Assessing the Impact of COVID-19 on the Mental Health of Seniors 
Douglas Steenblock, MD, Iowa Veterans Home

The coronavirus pandemic created unprecedented challenges for mental health clinicians who treat older adults. This session will summarize recent data relating to the psychological effects of the pandemic as well as the neuropsychiatric sequelae of COVID-19. Telepsychiatry for older adults will also be discussed, including services in the home and in long-term care facilities.  

• Identify the psychological effects of the coronavirus pandemic with regard to older patients. 
• Discuss the neuropsychiatric sequelae of COVID-19 in the elderly. 
• Improve telepsychiatry services to geriatric patients. 

Non-Pharmacologic Interventions for Behavioral Difficulties in the Nursing Home
Lyn Hilgenberg, BA, CDCP, CSA, Daylily Consulting

The purpose of this session is to assist the care partners in appreciation of intended and unintended communication consequences. One of the most frequently asked question is, “Why do they do that?” This presentation discusses some of the most problematic situations that professional care teams deal with in dementia care. By isolating and understanding distressing behaviors, successful care planning is possible.

• Recognize behavior as a form of communication.
• Define the four primary problem-solving components for distressing dementia behavior.
• Apply practical solutions in coping with five of the most frequent distressing behaviors.

Stress in the Professional Caregiver
Kathleen Laurin, PhD, Broadlawns Medical Center

As medical professionals who work with older adults, we are well aware of the stress of caregiving. We look for it in the spouses and children of our patients and encourage self-care and planning for adequate support. Sometimes we forget, as professionals, we are also vulnerable. Burnout is not just a buzz word. It is real, and there is evidence that it is increasing. Caregivers of older adults are at risk. This presentation is designed to help us understand and recognize signs of burnout as well as to begin implementing strategies to avoid it. 

• Differentiate between stress and burnout.
• Discuss the significant risk of burnout to caregivers of older adults. 
• Identify strategies to increase meaning and connection in our work with the patients we serve.
• Develop an individualized plan to promote long-term personal wellness. 

Meditation and the Brain
Robert Bender, MD

• List benefits of meditation for providers and patients.
• Describe the predictable effects on the brain with regular meditation.
• Discuss techniques to practice and teach meditation.

Case Presentations with Expert Panelists
Adrianna Mitchell, MD, Broadlawns UnityPoint Psychiatry Residency Program
Kyle LeMasters, DO, Broadlawns UnityPoint Psychiatry Residency Program
Walter Mogeni, MBChB, Broadlawns UnityPoint Psychiatry Residency Program
Leonard S. Richards, DO, Broadlawns UnityPoint Psychiatry Residency Program (Moderator)

Panelists will review several psychiatric cases in elderly patients, including psychosis, dementia, and obsessive compulsive disorder.

• Discuss differential diagnosis for psychotic symptoms in the elderly.
• List reversible causes of dementia.
• Describe challenges associated with use of antipsychotics in elderly patients with neurocognitive disorders.
• Evaluate management of benzodiazepines in the geriatric population.
• Identify treatment options for Lewy body dementia.
• Recognize the role of the physical exam in mental health.

Substance Use Disorders and the Brain in the Geriatric Population
Michelle Davids, DO, Broadlawns Medical Center
Dhrumil Patel, MD, Broadlawns UnityPoint Psychiatry Residency Program

The current global pandemic has had an impact on persons with substance use disorders, including the geriatric population. Substance use disorders have the ability to negatively impact older adults and the neurobiology of addictions will be reviewed. 

• Define Substance Use Disorders.
• Describe ways in which to screen for substances use disorders in the geriatric population.
• List common substances of misuse and how they impact the brain.
• Discuss treatment of substance use disorders in the geriatric population.

