Biomaterial Database

Providing Mental Health Care for the Complex Older Veteran: Implications for Social Work Practice. 2018

Gayle Clark, and Susan Rouse, and Heather Spangler, and Jennifer Moye

Gayle Clark, LICSW, is social worker and director, and Susan Rouse, CNS, is psychiatric nurse clinical specialist, Geriatric Mental Health Outpatient Clinic, VA Boston Healthcare System, Brockton, MA. Heather Spangler, LICSW, is senior social worker, U.S. Department of Veterans Affairs, Washington, DC. Jennifer Moye, PhD, is associate director of education and evaluation, New England Geriatric Research Education and Clinical Center at the VA Boston Healthcare System and the Bedford VA Medical Center.

Mental health conditions are underdiagnosed and undertreated in older veterans, as with all older adults. Social workers bring an important perspective to the interdisciplinary team for the care of older veterans with mental health conditions. In this study authors assessed 50 older veterans referred for mental health treatment (mean age = 74.52 years, SD = 6.48) with standardized measures of depression, posttraumatic stress disorder (PTSD), and cognitive impairment. At initial assessment, 24 percent had moderate depression, 30 percent had PTSD, and 62 percent (n = 31) had (mostly mild) cognitive impairment based on cut scores. These conditions were often comorbid with each other and with social (60 percent), retirement (26 percent), bereavement (32 percent), and financial (36 percent) stressors. Depression improved after three months of treatment [t(30) = 2.12, p = .04], but those with comorbid PTSD or social stressors had more depressive symptoms at follow-up [R2 = .36, F(4, 26) = 3.57, p = .02]. Interdisciplinary care is essential to address the multiple comorbidities and practical complexities of geriatric mental health care. Social workers play a valuable role on the interprofessional team in addressing these complexities.

UI	MeSH Term	Description	Entries
D007400	Interprofessional Relations	The reciprocal interaction of two or more professional individuals.	Etiquette, Medical,Medical Etiquette,Relations, Interprofessional
D008297	Male		Males
D008605	Mental Health Services	Organized services to provide mental health care.	Mental Hygiene Services,Health Services, Mental,Services, Mental Health,Services, Mental Hygiene,Health Service, Mental,Hygiene Service, Mental,Hygiene Services, Mental,Mental Health Service,Mental Hygiene Service,Service, Mental Health,Service, Mental Hygiene
D009483	Neuropsychological Tests	Tests designed to assess neurological function associated with certain behaviors. They are used in diagnosing brain dysfunction or damage and central nervous system disorders or injury.	Aphasia Tests,Cognitive Test,Cognitive Testing,Cognitive Tests,Memory for Designs Test,Neuropsychological Testing,AX-CPT,Behavioral Assessment of Dysexecutive Syndrome,CANTAB,Cambridge Neuropsychological Test Automated Battery,Clock Test,Cognitive Function Scanner,Continuous Performance Task,Controlled Oral Word Association Test,Delis-Kaplan Executive Function System,Developmental Neuropsychological Assessment,Hooper Visual Organization Test,NEPSY,Neuropsychologic Tests,Neuropsychological Test,Paced Auditory Serial Addition Test,Repeatable Battery for the Assessment of Neuropsychological Status,Rey-Osterrieth Complex Figure,Symbol Digit Modalities Test,Test of Everyday Attention,Test, Neuropsychological,Tests, Neuropsychological,Tower of London Test,Neuropsychologic Test,Test, Cognitive,Testing, Cognitive,Testing, Neuropsychological,Tests, Cognitive
D003863	Depression	Depressive states usually of moderate intensity in contrast with MAJOR DEPRESSIVE DISORDER present in neurotic and psychotic disorders.	Depressive Symptoms,Emotional Depression,Depression, Emotional,Depressive Symptom,Symptom, Depressive
D005260	Female		Females
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368	Aged	A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available.	Elderly
D012947	Social Work	The use of community resources, individual case work, or group work to promote the adaptive capacities of individuals in relation to their social and economic environments. It includes social service agencies.	Service, Social,Social Intervention,Social Service,Social Service Intervention,Social Work Intervention,Intervention, Social,Intervention, Social Service,Intervention, Social Work,Interventions, Social Work,Service Intervention, Social,Services, Social,Social Interventions,Social Service Interventions,Social Services,Social Work Interventions,Work Intervention, Social
D013313	Stress Disorders, Post-Traumatic	A class of traumatic stress disorders with symptoms that last more than one month.	Moral Injury,Neuroses, Post-Traumatic,PTSD,Post Traumatic Stress Disorder,Post-Traumatic Stress Disorders,Acute Post-Traumatic Stress Disorder,Chronic Post-Traumatic Stress Disorder,Delayed Onset Post-Traumatic Stress Disorder,Neuroses, Posttraumatic,Posttraumatic Stress Disorders,Stress Disorder, Post Traumatic,Stress Disorders, Posttraumatic,Acute Post Traumatic Stress Disorder,Chronic Post Traumatic Stress Disorder,Delayed Onset Post Traumatic Stress Disorder,Injury, Moral,Moral Injuries,Neuroses, Post Traumatic,Post Traumatic Stress Disorders,Post-Traumatic Neuroses,Post-Traumatic Stress Disorder,Posttraumatic Neuroses,Posttraumatic Stress Disorder,Stress Disorder, Post-Traumatic,Stress Disorder, Posttraumatic