expert type icon EXPERT

Dr. Ashok Bharucha, MD

Geriatric Psychiatrist

Dr. Ashok Bharucha is a geriatric psychiatrist practicing in South Abington Township and Bloomsburg, PA. Dr. Bharucha specializes in the diagnosis and treatment of mental disorders, particularly in older adults. Patients who visit geriatric psychiatrists typically look for help with problems such as memory loss, depression, difficulty coping with change, stress, dementia, anxiety and more. Older adults may also experience emotional distress after being diagnosed with a disease as well. Dr. Bharucha helps patients after a comprehensive diagnostic exam so the root of their problems can be treated.
36 years Experience
Dr. Ashok Bharucha, MD
  • South Abington Twp, PA
  • Bucknell University
  • Accepting new patients

My grandmother lives in assisted living and is depressed?

The medical staff should evaluate her for depression and rule out medical issues or medication interactions that can mimic depression. Apathy - lack of motivation and drive - can READ MORE
The medical staff should evaluate her for depression and rule out medical issues or medication interactions that can mimic depression. Apathy - lack of motivation and drive - can also mimic depression. Once a proper diagnosis is made, increased socialization, light exercise such as regular walking, and possibly an antidepressant may be indicated. Ashok J Bharucha, MD, MA Phone: 844-647-1455 FAX: 877-511-8663 In the event of an emergency, email is not an appropriate form of communication. If you are in a crisis, please call 911 or proceed to your nearest emergency room. All pertinent practice policies are also available

What is most important in hospice and palliative care?

Like much of medicine these days, the quality of care really comes down not so much to credentials and skills but rather to the quality of engagement between the provider and the READ MORE
Like much of medicine these days, the quality of care really comes down not so much to credentials and skills but rather to the quality of engagement between the provider and the family, and the time spent getting to know the loved one's preferences and wishes. Often the best way to figure this out would be to speak with those who had experience with various agencies. I hope I understood your question correctly.

How to handle my husband's dementia?

This is a very broad question so my response is broad as well. There might be some shorter term goals and some longer term goals. Ideally, he needs to be evaluated by a neurologist READ MORE
This is a very broad question so my response is broad as well. There might be some shorter term goals and some longer term goals. Ideally, he needs to be evaluated by a neurologist or geriatric psychiatrist for proper diagnosis. He may benefit from low doses of an antipsychotic to reduce the paranoia. There are many online support, including the Alzheimers Association website, a behavioral management program called DICE is also available for training online, and the book, The 36 Hour Day offers a lot of practical wisdom on all aspects of care. Ashok J Bharucha, MD, MA Phone: 844-647-1455 FAX: 877-511-8663 In the event of an emergency, email is not an appropriate form of communication. If you are in a crisis, please call 911 or proceed to your nearest emergency room. All pertinent practice policies are also available

How do I manage my fear of death?

Let me recommend a very practical book. Its Irvin Yaloms Staring at the Sun. There are other sources out there but I find them more impractical. Ashok J Bharucha, MD, MA Phone: READ MORE
Let me recommend a very practical book. Its Irvin Yaloms Staring at the Sun. There are other sources out there but I find them more impractical. Ashok J Bharucha, MD, MA Phone: 844-647-1455 FAX: 877-511-8663 In the event of an emergency, email is not an appropriate form of communication. If you are in a crisis, please call 911 or proceed to your nearest emergency room. All pertinent practice policies are also available

How do you help seniors who are nearing death?

If the person is cognitively intact and able to express themselves verbally, they will be able to identify many of the ways in which you can help. If cognitively impaired, often READ MORE
If the person is cognitively intact and able to express themselves verbally, they will be able to identify many of the ways in which you can help. If cognitively impaired, often behavioral cues can suggest pain, fear, physical discomfort (constipation, dry mouth, dry eyes, difficulty clearing phlegm or mucus, etc.). Towards the very end of life, hospice involvement can be quite helpful with these physical symptoms as well as psychological symptoms such as worry, fear, sadness, etc. Clergy may often be involved during this phase as well, not only for the dying individual but also their families.

How can you tell the difference between Alzheimer's and dementia?

Dementia is just a general term for brain conditions that lead to progressive decline of thinking and functioning abilities. Alzheimers disease is one type of dementia but there READ MORE
Dementia is just a general term for brain conditions that lead to progressive decline of thinking and functioning abilities. Alzheimers disease is one type of dementia but there are many others such as Parkinsons dementia, etc. Ashok J Bharucha, MD, MA Phone: 844-647-1455 FAX: 877-511-8663 In the event of an emergency, email is not an appropriate form of communication. If you are in a crisis, please call 911 or proceed to your nearest emergency room. All pertinent practice policies are also available

What is sundowning in seniors?

