. As you manage to feel more confident with the facts, the practicalities and benefits of talking to and helping older adults become clearer. There is nothing that surpasses learning on the job, with many opportunities through attachments in psychiatry, GPs, ED, and geriatric wards. There are excellent resources available with regard to dementia, including NICE guidelines and the Alzheimer’s Society website. The aim of the following questions is to touch on a range of areas throughout the subject, taking us from first principles to practical applica–tion, through effective management, and support of older adults’ mental health and wellbeing.

Keywords:   abbreviated mental test, apathy, blood pressure, codeine, driving, galantamine, heart rate, levodopa, memantine, muscarinic receptors, nasogastric feeding, pseudodementia, quetiapine, syncope, temazepam, urinalysis

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