Understanding Geriatric Behavioral Health: Overview and FAQ

By 2030, the number of aging Americans is expected to increase from 12% to 20% of the population. As this trend increases, so does the complexity of aging patients’ needs. If you operate a healthcare facility, you’re likely considering ways to prepare for our aging population. One way to do this is by partnering with a geriatric behavioral health specialist.

Considering the biopsychosocial needs of older individuals can help healthcare organizations improve patient health outcomes, satisfaction, and quality of life. In this article, we review the importance of addressing elderly behavioral health disparities and answer frequently asked questions from those looking to boost geriatric wellness within their organization.

Declining Elderly Behavioral Health: Risk Factors

Aging is a complex mental and emotional process. Older adults may experience physical or life changes that affect mental health. Experiencing the loss of loved ones — and facing the end of their own lives — places older adults at an increased risk for anxiety and depression. Other disease processes like Alzheimer’s cause memory, mood, and behavioral changes.

In addition to these challenges, elderly individuals often lack the support and community connections they had in their younger years. Whether they live independently or in a long-term care facility, these seniors tend to experience higher rates of loneliness, isolation, and neglect. Additional risk factors contributing to these mental health disorders include:

• Ageism
• Financial insecurity
• Decreased sense of purpose
• Declining physical health
• Frequently experiencing negative emotions like loss, grief, sadness

Frequently Asked Questions Surrounding Geriatric Behavioral Health

It’s essential that healthcare administrators provide these vulnerable patients with the services and resources they need to continue living robust and fulfilling lives. To do this, clinicians must be skilled at identifying signs and symptoms of declining mental health and should know how to initiate a psychiatry consultation for these individuals. Below, we answer frequently asked geriatric psychiatry questions and provide guidance to facilities looking to assist elderly patients in receiving the care they deserve.

What is geriatric psychiatry?

It can be hard for caregivers and providers to understand the complexity of an older adult’s mental health needs, or even how to respond to them. Providers with expertise in geriatric behavioral health consider the emotional, physical, and social needs of the older adult. They have the tools and experience to diagnose and treat mental health conditions an older adult may experience.

Who provides behavioral health treatment?

Practitioners who may provide geriatric mental health care include geriatric psychiatrists, psychologists, and nurse practitioners. A geriatric psychiatrist prevents, evaluates, diagnoses, and treats mental and emotional disorders in the elderly. They take into account the psychiatric disturbances of aging and the mental health effects of chronic conditions.

Common mental health disorders a geriatric psychiatrist may treat include:

• Dementia
• Depression
• Anxiety
• Bipolar disorder
• Later-life schizophrenia

A geriatric psychiatrist also considers someone’s overall health picture when managing mental health conditions. Many older adults have comorbidities that impact behavioral health, such as:

• Diabetes
• Heart disease
• Stroke
• Chronic pain
• Parkinson’s disease

Why is there a need for this service?

The American Association for Geriatric Psychiatry (AAGP) expects the number of older adults with mental illness to double to 15 million by 2030. The number of adults living with Alzheimer’s is expected to double to 13 million by 2060.

Geriatric mental health specialists have scientific knowledge about mental health and aging. Their specialized training considers the biopsychosocial needs of an older adult. Geriatric psychiatrists see patients in practice settings like:

• Hospitals
• Private practice
• Assisted living facilities
• Veteran care centers
• In-patient care centers

Depending on your location, you may have access to a geriatric behavioral health long-term care program that sees patients or residents at your facility. At a consultation visit, a geriatric psychiatric specialist may deliver services such as:

• Diagnostic assessments of mood disorders
• Decision-making assessments
• Grief counseling
• Family consultation
• Medication management
• Non-pharmacological behavior management

Do in-house doctors treat mental health conditions?

Most long-term care centers and acute care facilities have an in-house family medicine doctor called an attending physician. This individual oversees medical care for patients and residents, including medication management, cognitive therapies, testing, and more. Residents may also choose to continue seeing their primary family doctor to manage their care.

It’s common for family medicine doctors or nurse practitioners to manage mental health conditions. In fact, about two-thirds of depression cases are managed by primary care doctors. While family medicine doctors are well-prepared to treat mental health conditions, their ability to deliver targeted behavioral health therapy may be limited. A board-certified geriatric psychiatrist has the education and training to dive deeper into an older adult’s mental health needs.

What are the benefits of working with a geriatric psychiatrist?

Including an elderly behavioral health specialist on your multidisciplinary team has many benefits. Their expert clinical knowledge allows them to incorporate various interventions into a patient’s plan of care, including:

• An in-depth psychological evaluation to diagnose mild to moderate disorders.
• Medications to eliminate or reduce the severity of mental health disorder symptoms.
• Referrals to psychologists and therapists trained to counsel geriatric behavioral health patients.
• Education of patients and their caregivers on disease processes, side effects, and treatment options.
• Intervention at the earliest signs of emotional imbalance to prevent further neurological decline.

By employing these clinical care strategies, healthcare teams can customize their approach to a patient or resident’s care, which can drastically improve their quality of life. They can also help reduce the severity of symptoms associated with mental illness, helping individuals maintain close ties with community resources and support networks.

These treatments may also reduce the burden on families and direct care staff, who often experience caregiver strain. This can be a major relief at facilities with a high volume of residents with behavioral health challenges. When caregivers have a better understanding of their residents’ needs, their working relationship improves — and so does job satisfaction.

Where can I find a behavioral health specialist?

As a facility leader, you may be wondering how to find a geriatric psychiatrist to best serve your residents. Visit AAGP online to find geriatric psychiatry professionals in your area. You may also consider searching for a geriatric behavioral health long-term care service to visit your facility.

The Centers for Medicare and Medicaid Services (CMS) offers mental health services for older adults in qualifying Medicaid facilities. To qualify, a nursing home or long-term care facility must be considered an “Institution for Mental Diseases” (IMD). Check to see if your state offers a service called “IMD over 65” for Medicaid patients.

Looking for More Resources to Support Your Residents?

Offering services like geriatric behavioral health at your facility can help maximize patients’ quality of life. Now that you know the benefits of partnering with geriatric psychiatrists, you’re one step closer to providing individuals mental relief from the struggles of aging. Our IntelyCare newsletter can help you find additional healthcare insights and actionable tips for providing the best holistic, person-centered care possible.

IntelyCare writer Alexa Davidson, MSN, RN, contributed to the writing and research for this article.