Psychosis

Psychosis is characterized by hallucinations, delusions, and disordered thought processes, and can stem from an array of causes — from neurodegenerative conditions like Parkinson's or Alzheimer's disease to metabolic disturbances or reactions to medications.  

Key Elements for PALTC Providers

• Differential Diagnosis: The etiology of psychosis in older adults is diverse. Beyond primary psychiatric disorders like schizophrenia, consider delirium, neurodegenerative conditions, mood disorders, medication-induced syndromes, and metabolic disturbances.
• Therapeutic Implications: Antipsychotic medications, while valuable, come with potential side effects in older adults, including increased stroke risk and mortality. A judicious balance of benefits versus risks is essential.
• Environmental Factors: The PALTC environment itself, with unfamiliar surroundings and routines, can exacerbate or even precipitate psychotic symptoms in vulnerable individuals.

Strategies for Effective Management

• Comprehensive Assessment: Beyond the overt psychotic symptoms, a holistic assessment involving labs, neuroimaging, and a thorough medication review can pinpoint the root cause.
• Non-Pharmacological Interventions: Consider interventions such as environmental modifications, sensory aids, consistent staffing, and individualized behavioral strategies.
• Interdisciplinary Collaboration: An integrative approach, involving psychiatrists, psychologists, primary care providers, nurses, and occupational therapists, can craft a tailored care plan.