CG CLASSIFIEDS
We are looking for a second fellowship-trained Geriatrician to join our amazing rural Upstate New York community.
Supplements & Special Projects
Psychiatry Rounds
A Case of Rapidly Progressive Dementia
CASE PRESENTATION
Mr. D, a 51-year-old married male, accompanied by his wife and two teenage children, comes to the office of Dr. H, an internist and primary care physician. Mr. D has not seen a physician in over 10 years. Mrs. D describes a 3-month history of “strange behavior” by her husband, including getting up in the middle of the night and going to his office and eating meals at odd hours (eg, insisting it is dinnertime in the morning). He has been forgetful, calls his two children by a variety of different names, and last week was found banging on his neighbor’s door, insisting
Schizoaffective Disorder: Challenges of Diagnosis and Treatment in Late Life
CASE PRESENTATION
Mr. M is a 70-year-old retired typesetter and father of two who was admitted to a psychiatric facility after an attempt to strangle his wife of 50 years. He is a devout Catholic and explained that a message from God convinced him that his wife intended to kill their granddaughter. In the past weeks, he had cluttered the home with religious shrines of candles, flowers, and photographs of religious figures. His wife’s protests only resulted in his mounting anger and accusations that her attention to his needs—both culinary and sexual—was flagging. He had been preoccupied
Decision-Making Capacity
CASE PRESENTATION
Mrs. G is a 76-year-old widowed woman admitted to the hospital due to abdominal pain and distension. She has lost 30 lbs over the past 6 months. Mrs. G had been the main caregiver for her husband, who died 3 months earlier after suffering from lymphoma for more than 5 years. She has two daughters who live in distant states, whom she last saw at their father’s funeral. Mrs. G has been living alone since the death of her husband. A neighbor has been visiting her and became concerned when she did not answer the door all day. The neighbor called the police to check on Mrs. G,
Serotonin Syndrome in the Older Adult
CASE PRESENTATION
Mrs. M is a 77-year-old married woman who was brought to the emergency room after her husband found her to be confused and diaphoretic. She has a prior history of a right middle cerebral artery stroke, with left hemiplegia 3 months ago. Mrs. M was diagnosed with depression while undergoing rehabilitation. She was able to regain ambulation with a walker and was discharged home 1 month ago. She has a history of hypertension, atrial fibrillation, osteoporosis, and gastroesophageal reflux disease (GERD). Her current medications include venlafaxine extended-release 150 mg daily
Is This Patient Demented and Delusional? The Importance of Language and Culture in Evaluation and Diagnosis
CASE PRESENTATION
A 66-year-old widowed male comes to a psychiatrist with his daughter, who acts as a translator and informant. The daughter and patient are concerned that he is “taking too many medications and not getting better.” They are worried about the medical care that he has received, and provide a very detailed history. The patient is a native of Brazil, who immigrated to the United States 40 years ago. He retired from his job as a construction worker at age 63 after being seriously injured at work, suffering a depressed skull fracture requiring insertion of a metal plate over h
A Case of Musical Hallucinations
CASE PRESENTATION
A 77-year-old divorced Caucasian man is referred for psychiatric evaluation by his neurologist for a history of new-onset auditory hallucinations. His symptoms consist entirely of well-formed musical hallucinations of songs, including “Tiny Bubbles,” “The Tennessee Waltz,” “Till We Meet Again,” “Amazing Grace,” and “The Star-Spangled Banner.” Many are songs that the patient has played when performing in a band or has heard in church. He saw a neurologist for an evaluation and underwent a magnetic resonance imaging (MRI) scan of the brain. An electroencep
Problematic Gambling
CASE PRESENTATION
Mrs. C is a 74-year-old retired woman who comes with her daughter to see Dr. A, her endocrinologist and primary care physician. Dr. A has cared for Mrs. C for the past 8 years, after she was hospitalized in a hyperosmolar state due to poorly controlled diabetes mellitus. Mrs. C had been recently widowed then, and had difficulty adjusting to life without her husband. Dr. A was gratified to see how well Mrs. C has functioned over the past 8 years. She became compliant with her medications and diet, joined a diabetes support group, and monitored her blood sugars carefully. She
Problematic Gambling
CASE PRESENTATION
Mrs. C is a 74-year-old retired woman who comes with her daughter to see Dr. A, her endocrinologist and primary care physician. Dr. A has cared for Mrs. C for the past 8 years, after she was hospitalized in a hyperosmolar state due to poorly controlled diabetes mellitus. Mrs. C had been recently widowed then, and had difficulty adjusting to life without her husband. Dr. A was gratified to see how well Mrs. C has functioned over the past 8 years. She became compliant with her medications and diet, joined a diabetes support group, and monitored her blood sugars carefully. She
Electroconvulsive Therapy in a Geriatric Heart Transplant Patient
CASE PRESENTATION
Mrs. K is a 77-year-old woman with multiple medical problems, including insulin-dependent diabetes mellitus, peripheral vascular disease, peptic ulcer disease, and hypertension. Her cardiac history is significant for idiopathic dilated cardiomyopathy that developed at the age of 55 years, leading to severe congestive heart failure (CHF). After a deteriorating course, Mrs. K underwent a heart transplant in 1991. She has a long but poorly described history of mental illness. She was hospitalized in the 1950s for a “nervous breakdown,” although no records were available, an
Diogenes Syndrome: When Self-Neglect is Nearly Life Threatening
CASE PRESENTATION
Ms. G is a 72-year-old, single white female who lives alone and has no children. She was visited by local mental health services at the request of her neighbors, who complained about an intolerable smell and flies coming from her apartment. On observation from the entrance, the apartment was grossly dirty with an offensive odor. The carpets were soaked with urine and moldy feces. Piles of garbage, each about 5 feet high, restricted the living space. There was no furniture in the house, no refrigerator, and among the garbage the only signs of nourishment were cracker wrappers
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
