For LGBTQIA+ older adults, that line is crossed more often than we think.

Sometimes it looks like concern.

Sometimes it’s framed as protection.

But the impact is the same: autonomy is eroded, piece by piece.

Your patients are already using these treatments.The question is—should we be recommending them?

We’re often told antipsychotics are a last resort for agitation in dementia. And that’s true—they are. But when you do reach that last resort, you need to know how to use it—and how to talk about it with families.

We ask about alcohol.

We ask about weed.

Sometimes we even ask about TikTok.

But porn?

What happens when the patient doesn’t want therapy?

How do you approach patients who ask about cannabis for anxiety?

A reminder that focus problems don’t always mean ADHD. That suffering doesn’t always need a label. And that quick relief can sometimes do lasting harm.

Yesterday I wrote about what it feels like to live with social anxiety.

Today I want to talk about how we ask about it.