IMPACT OF BORDERLINE PERSONALITY-DISORDER IN LATE LIFE ON SYSTEMS OF CARE

Some symptoms that are bench-marks of borderline personality disorder in the younger patient-identity disturbance, impulsivity, self-mutilat ion, risk taking, and substance abuse-do not appear to define the diso rder in late life. However, changes in the environment or social conte xt of elderly persons may cause core symptoms to manifest differently. Identity disturbance in old age may be evidenced by an inability to f ormulate future plans or pursue goal-directed activities. Anorexia may be a substitute for more obvious forms of self-mutilation. Elderly pa tients with severe personality disorders may disrupt nursing homes and other service delivery systems. The authors suggest that staff who wo rk with these patients receive special training and that more research is needed to identify which symptoms of personality disorders are mai ntained into old age.