Geriatric Behavioral Health Questionnaire

Do you or someone you love exhibit any of the following?

Please print this page,place check marks on all that apply, then follow instructions below:

____Sad most of the day, nearly every day.
____Increased fears, anxiety or suspiciousness.
____Fatigue or loss of energy, nearly every day.
____Stopped taking prescription medications.
____Abandoning or losing interest in hobbies or other pleasureable pastimes.
____Change in daily hygiene habits (unkempt).
____Noticeable changes in personal environment.
____Marked personality change.
____Social withdrawal and isolation (reluctance to be with friends, engage in activities, or leave home).
____Unexplained physical ailments.
____Presence of hallucinations/hearing voices.
____Significant weight loss when not dieting or a significant decrease or increase in appetite.
____Sleep disturbances (difficulty falling asleep/staying asleep/oversleeping/ sleepiness).
____Loss of self-worth (worries about being a burden, feelings of worthlessness, self-loathing).
____Inability to think or concentrate, or indecisive, nearly every day.
____Increased use of alcohol or other drugs.
____Fixation on death; suicidal thoughts or attempts.

Tally your check marks.  If you have marked five or more characteristics, contact our community education director at Gottlieb’s Geriatric Behavioral Health Care Unit at 708/681-7893.

With treatment and support, seniors experiencing problems can feel better and enjoy life to its fullest.

You Are Not Alone

By 2020, depression will be second only to heart disease in its contribution to global disease burden.

An estimated one in five Americans suffer from depression.

Depression affects 6.5 million Americans age 65 years or older.

Community Help

A Caregiver’s Support Group meets every three months at Gottlieb Memorial Hospital for the benefit of the community. Led by the interdisciplinary team at the Geriatric Behavioral Health Care Unit, the support group offers the opportunity for those attending to express their concerns and challenges, exchange information with others as well as listen to a speaker on an appropriate subject.