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Mr. Peron was readmitted to the 7-North Inpatient Geriatric Psychiatry Unit on December 10, 2013. He was discharged home on December 12, 2013.

Mr. Peron is a married 85-year-old man who was admitted to the 7-North Geriatric Psychiatry Inpatient Unit under my care between December 3rd and December 6, 2013, with discharge diagnoses of major depressive disorder, mixed dementia, delirium, vitamin B12 deficiency, stroke complicated by delirium in 2011, anemia, remote shingles, bilateral total knee replacement with postoperative delirium in 2012, and chronic pain disorder due to psychological and general medical factors. Discharge medications included Cymbalta 30 mg q.a.m. and olanzapine 2.5 mg q. supper and 2.5 mg b.i.d. p.r.n. for agitation. Tylenol was discontinued by Dr. Yeung during the admission and the patient was advised to take extra strength Tylenol p.r.n. for his pain.

Mr. Peron's pain complaints improved significantly during his brief admission to hospital and, accordingly, Dr. Yeung advised that Tylenol No. 3 be discontinued given the adverse effects of codeine. Cymbalta 30 mg q.a.m. was prescribed for treatment of depression and pain, and olanzapine 2.5 mg q. supper and p.r.n. was prescribed for depression and agitation. Prior to admission, Mr. Peron had experienced significant suicidal ideation, and hopelessness. There was a history of an overdose one year ago with Emergency Room psychiatric assessment, but no other history of suicide attempts or psychiatric treatment. Mr. Peron scored 18/30 on the Mini-Mental State Examination during the admission.

Mr. Peron was discharged to the care of his wife on December 6, 2013 in improved and stable condition. It was recommended that medications be dispensed in a weekly blis...

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...th the family physician, Dr. Oded Fried in the next week for medical reassessment.
2. Mr. Peron will see me for psychiatric followup at the Seniors' Health Center on Monday, December 16th at 3:00 p.m.
3. Mr. Peron was referred to CCAC for mental health nurse visits at home and a long-term care application.
4. Mr. Peron has been referred to the Seniors' Health Center geriatric day hospital program.
5. Mr. Peron has been referred to the Mobile Crisis Service for discharge support.
6. Mrs. Peron will supervise Mr. Peron's medications which are in a blister pack system and a locked box will be used.
7. Mrs. Peron was provided information regarding supportive services such as a paid caregiver to stay with her husband when she is out of the home.
8. The dose of Cymbalta has been increased to 60 mg q.a.m. and Tylenol No. 3-1 tablet b.i.d. p.r.n. has been restarted.

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