Mental Health Concerns and The Older Adult
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to diagnosing and recommending mental health treatment. Biological components coupled with psychosocial components provide the mental healthcare provider with a more comprehensive assessment of the older adult presenting with mental health concerns. The older adult assess- ment can be extensive and take multiple visits. The complexity level does not ne- gate the need to assess in its entirety. Biological considerations The APA lists medical components for psychiatric evaluation. The healthcare worker can gather the data for the old- er adult directly from the client, family, friends, or caregivers (with consent), as well as historical medical charts. The in- formation can be accumulated over time and prioritized during each interview. For example, the healthcare provider needs a complete medication history that includes all interventional trials (successes and fail- ures), and most notably any side effects, prior to beginning or restarting psychiat- ric medication. The APA recommends that the following biological considerations be obtained by the healthcare worker: primary care involvement; allergies or drug sensitives; an exhaustive medication review of past and current prescription drugs as well as over-the-counter nutri- ents, supplements, and vitamins; current or historical medical illnesses, including hospitalizations, past or present medical treatments, surgeries, procedures, and alternative treatments; past or present neurological or neurocognitive disorders; physical trauma, especially head injuries and any sequela; sexual and reproduc- tive history; cardiopulmonary issues; en- docrinology involvement; past or current infectious disease; and current or past pain levels and treatments (Sadock et al., 2015).
There are a few notable biological considerations in neuropsychiatry for the healthcare worker to include when planning mental healthcare for the older adult. The healthcare worker understands the older adult can learn new informa- tion; however, the rate at which an older adult solidifies the material can take lon - ger than for other age populations (Sa- dock et al., 2015). In addition, psychomo- tor speech and memorization are slower in older age, especially simple recall and encoding ability, but they are considered normal for the older adult. In addition, the intelligence quotient (IQ) typically holds steady until age 80 (Sadock et al., 2015). These biological considerations can drive the approach and length of time the healthcare worker might allot for as- sessment, intervention, or treatment. The healthcare worker might also include the older adult’s family, friends, or caregiver(s) when new information is presented to the older adult. A historical baseline is an im- portant piece of the assessment for the healthcare worker. The healthcare worker needs to know basic objective measures for physiological functioning such as vital signs (blood pressure, pulse rate, tem- perature, respiratory rate, and pain level) and nutritional status for older adult cli- ents if psychopharmacology is involved. The healthcare worker adult can increase their understanding and provide a more thorough plan of care by coupling with the older adult’s primary care provider.
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