Explain late-life bipolar mania and lithium plan to patient and son — CASC communication station

Open and agenda-set. Greet both; ask main worries first (kidneys, "zombie" sedation, stopping lithium forever). Name time available. [5]

Explain illness. "Bipolar disorder is a long-term mood condition with episodes of unusually high energy and reduced need for sleep — mania — and episodes of depression. It often starts earlier in life and continues into older age. The recent admission was a manic relapse: less sleep, racing ideas, risky decisions. As we age, medical problems and other tablets change how we treat it safely, but the illness itself still needs protection against relapse."[1][5]

Explain lithium. Lithium is one of the best proven long-term treatments to prevent mania and depression coming back, and it is one of the few medicines with good evidence for lowering suicide risk in mood disorders. In older adults we often aim for a somewhat lower blood level than in younger adults, and we check blood lithium levels, kidney function, thyroid, and calcium regularly. We are not ignoring kidney risk — we are monitoring it. If levels climb or kidneys change, we adjust the dose or reconsider the plan together.[2][3][4]

Safety rules. Avoid over-the-counter anti-inflammatories like ibuprofen unless a doctor agrees; use safer pain options. If vomiting, diarrhoea, or not drinking, contact us — dehydration can raise lithium. Warning signs of too much lithium include vomiting, shaky coarse tremor, unsteady walking, or confusion — seek urgent care and say you take lithium.[3]

Suicide safety. After mood episodes, low mood and hopeless thoughts can appear; tell us or emergency services the same day if death wishes or plans emerge. We will also talk about safe storage of medicines and any weapons at home.[6]

Close. Summarise, teach-back, written information, blood-test appointments, crisis contacts, invite questions. [5]