My Blog

What in the World is a Geriatric Psychiatrist?

Welcome to my new blog, PositivelyAging!  I plan to blog about issues that impact the ability to age well both from my perspective as a geriatric psychiatrist as well as the daughter of two awesome 79 year old parents.

For my first post, however, I thought I would talk a little bit about what I do. I am a geriatric psychiatrist. Um, what is that? An older psychiatrist who is ready to be put out to pasture? Nope. A psychiatrist that has an extra comfy couch so that older patients can lie down and tell me about their mother (like the guy in the cartoon)? Also, nope (although I do enjoy comfortable furniture).

A geriatric psychiatrist is a psychiatrist that gets extra (1-2 years of subspecialty) training after residency in evaluating, diagnosing and treating the mental and cognitive health issues of later life like depression, anxiety and dementia. We manage patients with careful evaluation and assessment, medications, and psychotherapy (mostly focused on the here and now, and no lying on couches!). We maintain close linkage with other healthcare professionals, family and community resources. Our goal is to maximize quality of life and functionality for the older patient.

I chose this subspecialty for four main reasons. First, like many other geriatric psychiatrists, I had a very positive experience with an older adult growing up, my grandmother (YiaYia in Greek). At less than 5 feet tall, my YiaYia was the matriarch of the family and a repository of wisdom. Late in her life, after she had had a stroke, she also experienced depression and with treatment, was able to recover; this experience made a big impact on me. Second, I chose geriatric psychiatry because I loved the challenge of integrating the knowledge of psychiatry, neurology and medicine that is critical to understanding the mental and cognitive health problems of the older patient.  For example, depressive symptoms can be triggered by life events, stroke, medical issues like anemia and thyroid problems, and medication side effects. Each patient’s issues are different and present a puzzle for me to solve. Third, whether or not they have previously experienced mental or cognitive health issues, the common feature of older patients is a lifetime of accumulated experience. So with help, they can adapt to change and improve their function. And that leads me to the fourth reason, my patients are my best teachers. Because of that lifetime of experience, our treatment relationship is a two-way street. One of my strongest career memories to date was on September 11th, 2001.  I was in clinic that day and fear was in the air. My thoughts went to my children (aged four and one at the time), and I literally felt sick, thinking about what kind of world I had brought them into. As I brought my next patient back to my office, he must have picked up on this. Although he was there to get help from me, it was he who helped me that day. A veteran of WWII, he looked at me with a crinkly-eyed smile and said “Dr. Kales, our country has been through a lot, and we will get through this. I KNOW it.” And helping me with that comforting statement gave him a feeling of usefulness and purpose that made an impact on me as well. We all want to feel useful.

 

Here at University of Michigan, we have the unbelievable good fortune of having 10 geriatric psychiatrists on our faculty. There are only 1600 of us in the entire nation, and with an aging “tsunami” upon us, our mission is clear. We need to produce more geriatric psychiatrists and to train other providers to better manage the mental and cognitive health needs of older patients. That is a primary mission of the UM Program for Positive Aging.

 

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kales@umich.eduWhat in the World is a Geriatric Psychiatrist?

12 comments

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  • Lynn Holland - November 24, 2013 reply

    Love it Helen! I’m looking forward to reading your blog!
    Your mom and dad are fine examples of positive aging
    and it will be great to get a peek into “Helen’s World”!

  • kales@umich.edu - November 24, 2013 reply

    Thank you for the kind words Lynn! It was a leap out of my comfort zone to do this, but isn’t that what positive aging is all about!

  • Kadesha - November 24, 2013 reply

    Thank you Helen. Aging is a topic that we don’t read about as often as we should. I look forward to following your blog and possibly gaining a better understanding on how to address my own personal concerns about geriatrics and my family.

  • Joyce Kales - November 24, 2013 reply

    As one of the aging parents mentioned, I will look forward to the insights offered by our talented and dedicated daughter

  • kales@umich.edu - November 24, 2013 reply

    Thank you Kadesha! I look forward to discussing issues of aging and hearing from people what they are thinking about as well.

  • kales@umich.edu - November 24, 2013 reply

    Dr. Joyce Kales, you can also look forward to frequent shoutouts to you and dad in the blog. 🙂

  • rhea dane - November 25, 2013 reply

    Congratulations Helen. Looking forward to following your blog

  • kales@umich.edu - November 25, 2013 reply

    Thanks Rhea!

  • phyllis marusak - November 25, 2013 reply

    What a great blog….Yes, want to keep aware of all things to make this next chapter in our lives a Hey Wow!

  • kales@umich.edu - November 25, 2013 reply

    Phyllis–you have come up with something smashing. I love the idea of “hey wow!”!. We should aim that all of our chapters are such.

  • A Greek Christmas Carol | PositivelyAging - December 21, 2013 reply

    […] grandmother was an amazing woman.  I described her briefly in my first blog post, but that mention really didn’t do her justice.  Born in a tiny village in Northern Greece […]

  • “Bad to the Bone” or Broken Brain? - March 2, 2014 reply

    […] seek help from their doctor, starting with the PCP, and if needed, seek further referral to a geriatric psychiatry specialist .  A geriatric psychiatrist can give further help with behavioral/environmental interventions and […]

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