• Join us in Boston for our 4th conference!

    2018 GAPNA Pharmacology Conference:
    Contemporary Pharmacology and Prescribing in Older Adults

    March 16-17, 2018, Boston Park Plaza, Boston MA

    Earn up to 11.5 CNE hours

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  • Call for Abstracts:

    37th Annual GAPNA Conference
    September 26-29, 2018 in Washington, DC

    Research and Clinical Project Abstracts for Podium and Poster Presentation - due March 15, 2018
    Education Poster Abstracts - due March 15, 2018
    Student Poster Abstracts - due March 15, 2018

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  • Gerontology Resources for APRN Preceptors and Students ToolkitCareer Center

    The Education- and Toolkit Committees of GAPNA launched their 2017 revised “Gerontology Resources for APRN Preceptors and Students,” toolkit.

    The goal of this toolkit is to make geriatric and gerontological content accessible to those caring for older adults. It is designed with advanced practice registered nurse (APRN) students, preceptors, and educators in mind, and it provides a single portal to comprehensive resources.

    Learn more about the toolkit

  • Poster PresentationONLINE NOW:

    2017 GAPNA Conference Poster Presentations

    Note the latest trends in the care, education, and research of the older adult population.


    View the 2017 Poster Presentations

  • The GAPNA Clinical Resource Corner

    Designed Especially
    for the Gerontological Advanced Practice Registered Nurse

    With over 106+ categories, the short features/articles contain valuable information tailored especially for Gerontological APRN's that will help them with patients, as well as increase their knowledge of this field of nursing. All of the articles directly affect, involve, and impact the elderly.

    Go to the GAPNA Clinical Resource Corner

  • FREE continuing education credit is available for the following session:

    "Dermatology Emergencies"

    (session captured at the GAPNA 2016 Annual Conference)

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Psychosis in Older Adults

by Linda J. Keilman, DNP, GNP-BC, FAANP

Psychosis is the presence of delusions, disorganized thinking, disorganized or abnormal motor behavior, hallucinations, or negative symptoms (American Psychiatric Association, 2013).

Psychosis is a loss of connection to reality and is quite common in older adults, especially at the end of life or those living with dementia.

The etiology in older adults can also be related to a variety of conditions or diseases as well as prescribed or illicit drug use. Psychosis can be a primary diagnosis but 60% of the cases are secondary to neurologic or medical conditions (Morgan, 2017). Most often, the older adult will have changes in behavior before psychosis develops.

The APRN should be aware of the following early warning signs (National Institute of Mental Health, 2016):

  • Difficulty concentrating or thinking
  • Unease with others, suspiciousness, paranoid ideation
  • Disengagement/withdrawal
  • Apathy or hyperactivity with unfocused ideas or plans
  • Self-neglect related to hygiene and appearance
  • Difficulty differentiating fantasy from reality
  • Trouble communicating or confused speech

A thorough and careful history, along with a complete physical examination, should be implemented if older adult patients present with any of the above warning signs. Accurate assessment skills will help lead to early diagnosis and treatment of underlying conditions and prevention of psychosis.

Linda J. Keilman, DNP, GNP-BC, FAANP


  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
  • Morgan, S. (2017). Psychotic and bipolar disorders: Behavioral disorders in dementia. FP Essentials, 455, 18-22.
  • National Institute of Mental Health. (2016). Fact sheet: Early warning signs of psychosis. Bethesda, MD: National Institutes of Health.