What is a Geriatric Psychiatrist

A geriatric psychiatrist is a medical doctor with a higher qualification in psychiatry, and who has special training and experience in diagnosing and managing mental disorders in older persons. Some common disorders include dementia, depression, anxiety, psychoses and adjustment disorders.

Who needs to see a Geriatric Psychiatrist

Older persons, aged 65 years and above, with a variety of emotional problems see the Geriatric Psychiatrist. Common problems include stress, depression, anxiety, agitation, poor sleep, difficulty adjusting to life changes, difficulty coping with losses, deterioration in memory and functioning, personality changes and behavioural problems. Occasionally, the older persons need assessment of their mental capacity to manage their own affairs.

What special needs does an older person with mental disorder have?

Older persons have special physical, emotional and social needs which have to be taken into consideration. The older persons are often various medications for their coexisting medical illnesses. They are more frail compared to younger adults and more sensitive to the effects of medication. They also often have social, family, interpersonal and environmental issues. Thus in the management of the older person, a multi-disciplinary approach, involving the psychiatrist, psychologist, nurses, medical social worker, occupational therapist and physiotherapist is needed.

What is dementia?

Dementia is a disorder of the brain which causes deterioration in memory, intellectual functioning and personality. The forgetfulness causes interference in the person's work, activities daily life, and social interactions.

What causes dementia?

There are many conditions and diseases that can cause dementia. The commoner causes of dementia are strokes and Alzheimer's Disease. Other conditions that lead to dementia are serious head injury, brain infections, brain tumours, neurological disorders like Parkinson's Disease and vitamin deficiencies.

Can Alzheimer's dementia be treated?

Alzheimer's Disease is an irreversible and progressive illness for which currently there is no cure available. There are medications to improve the cognitive function slightly and temporarily, and help delay the severe stage of the illness. Apart from these, there are treatments to alleviate the psychiatric and behavioural problems of dementia like suspiciousness, agitation, depression and anxiety.

What are the symptoms of depression in an older person?

The recognition of depression may be more difficult in older persons compared with younger adults. In the older age group, both the doctors and patients may incorrectly attribute depressive symptoms to the ageing process. The depressed older person has several of the following symptoms: changes in appetite and weight, disturbed sleep, agitation or retardation, fatigue and loss of energy, depressed or irritable mood, loss of interest or pleasure in usual activities, feelings of worthlessness, self-reproach, excessive guilt, suicidal thinking or attempts, and difficulty with thinking or concentration. Sometimes the depressed older person may be excessively preoccupied with multiple bodily complaints.

Can depression in the older person be treated?

There are at present a number of antidepressants which are both effective and well-tolerated by the older persons. With treatment the depressed mood lifts and the he or she can function normally again.

Where can I find a Geriatric Psychiatrist?

The Institute of Mental Health has a Department of Geriatric Psychiatry which caters to the mental health needs of the elderly in Singapore. Services provided include both inpatient and outpatient assessments and management by the multi-disciplinary team.