By Selma Al-Samarrai
The Geriatric Psychiatry Clinic is part of a multidisciplinary program, The Regional Geriatric Program of Toronto, housed at Providence Healthcare since 1988. The role of the clinic’s geriatric psychiatrists is to assess, consult, and treat elderly patients who may have a mental health issue, dementia syndrome, behaviour disorder, or a psychosocial problem.
Symptoms that are of concern and may require long-term treatment include paranoia, disturbances of mood, hallucinations, misidentification phenomena, and disturbances of behaviour.
These symptoms contribute to significant impairment and compromise interpersonal relationships, and education about these symptoms is part of the treatment offered by the geriatric psychiatrists. The more families and caregivers understand about symptoms associated with an evolving dementia, the more we can minimize the use of psychoactive medications.
Referrals to the clinic come primarily from family physicians, geriatricians, and neurologists. A critical component of the program is the community outreach service, which involves health care professionals visiting patients in their homes to identify factors that contribute to frailty in the elderly.
Most of the patients coming to the clinic are seen in the community by one of the occupational therapists prior to their first appointment. The occupational therapist does a cognitive screen and preliminary appraisal of the social circumstances in which the patient lives. The geriatric psychiatrist is able to then use this information when offering treatment options.
The recommended treatments vary depending on the patient’s diagnosis, symptoms, and circumstances. A referral to Providence’s social worker is invaluable. The social worker visits the patient at home to discuss problems they are encountering, and may make recommendations including programs that are available for the patient and their family in the community.
One of the geriatric psychiatrists sees housebound patients in their homes and the other geriatric psychiatrist does consultations within the rehab programs at Providence.
As more patients are choosing to remain at home for the duration of a dementing illness, there is an increasing need for community involvement like the one done by this program.
Selma Al-Samarrai is a communications advisor at Unity Health Toronto.