Pyschiatry aids people at all stages in life

Many adult children worry that a parent is showing signs of dementia, and many older adults have the same fears for themselves. As is so often the case in life, often a visit to the doctor can put an end to needless worrying — or open the door to early treatment that can change the course of someone’s life for the better. But it’s often difficult or even impossible to get a parent to the senior behavioral center at the hospital; and sometimes, those refusals become more adamant as the parent becomes less lucid. What recourse is there for a family member who genuinely wants to help?

"Sometimes," Mubbashar said delicately, "you have to call 911 and explain that you have an elderly person who is living alone and having memory problems, and the home is in a bad condition, or they are forgetting to take medications and not eating meals; and my mother or my father or my relative is very resistant to coming to the hospital for evaluation."

An ambulance can be sent. The patient can then undergo a full neuro-psychiatric evaluation (covered by Medicare) in the senior behavioral center.

"Such an evaluation would include a complete medical workup, carefully teasing apart the dementia from the depression and seeing if any underlying physical issues are masquerading as dementia," he said. "Sometimes simple things such as a liver failure or renal failure can present as dementia in the elderly.

"During the hospital stay, in addition to evaluation, the doctors and the hospital staff also assess for response to medication.

"And another significant piece of this includes finding an appropriate disposition plan for the patient."

If it’s determined that the person can not go home and live alone (even with a helper who comes in daily to check in, administer meds and perhaps cook a meal), then the hospital staff helps to make arrangements for the transition to a nursing home.

Although many children will blanche at the thought of taking such measures with a beloved relative, Mubbashar stresses that often it can be a matter of life or death.

"I saw a lady the other day who had been living alone," he recalled. "A neighbor was watching over her, and her children visited her every weekend. But she had apparently fainted and fallen, and was not found for two-and-a-half days. By then she had renal failure and extreme dehydration. So in that kind of situation, you might feel guilty for calling 911; but you might be saving a life.