Problem
A88is the father of four adult childreand the grandfather of five grandchildren. The patient lives with his older daughter and family. The patient's daughter is a medical doctor and attends the initial visit with him at the outpatient office today. His daughter is worried that he has given up. She has requested palliative care.
Chief Complaint: "My daughter is worried about me because I've seen my dead wife in my dreams. I miss my wife. We were married for 66 years. She died over a yearago. I should havedied first. I'm not sleeping well. I've lost ten pounds in the last year. I used to read the newspaper but after a few sentences, I had to stop. All I think about is being with Mavis. "
Past Psychiatric History: He has never been hospitalized or treated for any mental health condition in an outpatient setting. There is no history of suicide. He denies substance abuse and reports he has never taken drugs or alcohol. In the last six months, his PCP prescribed Ativan 0.25 mg at night to help him sleep.
Past Medical History: Colon cancer, anemia, and dynapenia.
Using the DSM 5 and course materials answer the following questions.
1) What diagnosis should you consider? Explain your clinical reasoning for this diagnosis? Include your differential diagnosis.
2) What labs will you order? What evidence-based screening tools will you consider?
3) Describe the components of a lethality assessment? Include in your plan of care the treatment and rationale?