Panel Discussion on Geriatric Psychiatry: Embracing the Challenge
Brenda Irlbeck, MSN, MBA, RN, Iowa Health Care Association
Paul Mulhausen, MD, FACP, AGSF, Iowa Total Care
Heather Thomas, LISW, CADC, Unity Point-Eyerly Ball Community Mental Health Services
C. Tyler VanMilligen, DO, MercyOne Psychiatry Residency
Robert Bender, MD (Moderator)
Douglas Steenblock, MD (Moderator)

This panel of local experts and leaders will discuss the delivery of mental health services to seniors in our region, including the obstacles and some potential solutions. 

• Identify obstacles that limit the access that older adults have to psychiatric care. 
• Discuss solutions that could improve the access to and quality of geriatric psychiatry services. 
• Formulate a comprehensive action plan to coordinate the resources needed to improve mental health care for seniors. 

Is It Parkinson’s or the Anti-Psychotic Medication?
Wendy Zadeh, MD, Broadlawns Medical Center
Paul Schroeder, MD, Broadlawns UnityPoint Psychiatry Residency Program

This session will provide a more fulsome understanding of the prevalence of abnormal movements (Parkinsonism) with antipsychotics and the choices we must make in deciding to use them.

• List which antipsychotics pose a risk of being a Parkinson’s mimicker.
• Describe options to consider if an antipsychotic drug is causing Parkinsonism.
• Demonstrate what abnormal movements look like with antipsychotic medications through example patient cases.

Functional Neurologic Syndromes
Robert Bender, MD

• Discuss typical patient presentation for functional neurologic syndromes.
• Describe the underlying neurologic pathophysiology of these disorders.
• List practical treatment interventions for these patients.

Electroconvulsive Therapy (ECT) in the Geriatric Patient
Lori Suvalsky, MD, VA Central Iowa Health Care System
Christopher Stefan, DO, Broadlawns UnityPoint Psychiatry Residency Program

Did you know ECT might be the safest option to offer your geriatric patients struggling with mental illness? You’d be surprised – come and hear what we have to tell you!

• Describe the history of ECT.
• Discuss the current theories of the mechanism of action of ECT.
• List medical and psychiatric considerations in choosing appropriate geriatric patients for treatment with ECT.
• Compare and contrast the differences in the work up of patients for ECT based on age.
• Describe the risks, benefits, alternatives, and complications of ECT in the geriatric population.

Neuropsychiatry of Diffuse Lewy Body Dementia & Parkinson’s Disease Dementia
Kiel Morris, DO, Broadlawns Medical Center

Lewy Body Disease is one of the most common dementia-causing conditions, but may be difficult to distinguish early in its course given the significant overlap with features of Alzheimer’s.  This session will discuss early and unique features of Lewy Body disease to provide tools for learners to more easily recognize the diagnosis. Treatments relevant to symptomatic features, including cognitive & psychiatric manifestations, will also be discussed.

• Define Lewy Body Disease and dementia.
• Explain underlying pathophysiology of Lewy Body Disease.
• Differentiate between Parkinson Dementia (PDD) and Lewy Body Dementia (DLB).
• Review key identifiable features that make PDD and DLB stand out.
• Discuss treatments for cognitive and psychiatric symptoms.

Anxiety in Older Patients
Rebecca Lundquist, MD, Broadlawns UnityPoint Psychiatry Residency Program
Tyler Zahrli, MD, MA, Broadlawns UnityPoint Psychiatry Residency Program

Anxiety disorders are not uncommon among geriatric patients and are underdiagnosed and managed, contributing to increased risk for this patient population. Additionally, the COVID-19 pandemic has likely contributed to and exacerbated anxiety disorders among older patients. This presentation reviews the prevalence, diagnosis, and appropriate treatment of anxiety in older patients as well as provides strategies for medication management. 

• Recognize the prevalence of anxiety among older patients.
• Review common anxiety disorders among elderly patients.
• Determine how to evaluate anxiety.
• Assess management options for older patients with anxiety.
• Evaluate challenging prescribing methodology.