SAFETY AND DIGNITY IN OLDER ADULT MENTAL HEALTHCARE - EMBEDDING GERONTOLOGICAL INNOVATION IN PRACTICE - Research article

Sep 28, 2026

Uploaded by Rowan

Older adults increasingly need age-friendly outpatient and community mental healthcare, yet depression and anxiety are highly prevalent in later life while few clinicians receive gerontological training. Limited workforce gerontology expertise reduces both quality and safety, and evidence-based approaches such as CBT and reminiscence therapy remain underused. Innovation risks are illustrated by ketamine expansion with sparse geriatric literature and notable adverse outcomes, including dissociation, hypertension, sedation, fall risk, and delirium. A proposed evidence-based Gerontological Mental Health Framework integrates CBT, reminiscence therapy, psychoeducation, and caregiver support, delivered through interdisciplinary, developmentally informed team care to strengthen outpatient services.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages1

Reading Time3 min

AccessFree to download

Safety and dignity in older adult mental healthcare

Need for age-friendly outpatient services

Gaps in gerontological training and workforce capacity

Innovation vs evidence: ketamine concerns

Proposed Gerontological Mental Health Framework

1146 Innovation in Aging, 2025, Vol. 9, No. S2 groups. Interdisciplinary staffing, including geropsychiatrists, gerontologists, social workers, and caregiver peer facilitators, ensures developmentally informed, team-based care. This scalable framework addresses geropsychology, offering strategies to strengthen outpatient mental health services. Abstract citation ID: igaf122.3842 SAFETY AND DIGNITY IN OLDER ADULT MENTAL HEALTHCARE: EMBEDDING GERONTOLOGICAL INNOVATION IN PRACTICE Kristine Lee1, and Katarina Friberg-Felsted2, 1. University of Utah College of Nursing, Cedar Hills, Utah, United States, 2. University of Utah, Salt Lake City, Utah, United States The growing demographic of older adults calls for urgent considerations for age-friendly outpatient and community mental health services on their behalf. Rates of depression and anxiety are high in later life, yet few clinicians receive gerontological training. This lack of expertise undermines quality and safety. Although cognitive behavioral therapy (CBT) and reminiscence therapy are effective in older populations, they remain underutilized. Workforce shortages intensify these gaps: fewer than 4% of psychologists and 2% of social workers pursue advanced training in gerontology. The expansion of ketamine for treatment-resistant depression and anxiety illustrates the risks of innovation outpacing evidence. While FDA-approved for adults with depression under strict REMS monitoring, the scientific literature regarding ketamine use in older adults is minimal. Published data consist primarily of case reports and one small pilot study in mild cognitive impairment; there are no randomized controlled trials in Alzheimer’s disease, dementia syndromes, or residential care populations. Known adverse effects—dissociation, hypertension, sedation, increased fall risk, and delirium are particularly concerning. In the absence of gerontological expertise, off-label use in outpatient or assisted-living settings risks compromising patient safety. This project proposesan evidence-based framework for outpatient mental health care in aging populations. Drawing on Erikson’s psychosocial theory, Butler’s life review model, and Pearlin’s stress process model, the Gerontological Mental Health Framework integrates CBT, reminiscence therapy, psychoeducation, and caregiver support

FAQs

Why is gerontological training important for older adult mental healthcare?

Depression and anxiety are common in later life, but few clinicians receive gerontological training. This expertise gap undermines quality and patient safety.

What limits the use of CBT and reminiscence therapy in older adults?

Although CBT and reminiscence therapy are effective, they are underutilized. Workforce shortages and limited advanced gerontology training contribute to these gaps.

What safety concerns are associated with ketamine use in older adults?

Known risks include dissociation, hypertension, sedation, increased fall risk, and delirium. The literature for older adults remains minimal, especially without randomized controlled trials in key dementia-related populations.

Sep 28, 2026

Uploaded by Rowan