Geriatric Mental Health Disaster and Emergency Preparedness

396 Appendix II Glossary of Terms Commonly Used in Geriatric Mental Health
that assessment to make a decision about the presence of a dementing
disorder.
Generalized Anxiety Disorder. Generalized anxiety disorder is a chronic
mental health condition that involves excessive, uncontrollable worries
accompanied by motor tension (shakiness, muscle tension, restlessness,
fatigue) and hypervigilance (diffi culty concentrating, insomnia,
irritability, and heightened startle response). Symptoms occur most
days for a minimum of 6 months.
Hypomania. An episode of illness that resembles mania, but is less intense
and less disabling. The state is characterized by a euphoric mood,
unrealistic optimism, increased speech and activity, and a decreased
need for sleep. For some, there is increased creativity, while others
evidence poor judgment and impaired function.
Incremental Validity. The notion that information from multiple, reliable
sources enhances the validity of the assessment.
Indigenous Workers. Crisis counselors who come from within the local
community, cultural, or ethnic group targeted for crisis counseling
services. They are members of, familiar to, and recognized by their
own communities. They may be spouses of community leaders, natural
leaders in their own right, or have nurturing roles in their communities.
Examples of indigenous workers may also include retired
persons, students, active community volunteers, and so forth. Indigenous
workers may or may not have formal training in counseling or
related professions; they may be paraprofessionals or professionals.
Indirect Costs. The expense of morbidity (the value of lost or reduced
productivity of a patient, an unpaid caretaker, or both) caused by illness
and mortality (the present value of future earnings lost because
of premature death from disease).
Initial Assessment (for Dementia). An evaluation conducted when the patient,
clinician, or someone close to the patient fi rst notices or mentions
symptoms that suggest the presence of a dementing disorder.
This evaluation includes a focused history, a focused physical examination
of mental status and function, and consideration of confounding
and comorbid conditions.
Instrumental Activities of Daily Living (IADLs). Complex, higher order
skills such as managing fi nances, using the telephone, driving a car,