Geriatric

Psychology
Renuka Muralidharan
Unit 2 The Elderly Patient

Section 01 Section 02 Section 03

Erikson’s Pre-retirement Interviewing the

stages of counseling and elderly
psychosocial social support
development
Erikson’s Stages of Psychosocial development

Erikson’s stages of psychosocial development are

motivated by the need to achieve competence in certain
areas of our lives. According to psychosocial theory, we
experience eight stages of development over our
lifespan, from infancy through late adulthood. At each
stage there is a crisis or task that we need to resolve.
Successful completion of each developmental task
results in a sense of competence and a healthy
personality. Failure to master these tasks leads to feelings
of inadequacy.
Stages of Psychosocial Development
Trust vs. Mistrust (Birth-12 months) Virtue: Hope

Autonomy vs. Shame/Doubt (1-3 years) Virtue: Will

Initiative vs. Guilt (3-6 years) Virtue: Purpose

Industry vs. Inferiority (6-12 years) Virtue: Skill

Identity vs. Role Confusion (12-20 Years) Virtue: Fidelity

Intimacy vs. Isolation (20- 40 years) Virtue: Love

Generativity vs. Stagnation (40- 65 years) Virtue: Care

Integrity vs. Despair (65 years-Till Death) Virtue: Wisdom

Pre- Retirement of Counseling & Social Support
• Late life is commonly a period of transition (Eg. Retirement) and
adjustment to losses.

• Retirement is the first major transition

• Effects differ from one individual to another.

• 1/3 of the elderly population have difficulty in adjusting to aspects

of retirement.

• Appropriate preparation and counselling for retirees and families

who experience difficulties may help.
The overall purpose of a course for people around 60 years old -
considering the transition from the early career into the senior
career – is to assist and guide the participants to find their very
own answers on the following questions:
 Who am I – now?
 What do I want?
 How do I get there?
 How do I sustain it – and give back?
Kick out old stereotypes on retirement
It’s difficult for many seniors to find their own senior career, before
they have kicked out traditional images of retirement. A good start is
to identify and discuss such old-fashioned images – breaking down
mental barriers before planning your own way.
Identifying core competencies
The best milestone on the way to your senior career is to identify
examples of ‘what you did when you were best’ from your whole life.
As a senior you now know who you have become, and what you want
and that you can do it. Then go for it – and find out how to get there.
Purpose and passion – with or without - a pay-check
Find a passion and you will never retire from that – sounds more easy
than it is. During the final exercises it’s important to emphasize, that at
this moment of history it is mostly a DIY (doing-it-yourself) job for
the new generations of seniors to find their new ways to meaning and
purpose - whether in paid or unpaid activities – where you can find a
purpose and meaning more significant than yourself.
When seniors, through intense dialogs with other committed seniors,
become more conscious of their own strengths, and are able to see
through stereotyped imprints and images of retirement and create new
ways to a meaningful and fulfilling life in third age - a majority of
seniors following the courses change plans and decide a life in active
ageing.
Interviewing the elderly
The clinical interview is frequently the first and often the only,
assessment method used by health and mental health professionals
when assessing older adults. It can serve multiple functions
including screening potential clients, examining mental status,
formulating the presenting problem, and establishing a diagnosis.

In psychological interview, the obvious difference in interviewing

elderly compared with other age group is that we should emphasis
more on the evaluation on scrutinizing cognition, since the
chances of finding impaired cognition are statistically higher in
older people.
In addition other challenges of working with this population
are explained further.
Logistical issues
The psychiatric interview begins when the patient contacts
over phone requesting for an interview. There are certain
preliminaries that has to be taken into consideration in
making the first face-to-face experience easier for the elderly
people.
 Transportation issues
 Informants
 Medical Documentation
Establishing Rapport
Asking a questioning in a nonthreatening way
 Normalization
 Symptom expectation
 Symptom exaggeration

Moving through the interview rapidly

 Closed ended questions
 Gentle interruption
 Point redirection
The history of present illness
 It is certainly important to obtain the history of the patient’s
chief complaints
 Excessive interview structuring threatens the rapport.
Mental status examination
 Cognitive component
 Appearance, mood, affect, speech and etc.
Dealing with families
 We need to rely on family informants to help us make our
diagnoses, especially disorders like dementia.
 Data obtained from family has greater diagnostic sensitivity
Thank You