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When does anxiety about leaving the home become problematic for older adults?



Advice from a Liaison Psychiatrist specialising in Older Adults

This information is sourced from Dr Jayati Das-Munshi, Consultant Liason Psychiatrist for Older Adults

Q. When does anxiety about leaving the home become problematic/meet criteria for social phobia?

A. I’d suggest that the GP take a broader history before making this diagnosis:

  • In particular screen for comorbid depression, alcohol use, cognitive impairment/ dementia.
  • Use screening tools to assist (eg. GDS (depression), AUDIT (alcohol), MMSE (cognition)
  • If possible speak to a carer or someone else who knows the patient well to get a longer term view (what was their function 6-12 months ago, are there other issues apparent indicating decline) and see the patient at home
  • Assess the situation prior to lock down

In short it is very unusual for a condition like this to suddenly appear in later life (although these are unprecedented times, and this is based on pre-lockdown evidence) but if concerns around comorbidities or risk (self neglect, suicidality etc), consider onward referral to CMHT

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