American Journal of Geriatric Psychiatry最新文献

{"title":"67. AN INVESTMENT IN CAREGIVER TECHNOLOGIES IS AN INVESTMENT IN WOMEN’S HEALTH","authors":"Rachel Sava ,&nbsp;Julia Golden ,&nbsp;Weronika Pasciak ,&nbsp;Julia Kimball ,&nbsp;Kozbi Bayne ,&nbsp;Ipsit Vahia","doi":"10.1016/j.jagp.2025.04.069","DOIUrl":"10.1016/j.jagp.2025.04.069","url":null,"abstract":"<div><h3>Introduction</h3><div>As the prevalence of dementia grows, the demand for caregivers concomitantly rises. In the U.S. alone, over 11 million people serve as unpaid dementia caregivers, and women represent a majority among them (Alzheimer’s Association, 2024) (Xiong, 2020). Research shows that female caregivers experience greater overall burden, impact on their lives, and depression as compared with their male counterparts (Pillemer, 2018). A recent surge in technologies that support dementia caregivers may offer tools to combat these ever-growing gender disparities. We review the breadth of tech-based approaches that can support caregiving in dementia and explore how they may alleviate caregiving burden for women.</div></div><div><h3>Methods</h3><div>Given the constantly evolving field of technology in dementia care, we employed an exploratory approach to capture a comprehensive range of emerging technologies. To capture the broadest range of technologies, we utilized a literature review, brainstorming sessions with an interdisciplinary team and experts in the field, and internet searching to identify relevant web-based resources. We then deconstructed the evidence to determine the types of technologies whose use is supported by evidence.</div></div><div><h3>Results</h3><div>We identified several categories of technologies that may help support female caregivers. They include: communication and tracking tools, transportation tools, interventions aimed at reducing caregiver loneliness, AI-driven monitoring systems, caregiver support platforms and task management apps, and interventions aimed at stress reduction for caregivers.</div></div><div><h3>Conclusions</h3><div>A growing arsenal of technologies exists to reduce caregiver burden and improve the quality of life for the patient-caregiver dyad. These technologies may be particularly important for female caregivers, who are disproportionately affected by the role. We advocate for investment in these technologies as a path to supporting women and reducing gender disparity in caregiving.</div></div>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 10","pages":"Page S49"},"PeriodicalIF":4.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"22. IMPACT OF MEDICAL STUDENT INTERACTIONS WITH GERIATRIC PSYCHIATRY OUTPATIENTS","authors":"Jamie Scott ,&nbsp;Bianca Barreto ,&nbsp;Madeline Lane ,&nbsp;Aninditha Vengassery ,&nbsp;Bienvenida Austria ,&nbsp;Heidi Kaminsky ,&nbsp;Blaine Greenwald","doi":"10.1016/j.jagp.2025.04.024","DOIUrl":"10.1016/j.jagp.2025.04.024","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;The burgeoning elderly population in the US has catalyzed attention to both healthcare and manpower challenges. For example, since recent reports indicate that loneliness and social isolation in older individuals range from 18% - 33% and are associated with a wide range of adverse health outcomes (including chronic diseases, mental health disorders, cognitive decline and increased mortality), these undesirable and at times painful psychological states have emerged as important psychosocial targets. However, despite the demographic imperative of aging, several reports indicate that interest in geriatric care amongst medical students is generally low, but that exposure to and positive experiences with older adults during education can improve such interest. To address these issues, a unique intergenerational program was developed linking medical students to socially isolated patients being treated in an academic geriatric psychiatry clinic.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A six-month program called SHIELD (Students Helping Isolated Elders) was launched in the Geriatric Psychiatry Clinic of Zucker Hillside Hospital/Northwell Health in April 2024. Medical students in a Psychiatry Interest Group at Northwell’s affiliated medical college (Zucker School of Medicine at Hofstra/Northwell) were solicited to participate in a friendly visitor volunteer program to non-demented patients with depression and/or anxiety diagnoses occurring in the context of social isolation and loneliness. Twenty patients and twenty medical students (ranging from 1st to 3rd year) were recruited and individual patient-student pairs then linked for in-person interactions. In addition to typical conversational exchanges, students were directed to encourage patient reminiscence, play board games, accompany patients to medical appointments, and act as patient advocates. Frequency of visit guidelines were set between once/week to once/month at a minimum. Qualitative impressions of the program and their interactions with students were solicited from participating patients. At six months, a 5-point Likert-like scale (5 being highest [i.e. most interested] rating) was sent to the medical students surveying pre- and post-program potential interest in careers in Psychiatry, Geriatric Psychiatry and Geriatric Medicine.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Three patients initially signed up for SHIELD but then changed their mind about participating; and another met with a student several times and then withdrew. Three students withdrew from the program citing time constraints and schedule conflicts. Qualitative feedback from patients were uniformly positive, with nearly all reporting that visits were happily anticipated and interactions rewarding. Fifteen of 17 students completed the survey. Pre-program, 33% of students were interested in pursuing a career in Psychiatry; 13% in Geriatric Psychiatry; and 20% in Geriatric Medicine. Post-program 73% of student","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 10","pages":"Pages S16-S17"},"PeriodicalIF":4.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"29. THE MAKING ENGAGEMENT MEANINGFUL THROUGH ORGANIZED ROUTINE INTERACTION (MEMORI) CORPS PROGRAM: A DESCRIPTIVE ANALYSIS OF PARTICIPANT SATISFACTION","authors":"Macy Young ,&nbsp;Cynthia Fields ,&nbsp;Quincy Samus ,&nbsp;Katherine Marx","doi":"10.1016/j.jagp.2025.04.031","DOIUrl":"10.1016/j.jagp.2025.04.031","url":null,"abstract":"<div><h3>Introduction</h3><div>Virtual companionship services that utilize volunteers to engage with community-living persons with dementia (PWD) may be a cost-effective and sustainable way to improve behavioral outcomes, quality of life, and reduce caregiver (CG) strain. However, there is limited evidence about acceptability, feasibility, and perceived benefits of such programs. This study evaluates satisfaction with MEMORI Corps, a 12-week virtual companionship and activity program, among PWD and CGs who participated in a pilot randomized controlled trial.</div></div><div><h3>Methods</h3><div>Online program satisfaction surveys were completed by CGs of PWD who received the intervention. Descriptive analysis was used to summarize 3 major domains: acceptability and feasibility of program components, perceived program impact on the PWD, and perceived program impact on the CG.</div></div><div><h3>Results</h3><div>Nearly 90% of CGs reported excellent/good feasibility and acceptability for all 22 program aspects. GREATER THAN 50% of CGs agreed with 8/11 perceived benefits the PWD received from the program. The greatest perceived benefits were that the PWD enjoyed the volunteer’s companionship and the activity sessions. ≥70% of CGs disagreed that the program made things worse, was distressing/upsetting, or was boring for the PWD. GREATER THAN 50% of CGs agreed with 13/16 perceived benefits personally received from the program. The greatest perceived benefits personally received were the happiness it brought CGs to see the PWD engaging with the volunteer and the time it allowed CGs for themselves.</div></div><div><h3>Conclusions</h3><div>CGs reported high satisfaction with MEMORI Corps overall. They also identified areas with lower satisfaction, including program orientation and knowing program expectations, which provide opportunities for enhancement.</div></div>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 10","pages":"Page S21"},"PeriodicalIF":4.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"65. POLYPHARMACY AND BEHAVIOR CHANGE IN THE GERIATRIC PSYCHIATRY POPULATION: A CLINICAL CASE AND REVIEW","authors":"Karen Richardson ,&nbsp;Laura Marrone","doi":"10.1016/j.jagp.2025.04.067","DOIUrl":"10.1016/j.jagp.2025.04.067","url":null,"abstract":"<div><h3>Introduction</h3><div>According to recent data, seven in ten older adults had used at least one prescription drug in the past thirty days and one in five older adults had used at least five prescription drugs. These numbers indicate that polypharmacy is already prevalent, and with the number of prescriptions written and filled increasing, the number of patients taking multiple medications will also likely increase. Taking multiple medications increases the risk of adverse interactions and side effects, especially in the geriatric population. This issue was highlighted by a case in which psychiatry was consulted. The patient was an 80 year old female with a history of major depressive disorder with psychotic features who was admitted to the medicine service due to behavioral concerns and severe sleep disturbance in the setting of polypharmacy and recent onset of urinary retention and constipation in the weeks following a psychiatric hospitalization but prior to outpatient psychiatry follow up. The patient was prescribed nine oral medications total, four of which were psychotropic medications. Over the admission, her medical issues were addressed and some of her medications were tapered with the goal of discontinuing. This case inspired the following literature review and summary examining polypharmacy in elderly patients with psychiatric conditions.</div></div><div><h3>Methods</h3><div>A chart review of the hospital electronic medical record was completed for this clinical case. A literature search was performed in PubMed including publications in the last 5 years using terms such as “geriatric,” “psychiatry,” and “polypharmacy” and then further reviewed for relevance to search terms and topic and excluded if non-contributory. Studies examining polypharmacy without prescriptions of psychotropics were excluded.</div></div><div><h3>Results</h3><div>Results are presented in a table format organized by topic outlining findings, current recommendations, areas for improvement, and possible solutions to help mitigate polypharmacy practices.</div></div><div><h3>Conclusions</h3><div>Polypharmacy in the elderly continues to be a significant issue, and implementation of evidence-based recommendations will help mitigate the negative impacts of unnecessary polypharmacy on health and wellness of geriatric psychiatry patient populations. Areas for future study and intervention are discussed.</div></div>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 10","pages":"Page S48"},"PeriodicalIF":4.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"5. VALBENAZINE TREATMENT FOR TARDIVE DYSKINESIA IN A 64-YEAR-OLD FEMALE PRESENTING WITH NONHEALING WOUNDS DUE TO TRUNCAL DYSKINESIA: A CASE REPORT","authors":"Luis Navazo ,&nbsp;Samera Taki ,&nbsp;Ava Bamdad ,&nbsp;Tim Ho ,&nbsp;Kira Aldrich ,&nbsp;Dawn Vanderhoef","doi":"10.1016/j.jagp.2025.04.008","DOIUrl":"10.1016/j.jagp.2025.04.008","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Tardive dyskinesia (TD) is a persistent and often debilitating hyperkinetic movement disorder associated with prolonged exposure to dopamine receptor blocking agents (DRBAs). Uncontrolled movements due to TD can cause additional burdens to patients, including difficulty swallowing and performing activities of daily living. Even in the approximately 25% of patients with TD who are unaware of their uncontrolled movements, quality of life for the patient, caregiver, and family can be negatively affected. Valbenazine is a highly selective vesicular monoamine transporter 2 (VMAT2) inhibitor, approved as a once-daily medication for the treatment of TD and chorea associated with Huntington’s Disease. In placebo-controlled trials and long-term studies, valbenazine has been shown to be safe and uniquely effective in treating TD. Here, we report the case of a patient who had severe wounds due to undiagnosed TD and was eventually treated with valbenazine for TD.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;N/A&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;In May 2022, a 64-year-old female patient presented with severe wounds on her lumbar spine. At presentation, the patient was taking 200 mg quetiapine, lowered from 300 mg two months prior, for type 1 bipolar disorder and had a GREATER THAN 10-year history of DRBA use. Standard of care wound treatment was initiated by her primary care provider; however, the wounds were not healing with repeated re-openings. In October 2022, assessment by a geriatrician and certified wound care specialist determined that the wounds were caused by sheer force from uncontrolled dyskinesia while sitting or lying in bed. Based on clinician assessment and medical history, the patient was diagnosed with TD. She was also evaluated using the Abnormal Involuntary Movement Scale (AIMS), a clinician-rated scale used to measure the severity of dyskinesia across 7 body regions. AIMS item scores range from 0 (“none”) to 4 (“severe”), and the AIMS total score (sum of items 1-7) range from 0 to 28. The patient had an AIMS total score of 12, with particularly severe movements in both the trunk (item score = 4) and lower extremities (item score = 4). The patient was resistant to her TD diagnosis, expressing a lack of awareness of her movements. She was provided a trial of 40 mg valbenazine samples to treat her TD, but did not take this medication due to her hesitancy/aversion to acknowledge the TD diagnosis. In April 2023 (6 months after TD diagnosis), the patient finally initiated treatment with 40 mg valbenazine. After assessment at 2 weeks, the patient had improved but was still experiencing uncontrolled movements, particularly in the trunk and lower extremities; thus, her valbenazine dose was increased to 60 mg. After 23 weeks of consistent treatment with valbenazine, the patient’s AIMS total score decreased by5points (AIMS total score=7), and she reported improvements in her daily functioning. The patient saw significant im","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 10","pages":"Page S4"},"PeriodicalIF":4.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144613894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"7. MEDICAL EMERGENCIES IN INPATIENT PSYCHIATRY: PREVALENCE OF MEDICAL TRANSFERS FROM INPATIENT PSYCHIATRIC UNITS AT AN ACADEMIC MEDICAL CENTER","authors":"Sungsu Lee ,&nbsp;Kirk Harris","doi":"10.1016/j.jagp.2025.04.010","DOIUrl":"10.1016/j.jagp.2025.04.010","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Patients with severe mental illnesses have high health utilization rates yet also have poor medical outcomes. There is some evidence to suggest that medical emergencies occur while a patient is admitted to an inpatient psychiatric unit, in the context of already poor baseline health status. As we care for older patients with medical comorbidities, there is potential that medical complexity may limit admissions to inpatient psychiatric units, posing concerns of ageism. Here, we examine the number of cases requiring transfer to inpatient medical units and the characteristics of those patients.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This was a retrospective chart review of the medical record at Strong Memorial Hospital. We reviewed the psychiatric admissions that took place from 2015-2023 and found patients that were discharged to a medical unit. We found the number of psychiatric admissions over the 8-year period and calculated the rate of transfers to inpatient medical units. We calculated the odds ratio of medical transfers based on patient characteristics, including admission to a geriatric unit, gender, length of stay, smoking status, race, and whether they required the use of restraints.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;From 2015-2023, there were a total of 12,496 inpatient psychiatric admissions at our hospital. Out of these admissions, a total of 307 patients required a transfer to an inpatient medicine unit. There was a noticeable shift in medical transfers that occurred during COVID, as around 8% of all patients admitted to the geriatric psychiatry unit from 2020 to 2022 required a transfer to the medical unit. Age over 65 had an OR of requiring a medical transfer of 4.79 [95%CI 3.73 6.15], admission to the geriatric unit had an OR of 2.58 [95%CI 2.03 3.30]. Black patients less likely to require a medical transfer with an OR of 0.51 [95%CI 0.38 0.70]. There were no statistically significant differences in the ORs for gender, length of stay, whether the patient required restraints.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;It is not surprising that the rate of medical transfers is higher from the geriatric psychiatric unit, given the increasing medical complexity with age. What is surprising is that black patients were half as likely to experience a medical transfer, though possible that there are confounders that we have not yet adjusted for, which is a limitation for this study at this phase and is the next area of work. The likelihood of medical transfers based on other characteristics, including lab results of psychiatrically admitted patients remains a work in progress. This work demonstrates that there are significant numbers of patients who are admitted psychiatrically who develop medical complications serious enough to warrant transfer to a medical unit. With a better characterization of these cases, these predictors could be utilized in triage when patients first present to the hospital to determine ","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 10","pages":"Pages S5-S6"},"PeriodicalIF":4.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144613897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"23. COULD A PHONECALL TO AN AI SIMPLIFY MEASUREMENT-BASED CARE FOR OLDER ADULTS: PROOF OF CONCEPT","authors":"Praveen Paritosh ,&nbsp;Ipsit Vahia","doi":"10.1016/j.jagp.2025.04.025","DOIUrl":"10.1016/j.jagp.2025.04.025","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;The value of measurement-based care (MBC) in psychiatry and primary care is well-established. Implementation of MBC frequently leverages digital approaches including apps or ecological momentary assessment. However, for older adults only have low digital literacy simplifying the process further may lead to more efficient collection of meaningful clinical data. Voice as a modality can offer several advantages over web or text interfaces for older adults: significantly improve accessibility, reduce cognitive load, and lower physical barriers. A completely hands-free, voice only interaction provides a high level of accessibility and independence for users. Thus, we tested the feasibility of connecting with an AI via a simple phone call, for mental health screening&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This work represents the first application of the 3rd Ear voice interviewing platform for building conversational agents that dynamically adapt their questioning to each patient’s responses. By focusing on interviewing rather than offering clinical judgment or recommendations, the platform minimizes the risks of AI hallucinations and bias. The platform orchestrates adaptive, goal-directed dialogue that aligns with established screening tools while unveiling a more nuanced understanding of the patient’s story.&lt;/div&gt;&lt;div&gt;Stacy is a phone-based bot built on the third ear platform. The bot is designed to administer the PHQ 9 via interview/conversation. for this initial proof of concept, we implemented two screening calls, conducted by the investigators.&lt;/div&gt;&lt;div&gt;After the user calls the phone, a neural network model transcribes their speech into text. This text is then analyzed for evidence of the depressive system in question and then the derived evidence is passed to the conversational engine, which then guides an open-source large language model to produce a response. This is finally passed to a state-of-the art text-to-speech system which then produces a voice response back on the phone call.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Our primary finding was that Stacy can successfully carry out the PHQ-9, ask for elaborations when needed to get more confidence, and fill out the paper form. A typical interview took 3-5 minutes, with an average latency of 1200 milli seconds, which is about 100 ms/question. The users reported minimal delay in voice response and smooth conversational flow. Notably, the users reported that when they interrupted the Stacy bot mid conversation, it was able to pivot comparably to a human.