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We are looking for a second fellowship-trained Geriatrician to join our amazing rural Upstate New York community.
Supplements & Special Projects
Psychiatry Rounds
Delayed Occurrence of Psychosis in an Older Patient with Temporal Lobe Epilepsy
Case Presentation
Mrs. J is a 68-year-old divorced African-American woman with a history of depression and a seizure disorder who was admitted from the Emergency Department in the middle of the night to a geropsychiatry inpatient unit for treatment of increasing anxiety, religious and somatic preoccupation, paranoid delusions, and auditory hallucinations. She has no children and has been living alone in an apartment. Her only relatives in the area are a sister who has problems with drug addiction and was recently incarcerated and a brother. Her main social supports are mem
Reversible Dementia as a Result of Herbal Supplements and Medications
Case Presentation
Mrs. S is a 72-year-old widowed woman who is brought to the Emergency Department (ED) by her daughter. Mrs. S’s daughter, Mrs. B, returned from a 6-month stay in Europe and found her mother to be weak, pale, and confused. Mrs. B tells the ED staff that her mother has always taken a number of herbal and nutritional supplements in addition to medications for “indigestion.” Mrs. S has been followed in the past by a primary care physician but has not had any regular medical care since her doctor retired two years earlier. Her daughter brought a numb
Do-Not-Resuscitate Orders: When the Patient and Family Disagree
Case Presentation
Mrs. S is an 83-year-old widowed woman who presented to her primary care physician with complaints of difficulty swallowing. She was found to have an enlarged thyroid gland. The patient was referred to an otolaryngologist who performed a fine needle aspiration of the mass. Mrs. S was diagnosed with poorly differentiated thyroid carcinoma and underwent a thyroidectomy. At the time of surgery, the cancer was found to be invading both her trachea and esophagus. After excision of the tumor, Mrs. S recovered enough to swallow most foods and
Medication-Related Cognitive Impairments in the Elderly
Series Editor: Melinda S. Lantz, MD
Dr. Iwuagwu is Assistant Professor of Medicine, and Dr. Steiner is Assistant Professor, College of Medicine, University of Toledo, Health Sciences Campus, Toledo, OH; and Dr. Raji is Associate Professor, Director of Memory Loss Clinic and Medical Director of the Acute Care for the Elderly (ACE) Unit, Sealy Center on Aging, Department of Internal Medicine, University of Texas Medical Branch, Galveston.
Dr. Lantz is Chief of Geriatric Psychiatry, Beth Israel Medical Center, First Ave @ 16th Street #6K40, New York, NY 10003; (212) 420-2457; fax: (212) 844-7659; e-mail: mlantz@chpnet.org.
An Older Woman with Bipolar Disorder
Case Presentation
Ms. W is an 83-year-old unmarried white woman who is brought to the emergency room by members of her church. She has been hospitalized more than six times in the past two years due to episodes of mania. Her friends explain that Ms. W has been disruptive during church services, singing hymns during prayers and the minister’s sermon. They have tried to help encourage her to take her medications, but she insists that she is fine. Ms. W attends the church-affiliated senior center daily, where she eats meals and socializes. She i
A Case of Probable Shared Psychotic Disorder in a Pair of Older Identical Twins
Case Presentation
Mrs. G, a 76-year-old woman with a history of depression and anxiety, was admitted to an inpatient psychiatric unit after reporting a new onset of psychotic symptoms for one month. She was being treated as an outpatient prior to admission with sertraline 100 mg daily and alprazolam 0.5 mg twice a day for approximately 10 years for depression with anxiety, and was at her normal state of mental well-being until one month prior to admission. At that time, her identical twin sister, Ms. T, moved in with the patient and her husban
Adjustment Disorders in the Older Adult
Dr. Lantz is Chief of Geriatric Psychiatry, Beth Israel Medical Center, First Ave @ 16th Street #6K40, New York, NY 10003; (212) 420-2457; fax: (212) 844-7659; e-mail: mlantz@chpnet.org.
Case Presentation
Mrs. D is a 72-year-old widowed woman who was referred for psychiatric evaluation by her primary care physician, Dr. B. Mrs. D is a retired school librarian who worked until three months ago, when her school district had to downsize the
Tourette’s Syndrome and Tic Disorders in Older Adults
Case Presentation
Mr. H is a 66-year-old widowed male who is referred to a psychiatrist by his primary care physician, Dr. D, due to an increase in tic-like movements with occasional verbal outbursts of curse words and noises. Mr. H has worked at an outdoor newsstand for more than 40 years. Since the death of his wife from cancer two years earlier, he has been working double shifts, sometimes spending 16 hours a day at the newsstand.
Dr. D reports that the tics and verbal outbursts have increased over the past
Somatization Disorder: When the Patient Has Multiple Medical Problems and Ongoing Somatic Complaints
Case Presentation
The patient, Ms. C, is a 68-year-old unmarried white woman who presents to the emergency room (ER) with complaints of shortness of breath. She is well known to the hospital staff due to her frequent visits and because she was employed as a nursing assistant there for more than 30 years. Ms. C is a long-time smoker who suffers from chronic obstructive pulmonary disease (COPD). In addition, she has a diagnosis of hypothyroidism and underwent a lumpectom
Mild Cognitive Impairment Presenting as Agitation and Aggression
Case Presentation
Mr. V is an 84-year-old male who came to the Geriatric Psychiatry outpatient clinic accompanied by his female partner of 18 years, Ms. Y. Both Mr. V and Ms. Y reported that over the past three years he has suffered from progressively worsening anger issues and mild memory problems, which had intensified more over the past year. Mr. V was raised in a traditional Orthodox Jewish community. According to the patient, he agreed to see a psychiatrist because Ms. Y ha
Clinical Geriatrics Blogs
Coming in Future Issues of Clinical Geriatrics
Series: Diabetes in the Elderly
Series: Cancer in Older Adults
First Report® Conference Coverage: American Academy of Neurology, American Diabetes Association, 2010 Digestive Disease Week
Assessment and Classification of Pain in the Elderly Patient
Pharmacologic Management of Pain in Older Patients
Miscellaneous Pain Syndromes in Older Adults
Nonhernia Causes of Inguinal Pain in the Elderly
