I see a shocking amount of vaguely weak elderly folks with decreased appetite but nothing else particularly wrong in the ER. Holding a hand and asking the right questions with empathy will often elicit tales of the overwhelming sadness of loss or fear of their own end. Short 🧵
It is easy for us to spot the anxious or depressed youth, the histrionic middle aged person, the substance use disorders. But so often the mental health issues in our elderly are brushed aside, written off as a result of the chronically “dirty” urine that is asymptomatic… 2/
Maybe they are thrown on Zoloft, or given trazodone for sleep. They are encouraged to go to a nursing home. They bounce to and from the ER, their primary care, and back again, frustrated because all their labs are good, but they still feel like dogshit. 3/
Don’t forget, young (and older) docs- getting old isn’t for wimps. Loss doesn’t get easier with age. Watching your friends, spouse, siblings die is HARD. Loss of independence and long relentless days staring at your walls contemplating your mortality alone is HARD. 4/
Loneliness and recurrent bouts of grief are soul crushing. Be the doctor, the nurse, the tech that holds a hand, looks into their eyes and acknowledge their pain. SEE THEM. For they often feel forgotten, a burden, an afterthought. And often they are. 5/
Don’t write Xanax, Zoloft, seroquel or whatever and forget to refer to mental health professionals. The young don’t have a monopoly on this stuff. They just show it differently. You can’t fix the burdens that come with aging. But you can walk with them on their journey. 6/6
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