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Using phone based AI tools has the potential to simplify and improve the efficacy of measurement based care, particularly for older adults. Our proof of concept focused only on a single scale – the PHQ 9. However, this approach can be expanded to include multiple measures and has the potential to reduce cost while improving data collection by deploying a conversational/intervi","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 10","pages":"Page S17"},"PeriodicalIF":4.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144613980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"27. INTERNATIONAL HUMAN RIGHTS IN THE ELDERLY","authors":"Robert Kohn","doi":"10.1016/j.jagp.2025.04.029","DOIUrl":"10.1016/j.jagp.2025.04.029","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Attention to the mental health of the elderly and protection of their human rights is receiving increased attention internationally. In addition, how to manage the increasing burden posed by Alzheimer’s disease and related disorders has become an international priority. The COVID-19 pandemic has brought into the forefront the need to also consider protection in humanitarian emergencies.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;The current tools and mechanisms that protect the human rights of the elderly internationally are reviewed with a focus on mental health. The work of international commissions and reports with recommendations are examined. The state of human rights legislation in the Americas, Europe and Africa will be discussed. Examples of laws on human rights protection in specific countries such as India and China will be highlighted.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;On December 10, 1948 the General Assembly of the United Nations (UN) adopted resolution 217 A (III) The Universal Declaration of Human Rights. In the 1990’s the UN made a paradigm shift ethically and legally considering the elderly as bearers of rights rather than a vulnerable group requiring protection. The UN does not, however, have a specific treaty or convention regarding human rights of the elderly as part of its human rights system as is the case in relation to other specific groups. Office of the High Commissioner for Human Rights (OHCHR) has recognized this shortcoming, and its impact during the COVID-19 pandemic. In 1996 the Revised European Social Charter, Article 23, the Right of Elderly Persons to Social Protection to ensure the effective exercise of the right of elderly persons to social protection. The European Union has adopted the Charter of Fundamental Human Rights which includes respecting the rights of the elderly to lead a life of dignity and independence and to participate in social and cultural life. The African Charter on Human and Peoples' Rights has the distinction of being the only human rights treaty of its nature that embodies both civil and political as well as economic, social, and cultural rights in the same instrument. The aged and the disabled shall also have the right to special measures of protection in keeping with their physical or moral needs. Arguably, the Americas have gone further than any region in promoting the human rights of the elderly. On June 15, 2015 the OAS adopted the Inter-American Convention on Protecting the Human Rights of Older Persons. The most recent report on the progress of member states in its implementation was in 2022. How to manage the increasing burden of dementia has become a priority for many countries. Numerous countries have launched policies, plans, strategies or frameworks to improve the quality of life of those with dementia and their caregivers. The Alzheimer’s Disease International Kyoto Declaration, 2004 defined ten levels of action for countries to take.&lt;/div&gt;&lt;/div&gt;&lt;di","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 10","pages":"Pages S19-S20"},"PeriodicalIF":4.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144613995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"58. CONCEPTUALIZING TERMINAL DELIRIUM SUPERIMPOSED ON DEMENTIA: A SCOPING REVIEW","authors":"Andy Jan ,&nbsp;Jessica Declercq ,&nbsp;Sophia Wang ,&nbsp;Susan Maixner","doi":"10.1016/j.jagp.2025.04.060","DOIUrl":"10.1016/j.jagp.2025.04.060","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Terminal delirium is defined in the literature as persistent and intractable delirium present in the days, weeks, or months preceding death. This behavioral phenomenon is commonly recognized in palliative and hospice settings, with estimates that it affects between 25-85% of actively dying patients. Patients with delirium superimposed on dementia experience higher rates of mortality, longer hospital stays, increased risk of institutionalization, and accelerated cognitive and functional decline compared to patients with either condition alone. To the best of our knowledge (based on non-systematic literature reviews), terminal delirium is most often studied in cancer patients in palliative care settings. We hypothesize that less is known about terminal delirium in the context of dementia and other end-of-life conditions. The objective of our scoping review is to summarize the existing body of literature on terminal delirium superimposed on dementia and propose future directions for research.