Suicidal thoughts in older adults (OAs) require immediate attention because of the high rate of death by suicide in OAs. ● OAs account for 19% of suicide deaths in the US, despite being only 15% of the population. Be especially careful with elderly white men with suicidal thoughts, as their rate of death by suicide is 4x higher than the rest of the population.

ECT is one of the most effective treatments in psychiatry, and it’s important to keep it in mind for a variety of inpatients—especially those with treatment resistant depression and psychotic depression.

Health Care Proxy (HCP) and Power of Attorney (POA) are types of advance directives, which are legal documents allowing individuals to designate someone else to make decisions on their behalf, particularly when they are incapacitated. Unlike conservatorships or guardianships, which are court-assigned, advance directives like HCP and POA allow the individual to proactively choose a representative.

Providing patients with resources as they transition from inpatient psychiatric units to outpatient care is vital for their continued support and recovery. Here are several valuable national resources:

● Major depression o Depressed mood + SIGECAPS (4 of 8) o SIGECAPS: sleep, interest, guilt, energy, concentration, appetite, psychomotor, suicide ● Bipolar depression (use mood stabilizers/antipsychotics)

● Suicidal thoughts in older adults (OAs) require immediate attention because of the high rate of death by suicide in OAs. ● OAs account for 19% of suicide deaths in the US, despite being only 15% of the population. Be especially careful with elderly white men with suicidal thoughts, as their rate of death by suicide is 4x higher than the rest of the population.

● Late-life depression (LLD) impacts about 2-5% of older adults (OAs) in the community (Steffens DC et al, Arch Gen Psychiatry 2000;57(6):601-7). ● However, in medical and skilled nursing settings, it occurs in up to 25%. So, always screen patients for it in these locations. ● The diagnosis is often missed because it’s seen as an “understandable reaction to getting-old” or it’s misdiagnosed as anxiety. ● Depressive symptoms in OAs, which don’t full criteria for MDD, can result in similar disability as full depressive episodes and may still warrant treatment.

The process from when a psychiatrist orders medication in an Electronic Health Record (EHR) to when it arrives at the nursing station is complex and involves multiple steps. Understanding this process, including medication reconciliation, can help you ensure more efficient care and minimize delays in medication administration.

● Monitor for neuropsychiatric complications: HIV can affect the nervous system, leading to cognitive impairments, mood disorders, and psychotic disorders. ● Assess adherence to antiretroviral therapy (ART): Non-adherence can lead to treatment failure and the development of resistant HIV strains. ● Address psychiatric comorbidities: Patients with HIV are at increased risk for depression, anxiety, and substance use disorders. ● Evaluate psychotropic medications: Consider the potential interactions between psychotropic medications and ART

Providing patients with resources as they transition from inpatient psychiatric units to outpatient care is vital for their continued support and recovery. Here are several valuable national resources: