Mental Health Concerns and The Older Adult
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Table 6. A Snapshot of Decreased Older Adult Dosing and Side Effect Risk Profiles Drug Adult Dosage (mg/day) Geriatric Dosage (mg/day) Sedation Postural Hypotension Anticho- linergic Effects EPS TD Clozaril (clozapine) 300–450 12.5–25 High Moderate High Low Low Olanzapine (Zyprexa) 25–50 25 Moderate– high Moderate Moderate– high Low Low Quetiapine (Seroquel) 150–750 50–200 Moderate Moderate High Low Low Risperidone (Risperdal) 4–16 0.25–1.5 Low Low Low Low Low Haloperidol (Haldol) 1–15 0.25–0.5 Low Low Low Very high Yes
Note : Information taken from https://www.Medscape.com SERIOUS MENTAL ILLNESS (SMI) The healthcare worker should be able to identify the older adult who suffers with serious mental illness so that the complex- ity of the accompanying intervention and treatment can be addressed. SMI is a sig - nificant functional impairment caused by one or more mental disorders (most com- monly schizophrenia, bipolar, or MDD). Approximately 4.8% of older adults in the U.S. live with SMI (SAMHSA, 2022b). An older adult who suffers with SMI often needs greater medical and mental illness intervention than someone without SMI. The healthcare worker will need to assist with a comprehensive treatment plan. Older adults with SMI are likely to have comorbidities that complicate their qual- ity of life and increase their risk of mor- tality (SAMHSA, 2021). The most com - mon medical conditions contributing to earlier death are cardiovascular diseases, followed by diabetes, chronic obstructive pulmonary disease (COPD), obesity, and tobacco use (Bartels et al., 2020). Specific psychopharmacological interventions are
individualized for the older adult with SMI and are chosen to best meet the specif- ics of their medical and mental illnesses. Older adults with SMI have better phys - ical and mental health outcomes with psychosocial interventions that focus on improving independent living, teaching social skills, enhancing social support with peer mentors, and education about phys- ical and mental illness management for better self-management lifestyles (Bartels et al., 2020). The healthcare worker can refer to case management or commu- nity resources, along with support from friends, family, and caregivers. Treatment options will be offered in accordance with appropriate care settings and social de- terminants for the older adult with SMI. Psychosocial Interventions for the older adult with SMI include the following (Bar - tels et al., 2020): ● Helping Older People Experience Success (HOPES) : HOPES is a 12-month course that contains seven modules: Communicating Effectively, Making and Keeping Friends, Making
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