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Two health sciences librarians developed the search strategies and searched multiple databases (PsycInfo, Ovid Medline, Embase, CINAHL) in November 2024. The searches were based on a combination of keyword terms and controlled vocabulary related to Terminal Delirium or Terminal Restlessness. The searches were limited to 2013-present and English language. The librarians peer-reviewed each other’s searches and combined them into one search strategy per database. Duplicate articles between databases were removed using Covidence software (Veritas Health Innovation, 2022). Titles and abstracts were each independently reviewed by two researchers and discrepancies were resolved by a third researcher. Full texts were then independently reviewed by two researchers. Our review followed Preferred Reporting Items for Systematic Review and Meta-Analysis scoping review guidelines. Thematic analysis of studies that met inclusion criteria was performed.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The initial search by two health sciences librarians identified 2174 results across four databases. After removing duplicates, 1389 abstracts were screened for eligibility, with 309 studies remaining for full-text screening. Overall, 137 met inclusion criteria and were included in the final review. Studies included randomized controlled trials, observational studies with longitudinal or cross-sectional designs, review articles, and practice guidelines.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Thematic analysis revealed (1) Behavioral symptoms of terminal delirium superimposed on dementia (DSD) is linked to distress in patients, caregivers, and healthcare staff (2) Recognizing and diagnosing DSD is complex due to overlapping symptomatology and lack of validated screening tools (3) Balancing symptom management with minimizing psychotropic burden is an important but challenging aspect of treating DSD. Our review underscores kno","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 10","pages":"Page S43"},"PeriodicalIF":4.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"88. IMPLICATIONS OF INSTITUTIONALIZATION ON THE MENTAL HEALTH OF OLDER ADULTS: CASE-BASED ILLUSTRATIONS","authors":"Helen Kim ,&nbsp;Abyson Kalladanthyil ,&nbsp;Arooj Latif","doi":"10.1016/j.jagp.2025.04.090","DOIUrl":"10.1016/j.jagp.2025.04.090","url":null,"abstract":"<div><h3>Introduction</h3><div>Through this case series, we explore the implications of institutionalization on the mental health and well-being of older adults. Literature suggests this transition can create feelings of isolation, loss of independence, and other mental and physiological symptoms.</div></div><div><h3>Methods</h3><div>We conducted a retrospective chart review to explore the experiences of older adults who were identified by Cooper University Hospital faculty as having had extensive hospital stays due to unsecure disposition. This left them hospitalized until disposition was acquired. A literature review was conducted to explore the implications of this period of transition and subsequent institutionalization on the mental well-being of older adults.</div></div><div><h3>Results</h3><div>We identified seven older adults who had extensive hospital stays. This series includes patients whose hospitalization lengths range from two to ten months. Through our literature search we understood that Immediate institutionalization at the hospital while awaiting Long Term Care (LTC) placement for many months led to a loss of privacy and independence that likely made patients more vulnerable to feelings of stress, anxiety, and exacerbation of his depression. Increased risk of suicidal ideation can also present itself at the time of admission to the LTC. To mitigate the risk of suicide in older adults in LTC the following are some suggested ways to reduce the relocation stress for the residents of LTC: (1)Involving residents in decision-making (2) Adapting institutional routines to accommodate residents' preferences and practices (3) Assessing residents' adjustment and modifying the environment to enhance adjustment (4) Facilitating communication with residents' family and friends (5) Promoting residents' personal identity through productive activities and frank discussion about their relocation experience.</div></div><div><h3>Conclusions</h3><div>Through this case series, we discuss how older adults are mentally affected by the process of institutionalization. Older adults experience decreased independence and connection to loved ones. As institutionalization itself could increase mortality, we suspect that older adults with preexisting mental health conditions and prior suicide attempts have higher suicide risks. More extensive guidelines should be readily available for long-term care facilities to utilize to reduce relocation stress for older adults during their transition to institutionalization.</div></div>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 10","pages":"Page S66"},"PeriodicalIF":4.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}