Moderator: Brian Wood, DO, DFAPA
Meredith Lee, DO, DFAPA and Chelsey Rountree, MD
At the recent PSV meeting I had the privilege of participating in the Geriatric Case Panel with colleagues Dr. Chelsey Rountree and Dr. Brian Wood. I presented a case of an aging female with dementia who resides in an assisted living community where I provide psychiatric consultation. The consult request was to assess her capacity to consent to a sexual relationship with another resident of the facility. In my presentation I discussed some of the models to assess capacity to consent to a sexual relationship, but also discussed the limitations and how there is no “gold standard” for this type of assessment in someone with cognitive impairment. I discussed the importance of balancing patient autonomy and patient preferences with patient safety. I also mentioned some myths and realities regarding aging and sexual health. Other factors discussed during this presentation include challenges seen in long-term care facilities when it comes to intimacy, and when it may be appropriate to collaborate with decision-makers. Thanks again for those of you who attended the panel and for the opportunity to present at this meeting.
Dr. Rountree spoke to a difficult case of anxiety in a geriatric patient. She considered multiple psychosocial complexities in the case, including the impact of lifelong experiences, social stigma, personality factors, and internalized ageism. She also spoke to the need for providers to be persistent in working with patients to participate in psychotherapy and/or pharmacological interventions for anxiety.
