Emergency psychiatry for the elderly

The complex presentation of the older patient in crisis places unusual demands on psychiatrists. The patients themselves may be unable or unwilling to seek psychiatric evaluation. For various reasons psychiatrists and other physicians may stereotype older patients and their problems. These problems are frequently complex and require sophistication on the part of the examiner. The psychiatrist's approach must be unhurried and flexible. The routine mental status examination must be expanded to include brief psychological testing. As the cases demonstrate, emergencies may present in unexpected contexts.