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Practical Strategies in Geriatric Mental Health

Cases and Approaches

Edited by Laura B. Dunn, M.D., and Erin L. Cassidy-Eagle, Ph.D.

  • ISBN 978-1-61537-257-7
  • Item #37257

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The experienced editors of Practical Strategies in Geriatric Mental Health: Cases and Approaches recognize that older patients can pose unique challenges to general practitioners working outside this specialty, and that the shortage of geriatric mental health specialists makes the creation of trustworthy, user-friendly resources more critical than ever. In response, they produced this book to be accessible not only to physicians and mental health practitioners, but also to a broader audience of care and service providers for older adults, such as social workers and nurses. From the depressed patient who has not responded to one or more trials of antidepressants and is now losing weight and rarely leaving home, to the patient with major neurocognitive disorder whose behavior has become increasingly difficult for caregivers, older adults frequently present with complex diagnostic and treatment challenges.

Each chapter focuses on a specific symptom or disorder (e.g., depressive symptoms/syndromes, anxiety, neurocognitive disorder with behavioral disturbance, grief) and begins with a chief complaint, borrowed from common real-world clinical scenarios. A brief clinical vignette portrays how the chief complaint is often presented, followed by relevant discussion of practical approaches to assessment, diagnosis, and treatment. These cases bring the material to life and illustrate relevant clinical applications, as well as the nuances of common presentations.

  • Chapters are consistent in structure, flowing from the case illustration to diagnostic and assessment tools to treatment options, and ending with a return to the case to integrate the material presented.
  • Clinical guidelines and assessment tools suitable for both nonexperts and experts are provided for use in clinical encounters to assess functioning and treatment effectiveness.
  • Easy-to-follow algorithms, brief behavioral interventions, additional resources (e.g., organizations, websites, books to recommend to patients and families), and clear, take-home pearls are also included, making this text a valuable repository of usable information.
  • The text acknowledges the reality that the patient belongs to a family system. Family members, who are often also caregivers, have questions and fears—and their own medical and mental health conditions. Accordingly, the authors carefully consider family input and influence on the clinical situation.

Comorbid medical conditions, the increased likelihood of medication interactions, and the presence of cognitive changes all can complicate and confuse the clinical picture. Practical Strategies in Geriatric Mental Health: Cases and Approaches brings the geriatric psychiatrist's knowledge base and armamentarium to the reader, who will find its guidance essential and empowering.


  • Preface
  • Chapter 1. Late-Life Depression I: I can't keep up with my grandkids
  • Chapter 2. Late-Life Depression II: I think of ending my life every day
  • Chapter 3. Working with Depressed Caregivers: Behavioral Activation: I can't find the energy or time to leave the house
  • Chapter 4. Diagnosis and treatment of Generalized Anxiety Disorder in later life: Getting old is not for wimps!
  • Chapter 5. Somatic Complaints and Anxiety in Older Adults: I wish the doctor would figure out what's wrong with me
  • Chapter 6. Pain and psychological factors in older adults: I need more pain medication, not less!
  • Chapter 7. Primary sleep disorders: My wife says I snore loudly and sometimes stop breathing while I'm asleep
  • Chapter 8. Evaluation and Management of Insomnia: My sleeping pill isn't working anymore
  • Chapter 9. Bipolar Disorder: What's wrong with Mom—is it dementia?
  • Chapter 10. Post-Traumatic Stress Disorder: My stomach hurts
  • Chapter 11. Evaluation and treatment of substance use disorders: I just have one drink with dinner, Doc
  • Chapter 12. Mild cognitive impairment: I'm forgetting things. Is this normal for my age, or do I have dementia?
  • Chapter 13. Neuropsychological Testing: I sometimes forget things
  • Chapter 14. Behavioral and psychological symptoms of dementia: Little men are invading my backyard
  • Chapter 15. Delirium in older adults: Me, confused? Nah!
  • Chapter 16. Inpatient issues - behavioral and pharmacologic interventions: He tried to kick a staff member
  • Chapter 17. Post-Intensive Care Syndrome: He's just not himself.
  • Chapter 18. Physical activity in late life: I run out of breath


    Awais Aftab, M.D.
    Duane Allen, M.D.
    Ann Choryan Bilbrey, Ph.D.
    Mary (Molly) E. Camp, M.D.
    Erin L. Cassidy-Eagle, Ph.D., CBSM, DBSM
    Cathy I. Cheng, M.D., FACP
    Laura Clayton, LCSW
    R. Ryan Darby, M.D.
    Beth D. Darnall, Ph.D.
    Laura B. Dunn, M.D.
    J. Kaci Fairchild, Ph.D., ABPP
    Dolores Gallagher-Thompson, Ph.D., ABPP
    Elizabeth Hathaway, M.D.
    Aazaz U. Haq, M.D.
    Alana Iglewicz, M.D.
    Kevin K. Johnson, M.D.
    Michael Kelly, M.D.
    Babar Khan, M.D., M.S.
    Daniel Kim, M.D.
    Marla Kokesh, M.D.
    Clete A. Kushida, M.D., Ph.D.
    Sheila Lahijani, M.D.
    Peter Louras, M.S.
    Ajita Mathur, M.D.
    Monica Mathys, Pharm.D.
    Leah McGowan, J.D.
    Christopher O'Connell, M.D.
    Oxana Palesh, Ph.D., M.P.H.
    Kathryn Phillipps, M.S.
    Iuliana Predescu, M.D.
    Karen Reimers, M.D., FRCPC
    Patricia Serrano, M.D.
    Daniel D. Sewell, M.D.
    Kelli M. Smith, M.D.
    Barbara R. Sommer, M.D.
    Warren Taylor, M.D., MHSc
    Nishina A. Thomas, M.D.
    Larry W. Thompson, Ph.D., ABPP
    Eveleigh Wagner, M.D.
    Sophia Wang, M.D.
    Ilse R. Wiechers, M.D., M.P.P., M.H.S.
    Tonita E. Wroolie, Ph.D., ABPP

About the Authors

Laura B. Dunn, M.D., is Professor of Psychiatry and Behavioral Sciences in the Department of Psychiatry and Behavioral Sciences at Stanford University, Stanford, California.

Erin L. Cassidy-Eagle, Ph.D., is Clinical Associate Professor in the Department of Psychiatry and Behavioral Sciences at Stanford University School of Medicine, Stanford, California.

Every primary care physician would be delighted to include this book on their office bookshelf among other trusted medical textbooks. It serves as a practical guide for the busy clinician looking for quick guidance on management of geriatric mental health issues between patients. At the same time, the recommendations are well-referenced, offering the perfect jumping-off place for further study when desired.—Megan Mahoney, M.D., Clinical Professor, Section Chief for General Primary Care, Division of Primary Care and Population Health, Vice Chief of Staff, Stanford Health Care

The case vignettes featured in every chapter were engaging. They tie the book together and allowed one to read the whole book as a refresher and update for the experienced clinician, and a wonderful introduction for trainees. The chapters were sufficiently comprehensive to allow them to serve as a great resource when consulting a topic to help in the management of a challenging patient. The references are up-to-date and the links to web resources were very helpful. In addition, links to patient support organizations and professional organizations will help clinicians when caring for our patients. I plan on enthusiastically recommending this book for our primary care medical staff, who need to recognize and know how to treat and when to refer for all the common conditions so well covered in this text.—Jay Luxenberg, M.D., FACP, AGSF, Chief Medical Officer, On Lok Lifeways

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