I am an ST4 in old age psychiatry. In addition, I am also a dual General Adult Psychiatry Trainee.

Why I chose Old Age Psychiatry

Everyone discovers their love of old age differently. Old Age Psychiatry had been my favourite placement in Core Psychiatry Training – I’d enjoyed how complicated the drugs and interactions became with older people, coupled with the pragmatic and important end-of-life discussions. Old Age psychiatry allows you to work collaboratively and holistically with a broad range of professionals and draw on and develop your skills in psychiatry, general medicine and neurology.

Becoming a psychiatry trainee I had mistakenly thought I would leave my medicine behind…. but no! My old age placement made me realise that the wealth of knowledge I had acquired about the heart, kidneys, brain, and liver and were not wasted. In fact, it was needed more than ever in old age.

Life of an Old Age Higher Trainee

Being a higher trainee means that I have a lot of control about what I do, and I was encouraged to almost be ‘selfish’ in selecting the clinical experiences that I need.  I was also able to do a day a week as a ‘special interest’ and as long as your TPD is aware you can pretty much do whatever you want. I have chosen to do neurology and epilepsy clinic as my special interest day.

Our job in old age is about 50% dementia. It challenges me to be a more holistic doctor and I work constantly with other agencies and teams, which I appreciate, as we’re all on the same side: the patient’s.

After diagnosing dementia, I have to manage what happens next, and that is rarely simple. It’s so rewarding helping people when they are at their lowest, and old age psychiatrists like me work so closely with families, social services and other care agencies to try to get the best for my patients.

I love working with other specialties and agencies – it has challenged me to be a better doctor and better understand people in the context of the real world we live in. Practitioners have to be aware of the circumstances people live and thrive in, and work with our patients, their families and expectations to find the best solutions and outcomes for them.

The rest of my job is seeing patients who have all the same psychiatric disorders we see in other populations. They’re just older, so we have to better understand their bodies, medicines and interactions as well as the reality of a 90 year old taking 30 pills a day, which all have side effects. This often leads to truly frank and open discussions about extending life and the limits of all medicine.

I am constantly amazed by the lives of the patients I work with, their humour, their resilience and their capacity to grow and change, even into their 9th decade.