The Role of the Geriatrician

As we age the frequency with which we will encounter physicians and other medical providers tends to increase. Along with increased frequency there are also special needs that arise that are related to the aging process. The following, from the American Geriatrics Society helps explain how the medical community is responding to the special needs of older adults.

Geriatrics and the Role of the Geriatrician

Geriatrics is the branch of medicine that focuses on health promotion and the prevention and treatment of disease and disability in later life.

A geriatrician is a medical doctor who is specially trained to prevent and manage the unique and, oftentimes, multiple health concerns of older adults. Older persons may react to illness and disease differently than younger adults. Geriatricians are able to treat older patients, manage multiple disease symptoms, and develop care plans that address the special health care needs of older adults.

Generally, geriatricians are primary care physicians who are board-certified in either Family Practice or Internal Medicine and have also acquired the additional training necessary to obtain the Certificate of Added Qualifications in Geriatric Medicine. There are approximately 9,000 geriatricians in the U.S. In addition, there are several hundred osteopathic physicians (DO) certified in geriatrics, as well as some 2,400 board-certified geropsychiatrists (a psychiatrist trained to deal with the mental health needs and specific syndromes faced by older adults). Other health care professionals who work on a geriatrics team, such as nurses, pharmacists and physical therapists, may have advanced training and hold special certifications in geriatrics.

Geriatrics: The Team Approach

There are other trained health professionals who specialize in caring for older adults. In some situations, a team of health care professionals will work together in the medical evaluation of an older patient. The geriatrics team may include, in addition to the geriatrician, any or all of the following professionals:

• Geriatrician
• Nurse
• Social worker
• Nutritionist
• Physical therapist
• Occupational therapist
• Consultant pharmacist
• Geropsychiatrist

These specialists look at the person holistically. The team considers the person's medical history and present health condition. The team also looks for the effects of past illnesses, as well as "geriatric syndromes" - common health concerns found in the frail elderly such as incontinence, frequent falls, memory problems, and the side effects caused by multiple medications.

Members of the geriatrics team look at many aspects of the patient's life. They evaluate the social support available to a patient, usually a spouse, children or friends, and his or her living and community conditions. The team also considers the patient's ability to perform activities of daily living (ADLs), such as bathing, dressing and eating. While the geriatrician often serves as the "point person," each member of the geriatrics team is a skilled health professional. All play an important role in the proper assessment and care of an older patient.

Who Needs to See a Geriatrician?

People over the age of sixty-five have different degrees of disability and illness. Some have no problems at all, while others have many serious health concerns.

While primary care physicians - general internists and family physicians - care for most older persons, geriatricians are often sought to provide consultations for the frailest of older persons because of their unique qualifications and training. Geriatricians frequently provide the primary care for older adults who have complicated medical and social problems.

Regardless of an older person's age, a geriatrician should be consulted when:

• An older person's condition causes considerable impairment and frailty. These patients tend to be over the age of 75 and coping with a number of diseases and disabilities, including cognitive (mental) problems; or
• Family members and friends are feeling considerable stress and strain as caregivers.