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Psych CASC / OSCEOld age psychiatry — addiction interface

Psych CASC / OSCE · Old age psychiatry — addiction interface

Explain late-life alcohol and sleeping-tablet plan to patient and son — CASC communication station

MRCPsych/FRANZCP-style communication station: explain late-life substance harm, withdrawal safety, benzodiazepine deprescribing, alcohol supports, and check understanding without stigma.

communication2 min readVerification in progress

Target exams

FRANZCPMRCPsychABPNMD-DNB
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Study tools

Target exams

FRANZCPMRCPsychABPNMD-DNB
Prompt
A 71-year-old man with late-onset alcohol escalation and long-term temazepam use, and his adult son, want a plain-language explanation of why this is not 'normal ageing', why supervised withdrawal and thiamine matter, how a slow sleeping-tablet taper works, and what help looks like after discharge.

Station brief

Format. Communication station, approximately 7–10 minutes active time after reading. You are the psychiatry registrar on the old-age liaison service. [1]

Candidate instructions. Explain in plain language that alcohol and long-term sleeping tablets can cause serious harm in later life; address the son's worry that suggesting change means calling Dad an "alcoholic"; outline why stopping both suddenly in hospital is unsafe; describe a supervised plan including vitamins for brain protection, a slow temazepam reduction, alcohol supports and optional medication such as naltrexone; discuss mood and safety; check understanding. [1][2][4]

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References5ShowHide
  1. [1]Kuerbis A, Sacco P, Blazer DG, Moore AA Substance abuse among older adults Clin Geriatr Med, 2014.PMID 25037298
  2. [2]Soyka M Treatment of Benzodiazepine Dependence N Engl J Med, 2017.PMID 28614686
  3. [3]Tannenbaum C, Martin P, Tamblyn R, et al. Reduction of inappropriate benzodiazepine prescriptions among older adults through direct patient education: the EMPOWER cluster randomized trial JAMA Intern Med, 2014.PMID 24733354
  4. [4]Reus VI, Fochtmann LJ, Bukstein O, et al. The American Psychiatric Association Practice Guideline for the Pharmacological Treatment of Patients With Alcohol Use Disorder Am J Psychiatry, 2018.PMID 29301420
  5. [5]Conwell Y, Van Orden K, Caine ED Suicide in older adults Psychiatr Clin North Am, 2011.PMID 21536168
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