Why Do You Need to Visit A Geriatrician? Everything You Always Wanted To Find Out About Geriatrics

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A Geriatrician is still a new concept in India. Here’s an expert guide on how a why you should visit a Geriatrician and they manage the unique healthcare needs of older people.
Whenever a child seeks medical attention, he or she is taken to a pediatrician. That age group merits special attention. Looking at the other end of the spectrum are the elderly, who are heterogeneous and require a specific plan of care. This special care is given to them by a geriatrician or an elderly care specialist. People often wonder at why they should visit a geriatrician and what their role is.

A geriatrician is a doctor who is specially trained to evaluate and manage the unique healthcare needs and treatment preferences of older people. He/she usually works along with a nutritionist, physiotherapist and nurse to provide the best care that elders need.

How Do The Elderly Benefit from the Geriatrician/Elder Care Specialist?
Geriatricians always use a holistic approach to address the physical, psychological and social problems surrounding the patient and the family. They are experts in dealing with multiple medical problems and chronic illness. Their expertise also lies in working closely with other health care professionals and organizations in order to address the special needs of the older population. The emphasis is always on optimizing quality of life and functional independence. A geriatrician considers the patient and family to be key members of the health care team, and expects their contribution in the various decisions needed to be made.

They are particularly experienced in dealing with geriatric syndromes. A geriatric syndrome is defined as a multifactorial condition that involves the interaction between identifiable situation specific stressors and underlying age-related risk factors, resulting in damage across multiple organ systems. These include delirium (altered mental status), memory impairment, depression (low mood), incontinence (urinary and fecal), falls, immobility, pressure sores, frailty and malnutrition.

For example, if an older person has Diabetes, chances of the urinary infection are higher, and it can then lead to losing control over the passing of urine. When this happens, the elderly avoid going to public places, which might lead to a low depressed mood. An instance of urinary incontinence and the elderly slipping on it can cause a fall. In addition with constipation and lack of movement (immobility), the chances of pressure sore would increase. Ultimately this elderly with all these problems might just come with a single symptom of altered behavior, such as Delirium.

Who Would Benefit From Consulting a Geriatrician?
If you or a loved one is over the age of 60 and has one or more of the following conditions:
• Multiple medical problems
• Taking multiple medications
• Difficulty in performing routine activities
• A history of recurrent falls or a fear of falling
• Sleep problems
• Memory problems
• Difficulty in walking, imbalance, dizziness
• Recurrent urinary problems
• Constipation
• Weight loss, loss of appetite
• Constant pain
• Cancer and Palliation

Why Geriatrics Is Team Work
Geriatrics is known for its team approach in caring for older people and supporting their families and other caregivers. The Geriatrician will work with the other members of the team:
• Physical therapist
• Nutritionist
• Nurse
• Social worker

This would form the core team. Apart from this there would a complementary team which is drawn upon as needed such as, psychiatrist, occupational, speech and swallowing therapist, dentist, podiatrist. The other members of the team would vary depending upon the needs of the individual older person. The caregiver of the older person and the older person themselves are the most important members of the team. The focus is always on the preservation of function and improving the quality of life.
The team members take into consideration the older person’s medical, social, emotional, and other needs and formulate a care plan for that person. The person’s preferences and values are always taken into consideration in making the care plan. The team will focus on health concerns common in older people such as incontinence, falls, memory problems, and managing multiple chronic conditions and medications.

What is a Geriatric Assessment?
A geriatric assessment is the first step toward getting the care and treatment you need. It provides your Geriatrician with a base line, which is then used to monitor your progress. A geriatric assessment usually involves:
• A comprehensive medical history review
• A complete physical examination
• Medication assessment
• Cognitive testing
• Functional assessment
• Psychosocial assessment
• Vision and hearing tests
• A social worker evaluation
• Life style advice and diet and exercise programs
• Developing a personal care plan
• Comprehensive preventive care including vaccinations
• Consultations by specialists when required
• Comprehensive interdisciplinary inpatient care where required

What Should I Carry When Visiting A Geriatrician?
• Your detailed past medical history
• A list of your current medications
• Glasses prescription
• Hearing aid
• Dentures
• The names of the doctors who have been treating you
• Notes on your family health history

To sum it up, a Geriatrician always looks at an older person as a whole and would not want to miss any aspect of the elderly individual.

You may also like to read: Adverse Drug Reactions In Elders: What To Watch Out For

Insomnia In Senior Citizens: How To Sleep Well

About Author

Dr Naganath Narasimhan Prem

Dr Naganath Narasimhan Prem is MBBS, MD Geriatric Medicine and Consultant Geriatrician, Elderly Care Specialist at Jaslok Hospital and Research Center, Mumbai. He also heads the dedicated one of its kind Geriatric Care department at Jaslok Hospital and is passionate about spreading the word on the importance of geriatric care management and services for senior citizens.