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The importance of feedback and communication strategies with older adults: therapeutic and ethical considerations

Nancy A. Pachana, Natasha S. Squelch and Helen Paton

in Casebook of clinical geropsychology

Published on behalf of Oxford University Press

Published in print September 2010 | ISBN: 9780199583553
Published online February 2013 | e-ISBN: 9780191754678 | DOI: http://dx.doi.org/10.1093/med/9780199583553.003.0010
The importance of feedback and communication strategies with older adults: therapeutic and ethical considerations

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The aging of the population, well established in developed countries and beginning to be felt now in the developing world, is a well-recognized phenomenon (UN Department of Economic and Social Affairs Population Division, 2007). The practice implications for health professionals interacting with older clients are starting to be more widely discussed (Laidlaw & Pachana, 2009). Older adults themselves are increasingly aware of the effects of aging on their health. In particular, health professionals and older adults are increasingly cognizant of the possibility that memory or other cognitive and behavioral changes may signal the presence of a health concern which warrants investigation. Part of this investigation may include referral to a neuropsychologist.

Neuropsychologists are called upon to evaluate older adults in a wide range of settings. The client himself or herself, a family member, other health professionals, legal professionals, health care, and residential care agencies all may wish to avail themselves of neuropsychological testing. Some common referrals for neuropsychological testing might include establishing a differential diagnosis between dementia and another psychiatric condition such as anxiety, evaluation of financial or health decision-making capacity, or ascertainment of service needs within a rehabilitation or long-term care setting. In nearly all cases, these individuals would expect to get some sort of feedback about the performance of the individual, an interpretation of the data in terms of diagnosis or intervention strategies, as well as the possibility that further referrals are warranted.

It would seem obvious that the neuropsychologist should understand how to give feedback, particularly to older clients who may have some anxieties about having their cognition evaluated. Just as psychotherapy interventions should be guided by empirical research, so too therapeutic and ethical aspects of giving neuropsychological feedback have a small but growing literature. In this chapter, we aim to introduce concepts guiding therapeutic, collaborative, and ethical feedback and recommendations to individuals, families, and organizations.

Chapter.  11406 words. 

Subjects: Psychiatry ; Geriatric Medicine

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