Sundowning refers to the fact that older individuals, typically those who are diagnosed with dementia, become more fatigued, confused, and bewildered as the day progresses. The READ MORE
Sundowning refers to the fact that older individuals, typically those who are diagnosed with dementia, become more fatigued, confused, and bewildered as the day progresses. The individual can become more disoriented, restless, demanding, clingy, and possibly even aggressive, in the early to late afternoon. Although it was commonly believed that the problem arises later in the afternoon, more recent evidence suggests it may start even earlier, perhaps not long after lunch time. The factors leading to sundowning are likely multiple, but damage to their internal biological clock probably plays a major role.

Is hospice care best for an adult with advanced Alzheimer's?

It depends on the persons stated goals for care, lifelong values, preferences, etc. it is certainly true that at some point in the progression of the dementia, currently available READ MORE
It depends on the persons stated goals for care, lifelong values, preferences, etc. it is certainly true that at some point in the progression of the dementia, currently available treatments do not provide much benefit, and comfort oriented care may be best. There is also a lot of variability though in the quality of services provided by hospice. Ashok J Bharucha, MD, MA Phone: 844-647-1455 FAX: 877-511-8663 In the event of an emergency, email is not an appropriate form of communication. If you are in a crisis, please call 911 or proceed to your nearest emergency room. All pertinent practice policies are also available

Does forgetfulness in seniors mean dementia?

Not necessarily. There are age-related changes in cognitive functions such as memory. With aging, one may observe slower information processing speed, less efficient working memory READ MORE
Not necessarily. There are age-related changes in cognitive functions such as memory. With aging, one may observe slower information processing speed, less efficient working memory (ability to hold information in mind while executing a task, such as using a recipe while cooking), some visual changes in space and depth perception. Typically, someone with age-related memory decline is able to recall information spontaneously at a later point, or with some cueing. In Alzheimer's disease, for example, individuals fail to store new memories so that providing cues typically does not help them, i.e., the memory was never stored. Neuropsychological testing is helpful in determining the extent and pattern of cognitive changes. A diagnosis of dementia requires that there are functional losses such as inability to drive, problems managing finances, difficulty using household appliances, and in more advanced stages, difficulties with basic activities of daily living such as bathing, dressing, toileting, etc. In short, a diagnosis of dementia requires evidence of functional impairment.

What is the best treatment for gambling disorder?

Comprehensive treatment approach is required focusing primarily on behavioral interventions. As with Alcoholics Anonymous (AA), there are groups for those with gambling problems. READ MORE
Comprehensive treatment approach is required focusing primarily on behavioral interventions. As with Alcoholics Anonymous (AA), there are groups for those with gambling problems. Practical steps may need to be taken to not allow someone with gambling issues to have access to credit cards or debit cards. The amount allocated to them may need to be properly apportioned. In some cases, it might even be necessary to ensure that monthly bills are paid automatically before the person receives his/her paycheck. There are also resources to list someone with a gambling disorder with casinos so that they are not allowed to "play" there. Finally, in some instances, a serotonin antidepressant may be helpful in curbing compulsive behaviors, but these work best in the context of a comprehensive approach.

Is anti-anxiety medicine safe for seniors?

It depends on what you mean by anxiety medications. The benzodiazepines such as Xanax, Ativan, Klonopin or Valium should ideally be avoided due to high risk of falls, accidents READ MORE
It depends on what you mean by anxiety medications. The benzodiazepines such as Xanax, Ativan, Klonopin or Valium should ideally be avoided due to high risk of falls, accidents and cognitive impairment. First line medication treatment would be a serotonin antidepressant such as Zoloft or lexapro if medication is necessary. Ashok J Bharucha, MD, MA Phone: 844-647-1455 FAX: 877-511-8663 In the event of an emergency, email is not an appropriate form of communication. If you are in a crisis, please call 911 or proceed to your nearest emergency room. All pertinent practice policies are also available

What drug is commonly used to treat alcohol addiction?

There are several that are used. The most commonly used one is Naltrexone which comes in an oral formulation as well as a monthly injection. It does NOT reduce cravings but if READ MORE
There are several that are used. The most commonly used one is Naltrexone which comes in an oral formulation as well as a monthly injection. It does NOT reduce cravings but if someone does drink, they are less likely to spiral out of control because it blocks the rewarding effects of alcohol. Another one that is FDA-approved is acamprosate which has some evidence for reducing alcohol relapses. Both are modestly effective. Off-label medications such as topiramate and gabapentin are also used to assist with alcohol use disorder. AA and psychotherapy are very important parts of the treatment.

