How to help an Alcoholic?

It is painful and overwhelming to see someone you love destroy their life due to an addictive behaviour. Alcoholics usually tend to deny their addiction and only realize it when its negative effects have spread into almost all areas of life. Here the role of friends and family members can be effective in encouraging them […]

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First aid for Panic Attacks

Panic attack is a condition which is episodic in nature marked by high anxiety and fear, also discomfort that develops suddenly and reaches heights within 10 minutes.   Observable symptoms: Trembling and shaking Sweating Short breaths and sensations of choking If the person reports – palpitations, chest pain or discomfort, abdominal distress or nausea, dizziness […]

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Panic Attack in Child

Did you know that a panic attack in children often manifests in the early stages of adolescence? And, it is the most common psychological problem in the western countries, usually affecting about 2-3% of the people especially the younger ones in a year. There is no specific event triggering the first panic attack in children, […]

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Alcohol Detoxification

Do you know that Delirium tremens kills one in  20 people during alcohol withdrawal? Yes, It is estimated these tremors occur in 5 percent of the people who go through the process of alcohol withdrawal. This is the time where the alcohol detoxification comes into the picture.   It is good if you have decided […]

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How To Stop Panic Attack

Dying on EMI basis?   In the spur of a moment suddenly thinking of losing control, having a heart attack or even dying. No clue of what’s happening in and around? That could be a panic attack. Yes! A panic attack is a sudden impact of intense fear that creates severe physical reactions in the […]

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Geriatric psychiatry: Proper diagnosis helps treatment

Ageing is a normal process of gradual deterioration of physiological function

geriatric-04accompanied by loss of viability and increase in vulnerability. It is common to all living beings such as animals and plants. Ageing becomes mor
e pronounced and our mental faculties become dull as we grow in age, needing urgent psychiatric care and medication.

Age related issues

Man’s physical abilities and the capacity to apply intellectual reasoning is considerably impaired as he grows old. Geriatric psychiatry, also known as psychiatry of old age, entails treating and dealing with this essentially age-related problem.

Increasing elderly population

In India’s context Geriatric psychiatry has assumed paramount importance. As per the latest provisional data of Census of India, the elderly in the age group of over 60 comprise 8.3% of India’s population, second largest in the world. This 60+ group is also the second fastest growing segment of Indian population. The population growth is likely to register 3.5 times increase by 2050, in percentage terms.

Need for action-plan

This calls for a comprehensive action-plan to deal with Geriatric psychiatry, involving diagnosis, treatment and management of dementia and depression among aged persons. It is important to know that psychiatric illness of the elderly is different from the illnesses of adult patients. Doctors and psychiatrists need to be well prepared to deal with this problem to avoid any future complications.

History important!

To properly diagnose a geriatric psychiatric illness it is imperative to take a detailed note of the elderly’s history. The history needs to focus on:

  • Changes in functional performance of daily life
  • Need to document the drugs consumed
  • Need to know if non-prescription drugs, responsible for psychiatric symptoms are being used
  • Need for a proper physical examination of higher functioning
  • Need to check all sensory systems such as hearing and vision
  • Need to assess mental status through Mini Mental State Examination (MMSE)
  • Need to conduct simple lab tests for electrolyte imbalance, anemia, malnutrition, metabolic abnormalities, urinary retention

Management of Geriatric psychiatry

Psychosocial intervention can make considerable difference to the elderly person’s condition.

  • New drugs working through one neurotransmitter, of late, has been found to be safer
  • Start the treatment without further delay. Risk of suicide increases with delay in treatment
  • There is a need for adequate treatment of co-morbidity
  • Mental functioning of patients and dementia may aggravate if treatment of any illness or severe infection is delayed
  • It is better to avoid benzodiazepine group of drugs that cause more harm than benefit
  • Medication needs to go slow and start slow
  • Any sudden or early withdrawal of medicines should be avoided at all costs

 

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