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Although ECT has traditionally been an inpatient treatment modality, a shift has occurred in recent years—much like the one that has occurred in the realm of surgical procedures—to offer it on an outpatient basis (American Psychiatric Association 2001). At present, inpatient ECT is reserved for situations in which 1) the patient's psychiatric illness itself requires an inpatient level of care or 2) such a level is required to ensure that ECT can be safely administered (e.g., for patients with high medical risk factors and no support system). These situations are particularly likely to occur with older adults. Even when inpatient treatments are initially required, consideration should be given to switching to an outpatient mode when it is clinically feasible.

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