Psychiatric Assessment: Challenges in Older Adults (PSYCH 101)

This report provides a comprehensive overview of psychiatric assessment in older adults. It emphasizes the unique challenges associated with assessing this population, including age-related biological, psychological, and social changes, multiple medications, co-morbidity of physical and mental problems, cognitive and sensory deficits, and limited assessment tools. The report highlights the differences between normal and abnormal aging, focusing on symptoms such as inappropriate behaviors, forgetfulness, personality changes, and falls. It stresses the importance of early detection of psychiatric disorders, cognitive screening, and collaboration with other health professionals. The assessment process involves consent and decision-making, including capacity evaluation, with considerations for older adults who may have diminished capacity. References to key literature, including works by Blazer, Meeks, Moye, and the American Psychological Association, support the information presented. The report underscores the need for clinicians to be competent in geriatric psychiatry, providing adequate care for older adults.

Running head: PSYCHIATRIC ASSESSMENT 1
Psychiatric Assessment
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Psychiatric Assessment
Psychiatric assessment of older adults requires special attention to various issues. Aging is
associated with a lot of social, biological and psychological changes. Psychiatrist assessment of
adults differs from the assessment of older adults due to the several challenges associated with
the assessment of the elderly (Meeks et al., 2009). These challenges include multiple
medications, frequent co-morbidity of physical and mental problems, cognitive and sensory
deficits that are associated with age, medication interactions, and paucity of assessment tools. It
is worth noting that normal aging affects attentional control and the speed of thinking of an
individual. In cases of abnormal aging, however, there is a severe decline in cognition thus
affecting the thinking abilities of older adults (Moye, Marson & Edelstein, 2013). Most adults do
not experience severe problems related to forgetfulness, problem-solving, communication, and
social interaction. However, older adults especially those with abnormal aging experience
difficulties in solving problems, expressing themselves in conversations, and behaving away
from social rules. Psychiatric assessment of older adults should also involve an assessment of
motor skills to avoid accidents such as falls and excessive tripping (Moye et al., 2013).
Symptoms of aging differ between adults and older adults and thus something that may seem
normal for an adult may be abnormal for an older adult. This difference in symptoms contributes
to the challenges faced by most clinicians and psychiatrists in performing psychiatrist
assessments on their clients; both adults and older adults (Blazer, 2004). Some of the most
common symptoms that are identified in an assessment of older adults include inappropriate
behaviors, getting lost in familiar places, increased apathy, personality changes, loss of balance
characterized by repeated falls, and forgetfulness.

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It is, however, important to note that apart from dementia, psychiatric disorders are less common
among older adults as compared to adults. Cognitive disorders are undoubtedly more common
among the elderly because these disorders increase with age. Clinicians must, therefore, be
adequately competent in psychiatric assessment and caring of the older adults ("Working With
Older Adults", 2020). Competent assessment should involve early detection of any psychiatric
disorders, early education about dementia, use of cognitive screening in assessment, treatment of
other conditions that may resemble dementia, and cooperation with other health professionals in
providing adequate psychiatric assessment and care.
The psychiatric assessment also involves consent and decision making. Most young adults have
good cognitive abilities and may be able to give consent and make decisions regarding their care
and assessment plans. A psychologist or a psychiatrist should be able to perform a capacity
evaluation to determine whether an individual is capable of making good decisions. A
psychologist will have to determine whether a client is making a decision they can agree or
disagree with. They can, therefore, respect the individual’s decision or step in to protect their
client when they feel that their patients are not making the right decisions (American
Psychological Association, 2006). However, it is important to note that aging is not an
implication of a diminished capacity to make decisions. Older adults, however, are at a danger of
dementia and related disorders. They are, therefore, not capable of making the right decisions
and giving consent. Their assessment should, therefore, involve the clinician stepping in to
protect their client and ensure that they get the best psychiatrist assessment and care.

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References
American Psychological Association. (2006). Assessment of older adults with diminished
capacity. A handbook for psychologists. American Bar Association Commission on Law
and Aging–American Psychological Association, 52.
Blazer, D. G. (2004). The psychiatric interview of older adults. Focus, 2(2), 224-235.
Meeks, T. W., Lanouette, N., Vahia, I., Dawes, S., Jeste, D. V., & Lebowitz, B. (2009).
Psychiatric assessment and diagnosis in older adults. Focus, 7(1), 3-16.
Moye, J., Marson, D. C., & Edelstein, B. (2013). Assessment of capacity in an aging
society. American Psychologist, 68(3), 158.
Working With Older Adults. (2020). Retrieved 8 March 2020, from
https://www.apa.org/pi/aging/resources/guides/practitioners-should-know