Geriatric Psychiatry

Geriatric Psychiatry at University of Iowa Hospitals and Clinics provides expertise in the diagnosis and treatment of mental illness in later life. As we age, there are changes in the way our brains work. There are, however, illnesses that are not normal with aging. Distinguishing among illnesses is key, as well as differentiating illness from normal aging. With this in mind, improving the quality of life for patients, caregivers, and families is a priority. Dementia, or neurocognitive disorder, includes a group of illnesses with different causes but similar effects. These can include a loss of the brain’s ability to think, remember, and use information. Alzheimer’s is the best-known kind of dementia, but there are many others. Problems that occur in people with dementia may include anxiety, restlessness, depressed mood, irritability or suspiciousness, among others.

Geriatric Psychiatry at U of I Hospitals and Clinics can diagnose and provide answers to improve quality of life. We can:

• Alleviate many of the behavioral and psychological symptoms that are often part of dementia
• Walk the patient and family through the progression of the illness
• Help recognize need for additional services, for change in management, when medication can and cannot help
• Help families plan ahead for the needs of their loved one to receive the best, most dignified care possible

Emphasis is placed on ensuring that every patient receives the care needed and deserved while preserving and using as much independent function as possible. Illnesses such as depression and anxiety can also be treated. Physicians in other specialties are consulted frequently, as most older adults have one or more medical conditions and multiple medications. Each patient deserves individual care. This includes having their history known, identifying problems to overcome, and acknowledging tragedies survived. Patients also deserve to have their triumphs and losses recognized. These aspects are celebrated and made part of the rest of their lives as fully as possible.

Levels of Care

Inpatient Services

Care in the Geriatric Psychiatry Inpatient Unit can help provide an assessment and treatment plan to improve care and quality of life for people with dementia.

The Geriatric Psychiatry Inpatient unit is a 14-bed unit dedicated to the evaluation and treatment of older adults with mental illness, any who have an early onset of a mental disease usually found in old age, and for some medically frail patients with mental illness who don't require the medical psychiatry unit, but benefit from the expertise and quieter atmosphere of the Geriatric Unit. Beds, hand rails, furniture, lighting, and activity programs are designed to meet the needs of an older population. The attending psychiatrist is often board-certified in Geriatric Psychiatry, with additional staffing by psychiatrists dually certified in Internal Medicine and Psychiatry or trained in Neuropsychiatry. All residents in Psychiatry  —  qualified doctors obtaining specialty training in Psychiatry — are assigned at least one month on this unit, as all need to know about the special diagnostic and treatment needs of older adults.
A dedicated nursing staff who not only have expertise in nursing care of older patients, but also love what they do — helping these patients — offer comprehensive observation of patients' functioning and behaviors. Nurses engage patients in activities to increase comfort, learn what causes distress, and what approaches will work best. The physician team works closely with nursing, social work, occupational therapy, activities therapy, music therapy, clinical pharmacists, and others to provide the best evaluation and treatment plan. The goal as a team is always to provide the best quality of life for each patient.

Additional Services

Diagnostic and clinical management is available through the Adult Psychiatry Clinic. Outreach services are available to nursing homes in southeast and east-central Iowa, delivered by a Geriatric Psychiatry ARNP who provides consultation, diagnostic, and management services to nursing home patients with collaboration from the hospital Geriatric Psychiatry team.
Neuropsychological and Occupational Therapy testing are also available. For people with dementia, it is often necessary to understand their presentation fully by conducting neuropsychological testing to learn the extent of memory and other cognitive losses. Neuropsychological testing can also help identify what cognitive strengths remain.  It is also necessary at times to understand problems in daily living skills that can be examined through Occupational Therapy testing.