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Policy, Ethical, and Legal Issues

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Psychiatric Disorders Late in Life

Abstract

Physical and cognitive decline in old age often put the autonomy of older adults at risk. A comorbid mental illness is likely to further compound this problem, increasing their dependency on those around them. A key issue encountered in the clinical care of older adults is respecting their autonomy, while also ensuring their overall well-being. This chapter describes important ethical and medicolegal concepts relevant to the care of older adults. The first section of the chapter examines the role of a geriatric psychiatrist across health-care systems and models of care. The next section describes the commonly encountered task of assessing the decision-making capacity of older adults across domains of health care, finances, independent living, driving, and sexual relations. This is followed by a discussion of medicolegal issues germane to the older adult, which includes the concepts of advance care planning, surrogate decision-making, as well as the assessment and diagnosis of elder abuse. We will then review issues that relate to the elderly prisoner, namely, their care in the criminal justice system, as well as the assessment of criminal responsibility and competence to stand trial. The last section of the chapter is a description of treatment setting regulations in geriatric psychiatry, specifically the care of older adults in nursing homes.

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Authors and Affiliations

  1. Department of Psychiatry, Connecticut Valley Hospital, Middletown, CT, USA

    Aarti Gupta M.D.

  2. Department of Psychiatry, Yale Univeristy School of Medicine, New Haven, CT, USA

    Aarti Gupta M.D.

  3. Department of Psychiatry, New York University School of Medicine, New York, NY, USA

    Meera Balasubramaniam M.D., M.P.H.

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  1. Aarti Gupta M.D.
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  2. Meera Balasubramaniam M.D., M.P.H.
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Correspondence to Aarti Gupta M.D. .

Editor information

Editors and Affiliations

  1. Professor of Psychiatry, Case Western Reserve University School of Medicine, Vice Chairman for Education and Faculty Development, Residency Program Director and Chief of Geriatric Psychiatry, MetroHealth, Cleveland, Ohio, USA

    Rajesh R. Tampi

  2. Executive Vice President, Clinical Services, Diamond Healthcare, Richmond, Virginia, USA

    Deena J. Tampi

  3. Associate Clinical Professor of Psychiatry, University of Wisconsin School of Medicine and Public Health Program Director, Geriatric Psychiatry Fellowship, Madison, Wisconsin, USA

    Lisa L. Boyle

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Gupta, A., Balasubramaniam, M. (2018). Policy, Ethical, and Legal Issues. In: Tampi, R., Tampi, D., Boyle, L. (eds) Psychiatric Disorders Late in Life. Springer, Cham. https://doi.org/10.1007/978-3-319-73078-3_31

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