Chapter 30 - Geriatric psychiatric emergencies

Summary

This chapter covers key emergent geriatric psychiatric conditions including depression, suicide, psychosis, substance abuse, and elder abuse and provides guidelines for diagnosis, assessment, and management for these conditions. An emergency department-depression screening instrument (ED-DSI) has been developed as a quick tool to identify elderly patients with depression in the ED setting. The assessment for suicide in the elderly requires the emergency physicians (EP) to perform a comprehensive history and examination, assess for risk factors, and to constantly maintain a high index of suspicion. Psychosis may commonly develop in the elderly secondary to medical illness, substance use, medication side effects, or exposure to a stressful situation. To optimize care for the patient, the EP must unearth the etiology of the psychosis and initiate the correct therapy and disposition. In the event that elder abuse is suspected, the EP is responsible for ensuring the safety of the elderly patient.