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Created by: Pamela Ho 10May2013 Geriatric Psychiatry Outreach Assessment, Consultation and Enablement (GRACE) Referral Form for GRACE Service Please ensure that ALL sections of the referral form are
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How to fill out geriatric psychiatry out-reach assessment

01
Start by gathering all necessary information and documents related to the patient, such as their medical history, previous psychiatric evaluations, and any relevant treatment plans.
02
Begin by filling out the patient's personal information, including their full name, date of birth, address, and contact information. This is important for identification and future communication.
03
Next, provide a brief overview of the patient's presenting problem or reason for seeking geriatric psychiatry out-reach assessment. Describe any symptoms, behaviors, or concerns that have led to the need for this assessment.
04
Use the assessment form to gather information about the patient's mental health history. This may include questions about previous psychiatric diagnoses, medications, hospitalizations, and any history of substance abuse or addiction.
05
Evaluate the patient's physical health and gather information about any medical conditions or medications they are currently taking. This is important as physical health can often impact mental health in older adults.
06
Assess the patient's cognitive functioning by asking questions related to their memory, attention, and problem-solving abilities. This can help identify any potential cognitive impairments or dementia-related issues.
07
Include a section where you document the patient's social history. This may involve questions about their living situation, relationships, support networks, and any recent life changes or losses.
08
Use standardized assessment tools or rating scales to measure the severity of specific symptoms or mental health conditions. This can provide a more objective measure of the patient's functioning and assist in diagnosis and treatment planning.
09
Summarize your findings from the assessment and provide a clinical impression or tentative diagnosis if appropriate. This should be based on the information gathered and any clinical judgment or expertise.
10
Finally, based on the assessment results, outline specific recommendations for further evaluation, treatment, or referrals. This may involve suggesting therapy, medication management, or additional diagnostic tests.
Who needs geriatric psychiatry out-reach assessment?
01
Older adults who are experiencing mental health symptoms or distress.
02
Individuals who may have complex medical and psychiatric conditions that require specialized evaluation and care.
03
Older adults who have difficulty accessing traditional mental health services due to physical limitations, transportation challenges, or other barriers.
04
Patients who have been referred by their primary care physician or other healthcare providers for comprehensive psychiatric assessment and treatment.
05
Family members or caregivers who have concerns about an older adult's mental health and well-being and want a thorough evaluation to determine appropriate interventions or treatment plans.
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What is geriatric psychiatry out-reach assessment?
Geriatric psychiatry out-reach assessment is a comprehensive evaluation and treatment plan for elderly individuals with mental health issues.
Who is required to file geriatric psychiatry out-reach assessment?
Healthcare professionals specializing in geriatric psychiatry are required to file geriatric psychiatry out-reach assessment.
How to fill out geriatric psychiatry out-reach assessment?
To fill out geriatric psychiatry out-reach assessment, healthcare professionals must conduct a thorough assessment of the patient's mental health and create a treatment plan.
What is the purpose of geriatric psychiatry out-reach assessment?
The purpose of geriatric psychiatry out-reach assessment is to provide specialized mental health care to elderly individuals and improve their overall well-being.
What information must be reported on geriatric psychiatry out-reach assessment?
Information such as patient's medical history, current mental health symptoms, any medications being taken, and treatment plan must be reported on geriatric psychiatry out-reach assessment.
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