Lesson 1Documentation templates and medico-legal considerations for outpatient geriatric psychiatryExplores practical documentation structures for outpatient geriatric psychiatry, emphasizing clarity, risk documentation, capacity notes, informed consent, and medico-legal safeguards to reduce liability and support high-quality, defensible care.
Structuring the geriatric psychiatry noteDocumenting risk, capacity, and consentHandling late-life safeguarding concernsUse of templates and checklistsCommon medico-legal pitfallsCommunication with primary care and familyLesson 2Standardized screening tools: selection, administration, and scoringCovers choosing appropriate screening tools, correct administration, scoring, and interpretation, with attention to cultural, language, and sensory factors, and how to integrate results into diagnostic reasoning and ongoing clinical monitoring.
Selecting tools by clinical questionStandardized administration proceduresScoring rules and cutoffsAccounting for education and cultureTracking change over timeCommunicating results to patientsLesson 3Assessing activities of daily living (ADL) and instrumental ADL (IADL)Outlines practical methods to assess basic and instrumental activities of daily living, interpret functional decline, and link findings to diagnosis, risk, and care planning, including driving, finances, and medication management.
Core ADL domains and rating scalesKey IADL tasks in late lifeLinking function to cognition and moodAssessing driving and community safetyFinancial and medication managementUsing functional data in care plansLesson 4Interpreting Mini-Cog, Geriatric Depression Scale (GDS-15), and Montreal Cognitive Assessment (MoCA) resultsProvides stepwise guidance on administering and interpreting Mini-Cog, GDS-15, and MoCA, recognizing limitations, false positives and negatives, and how to integrate scores with clinical judgment and collateral information.
Administering the Mini-Cog correctlyUsing and scoring the GDS-15MoCA domains and scoring nuancesAdjusting for education and languagePatterns suggesting delirium or dementiaExplaining results to patients and familiesLesson 5Identifying atypical presentations: psychomotor slowing, apathy, and masked affectFocuses on recognizing atypical or subtle presentations of psychiatric illness in older adults, including psychomotor slowing, apathy, and masked affect, and differentiating these from normal aging, depression, dementia, and medication effects.
Clinical features of psychomotor slowingDistinguishing apathy from depressionMasked affect and cultural factorsMedication and neurological mimicsUse of collateral to clarify changesImplications for diagnosis and treatmentLesson 6Comprehensive history taking: psychiatric, medical, social, functional, and medication reviewDetails a structured, efficient approach to history taking in older adults, integrating psychiatric, medical, social, functional, and medication data, while managing time, cognitive impairment, and multiple informants in busy clinical settings.
Structuring the initial interviewEliciting psychiatric symptom historyMedical and neurological comorbiditiesSocial, family, and support contextFunctional status and role changesMedication and substance reviewLesson 7Assessment of sleep, appetite, weight change, and sensory deficitsReviews systematic assessment of sleep, appetite, weight change, and sensory deficits, highlighting their diagnostic value, links to mood and cognition, and practical strategies for history taking, measurement, and initial management planning.
Characterizing insomnia and hypersomniaAppetite and weight change patternsScreening for malnutrition and frailtyVision and hearing assessment basicsSleep, mood, and cognition linksWhen to refer for further evaluationLesson 8Focused physical and neurological exam elements for older adultsSummarizes focused physical and neurological exam elements most relevant to geriatric psychiatry, including gait, motor, sensory, and extrapyramidal signs, and how to document findings and decide when to seek further medical input.
Vital signs and general inspectionGait, balance, and falls assessmentScreening neurological examinationExtrapyramidal and tremor assessmentSigns of delirium and acute illnessWhen to refer to neurology or geriatricsLesson 9Collateral sources and interviewing caregivers: structured questions for daughters/partnersExplains how to obtain and integrate collateral information from caregivers, with structured question sets for daughters, partners, and others, while managing confidentiality, conflict, burden, and differing perspectives on the patient.
When and why collateral is essentialPreparing caregivers for the interviewStructured questions for daughtersStructured questions for partnersReconciling conflicting accountsAddressing caregiver burden and distress
