How a Geropsychiatrist Helps Older Adults

May is Mental Health Month, a reminder that mental health is essential to everyone’s overall health and well-being, and that mental illnesses are common and treatable.

At Windward, we’re happy to be able to offer our aging clients – especially those living with dementia – the expertise of Dr. Raisa Yagudayeva, a geropsychiatrist. It can take months to get an appointment with a psychiatrist – much too long for someone in distress. Thankfully, Windward clients have quick, direct access to Dr. Yagudayeva, one of a small number of psychiatrists nationwide who specialize in treating older adults.

We asked Dr. Yagudayeva to explain her work.

Q: What does a geropsychiatrist do?

A geriatric psychiatrist or geropsychiatrist is a physician who has specialized in psychiatry and then obtained further training in the form of a geriatric psychiatry fellowship, obtaining two board certifications.

Dr. Raisa Yagudayeva
Dr. Raisa Yagudayeva

There is an advantage in having specialized care by a geriatric psychiatrist who has the expertise in both the biological and psychological changes that occur with aging. They often work in tandem with a neurologist to evaluate, diagnose and treat the psychiatric manifestations of dementia.

Q: What drew you to this profession?

My closest mentor once told me that those who are drawn to geriatric work tend to have a strong relationship with a grandparent. This was especially true in my case, as I am extremely close with my maternal grandmother, who resides overseas.

The contrast between my grandmother’s resiliency and the frailty we often see in other older adults really caught my attention. One example of her resiliency was when she was undergoing treatment for thyroid cancer in her late 70s – it did not slow her down from caring for her sister-in-law with dementia or from her full-time job. This inspired me to help others recognize their own resiliency in moments of suffering or crisis.

Another aspect that drew me to this profession was getting the opportunity to work with the entire family unit.

Q: What issues do you see most often affecting older adults’ mental health?

The issue that most often comes up for older adults is that of loss. This can range from loss of a loved one to loss of independence due to physical disability.

Q: What activities can boost mental health in older adults?

Research suggests that moderate physical activity, cognitive stimulation (board games, crossword puzzles, card games), diet and nutrition, social engagement and positive psychological traits (optimism, resiliency, adaptation) can help boost mental health in older adults. Spirituality and practices such as meditation have also been shown to lead to positive psychological functioning in older adults.

Q: How has the pandemic affected the mental health of older adults and their family caregivers?

There is an overwhelming body of data that suggests older adults have higher life satisfaction due to their resiliency, wisdom and ability to cope with various life situations. There may be groups of older adults at greater risk of experiencing loneliness due to isolation and other untoward effects of this pandemic. However, various studies suggest that older adults are not disproportionately experiencing negative effects from the pandemic due to a number of protective factors.

Q: Experts agree that behavioral approaches should be attempted first when addressing behavior concerns in people living with dementia. When is medication necessary or appropriate for someone with dementia?

Medications for behavioral symptoms associated with dementia – such as mood changes and sleep disturbances – are typically the last resort. When other interventions have failed a medication trial may be initiated to help with some of these behaviors. Pharmacological intervention may be of benefit in advanced stages of dementia, where a fear may develop which causes the patient to either harm themselves or others.

Q: In addition to consulting with Windward Life Care clients, you are also the Medical Director of Windward Home Health. How can licensed home health RNs help patients living with chronic mental health concerns?

Licensed home health RNs are the backbone of Windward Home Health. Since they see the patient in their home environment, the RNs can guide the team in understanding the patient’s current needs and then creating a successful care plan. The RN can track the patient’s compliance with their medications, watch for acute changes in the patient such as side effects, provide healthcare literacy education, and most of all support the patient in time of need.

Q: What do you enjoy in your spare time?

I really enjoy spending time with my family and friends, especially hosting dinner parties – at a time when we could. Our family really enjoys spending time outdoors, whether it is at the beach or at the park with the little one and our dog. They truly are inseparable.