Write an Initial PSYCH VISIT, chief complaint, , Psychiatric visit HPI, current Psych meds, exam, social history,, screening tools and results MSE, diagnosis and recommended Plan (medication and dosages), rationale for using the medications for 74 years old female referred to be seen for initial psychiatric visit because of PHQ 20/27 AND RESIDENT IS REPORTING A LOT OF STRESS FROM FAMILY SITUATION. SHE HAS INCREASED DEPRESive symptoms and anxiety symptoms and she is also on psychotropic meds. She has hx of depression and anxietyAssessment was done in the patient's room. She said she has fibroyagia and things got worse as she fell on Monday (06/06/2025) and hurt herself. Her speech was very anxious. She said she does not sleep well here because it is a new place and she does not have her c-pap. She said without good sleep, she has just been moody. She said she needs a new c-pap because the one she owns is old. She said she has used a c-pap for 30years. She said her anxiety has also increased because she can no longer go back to her sister's hpuse where she was previously living because the sister has some bad habits. She is stressed because she does not know where she will be going yet after discharge Current meds are Trazodone 150mg at HS (give 0.5 tablet), Duloxetine 60mg capsule, take 1 capsule daily, hydroxyzine 25mg every 12hours PRN FOR ANXIETY (stop date 6/23)