How to explain what's going on to someone with dementia?

I think it would depend on why she does not understand: (1) for example, does she just very quickly forget what you are telling her, (2) are her abilities to understand language READ MORE
I think it would depend on why she does not understand: (1) for example, does she just very quickly forget what you are telling her, (2) are her abilities to understand language seriously affected, (3) or as a result of dementia, is her thinking just more rigid. If the issue is primarily memory, sometimes writing somewhere clearly visible what day and time you will visit, as well as having a daily day/date on there could be helpful. Some individuals have given such individuals a written note stating this in their pocket so they are reminded whenever they check. For many individuals with dementia, anticipatory anxiety about future events is very troubling and sometimes it's best not to give them too much notice that they will then brood over. The Alzheimer's Association (Alz.org) has wonderful tips on communication skills that you may find helpful, as does the book The 36 Hour Day.

My mother feels depressed after being put into a nursing home?

Placement in a long term care facility is often a difficult transition. It also depends on whether dementia is involved. Generally speaking, trying to create structure and socialization READ MORE
Placement in a long term care facility is often a difficult transition. It also depends on whether dementia is involved. Generally speaking, trying to create structure and socialization in the new setting is helpful. Family visits, pet therapy, group activities, etc are important Bringing in favorite foods, photos, and other items that make the environment more homelike are helpful. If the sadness turns into clinical depression with major changes in sleep, appetite, energy, and suicidal thoughts, medical and psychiatric evaluation should be pursued. Ashok J Bharucha, MD, MA Phone: 844-647-1455 FAX: 877-511-8663 In the event of an emergency, email is not an appropriate form of communication. If you are in a crisis, please call 911 or proceed to your nearest emergency room. All pertinent practice policies are also available

Is it normal for a parent's illness to cause marriage problems?

As you know, pancreatic cancer is one of the most painful conditions and the course is often rapid. Hospice offers many benefits by way of pain and other symptom management, usually READ MORE
As you know, pancreatic cancer is one of the most painful conditions and the course is often rapid. Hospice offers many benefits by way of pain and other symptom management, usually far better than nonspecialists. Hospice care does not mean giving up on the person. It actually means a skilled person is assessing all of their needs, emotional, physical, and spiritual. Ashok J Bharucha, MD, MA Phone: 844-647-1455 FAX: 877-511-8663 In the event of an emergency, email is not an appropriate form of communication. If you are in a crisis, please call 911 or proceed to your nearest emergency room. All pertinent practice policies are also available

What does it mean when seniors "sundown"?

It refers to the observation that older individuals with dementia become more confused as the day progresses, particularly in the afternoon and evening. There are many factors READ MORE
It refers to the observation that older individuals with dementia become more confused as the day progresses, particularly in the afternoon and evening. There are many factors that may be at play: fatigue, ones internal biological clock is no longer in sync with actual time of day, being overstimulated by surroundings etc. Ashok J Bharucha, MD, MA Phone: 844-647-1455 FAX: 877-511-8663 In the event of an emergency, email is not an appropriate form of communication. If you are in a crisis, please call 911 or proceed to your nearest emergency room. All pertinent practice policies are also available

What are the benefits of hospice care?

Hospice has many benefits. Most importantly, their presence is a major source of support to the family. Hospice providers are trained to manage ALL symptoms that one might have READ MORE
Hospice has many benefits. Most importantly, their presence is a major source of support to the family. Hospice providers are trained to manage ALL symptoms that one might have to deal with at the end of life such as pain, depression, anxiety, fear, and many physical symptoms. Overall, I strongly recommend hospice care for those who may be within the last 6 months of their lives.

What can grandmother take for anxiety?

The first step would be a medical evaluation to rule out medical causes of anxiety such as thyroid problems, amongst many others. The list of issues that can result in anxiety READ MORE
The first step would be a medical evaluation to rule out medical causes of anxiety such as thyroid problems, amongst many others. The list of issues that can result in anxiety is very long, so ideally, an evaluation with a geriatric psychiatrist or a counselor who specializes in the care of older adults would be helpful. It's important to treat the causes of the symptom, and not just the symptom, to avoid complications. For example, individuals who are dementing often experience "abandonment anxiety" when left alone (out of sight, out of mind), even when you are just in another room.

Can you help with smoking addiction?

Yes there are medication and cognitive behavioral therapy options.

Is depression common among elders?

Depression is common especially as one moves from community settings to hospitals to longterm care. Late-life depression is certainly treatable but tends to be more brittle, requiring READ MORE
Depression is common especially as one moves from community settings to hospitals to longterm care. Late-life depression is certainly treatable but tends to be more brittle, requiring close monitoring.