Just as pediatricians provide specialized care to children, geriatricians provide specialized care to older adults. They understand that seniors respond differently to treatment and medicines than younger adults.
Geriatricians also know how to manage several conditions at once. This coordination of care is helpful because older patients are more likely to have many health issues.
Here are some of the main benefits that geriatricians provide.
What Is the Role of Geriatricians?
Geriatricians are doctors who are first trained in internal medicine or family medicine and then undergo additional training in geriatric medicine.
They have specific expertise in how to:
- Diagnose and treat diseases in older adults.
- Diagnose and treat geriatric syndromes (e.g., confusion, dementia, falls, incontinence).
- Best prescribe medications.
- Handle medical conditions when many are present at the same time.
- Deal with problems common at the end of life.
- Access and utilize the many types of support services available to older adults.
Geriatricians provide care in all settings, including offices, hospitals, homes and assisted living and skilled nursing facilities. They can provide consultations, co-management of patients with a primary care provider, or primary care.
The ‘Big Picture’ Approach to Your Health Care
Specialists who treat a single health problem in a patient don’t always see the big picture. In contrast, geriatricians think about all of the patient’s health conditions. Their focus is making connections.
Could poor sleep be what is worsening your diabetes? Is a drug to treat your depression pushing your blood pressure too high?
Geriatricians recognize the connections between various health problems and treatments. It helps them to prevent issues before they occur, or respond to issues when they’re at a treatable stage.
And by collaborating with a patient’s other health providers, geriatricians can ensure a more holistic approach to care.
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Less-Invasive Health Care
Younger people often do well with aggressive treatments. In older patients, the side effects of some medicines can outweigh their benefits. Likewise, the possibility of complications may outweigh the benefits of surgery.
For this reason, geriatricians often tend to decrease a patient’s medicines. They also look for alternatives to invasive treatments like surgeries.
Research shows this approach is highly effective. A 2018 review in the Journal of Geriatric Oncology found that older cancer patients improved with a geriatrician’s care. Those patients were more likely to complete treatment and less likely to suffer complications.
A 2017 review published in the journal Age and Aging showed similar findings. Older patients cared for by a geriatrician in the hospital had improved function, fewer complications, and shorter hospital stays.
Putting the Patient in the Driver’s Seat
As geriatricians get to know their patients, they talk to them about their goals for care. These conversations help geriatricians make decisions about which treatments to recommend.
Geriatricians may ask questions like: What activities do you want to continue doing? Do you prefer a treatment plan that prioritizes your quality of life?
Geriatrics doctors help their patients make informed choices. They talk to patients about what they can expect from treatments. As a result, patients get a treatment plan that matches their values, goals, and lifestyle.
Maintaining and Improving Quality of Life
Geriatricians take time to assess a patient’s living situation and understand their challenges. They may suggest an in-home caregiver to reduce stress and improve nutrition. They also can connect patients to social programs to prevent loneliness and cognitive decline.
Additionally, geriatricians can refer patients to pain management, exercise, and physiotherapy programs. Adding these specialists to the care team can help patients maintain or improve energy levels and mobility. These programs also promote independence in shopping or personal care needs.
Ensuring Appropriate Medicines
Older adults often have several medical conditions that need different medicines to treat. For example, muscle relaxants and allergy medicines can be dangerous for older adults. Geriatricians can help patients determine which drugs are necessary and which are not.
They also help patients avoid dangerous drug combinations which can lead to adverse drug reactions and hospitalizations. A 2018 study in Expert Opinion on Drug Safety found that 20% of hospitalizations caused by drug reactions were preventable.
At What Age Should You See A Geriatrician?
When geriatricians provide primary care, it is usually for medically complex or frail older adults. Their typical patient is over age 70. The most common things geriatricians evaluate include the person’s ability to carry on their activities of daily living, hearing, fecal and urinary continence, balance, and cognition.
What Is Included in a Geriatric Assessment?
The geriatric assessment involves a comprehensive evaluation of a patient’s health status by a multidisciplinary team. It usually is initiated when the doctor identifies a potential problem, and yields a more complete and relevant list of medical problems, functional problems, and psychosocial issues
A geriatric assessment can aid in the:
- Diagnosis of medical conditions.
- Development of treatment and follow-up plans.
- Coordination of management of care.
- Evaluation of long-term care needs and optimal placement.
According to the American Association of Family Practitioners, the assessment measures an older person’s functional ability, physical health, cognition and mental health, and socioenvironmental circumstances. Specific elements of physical health that are evaluated include nutrition, vision, hearing, fecal and urinary continence, and balance.
To connect with a geriatrician who can assist with your health care needs, call the Benedum Geriatric Center 412-692-4200 or the Senior Care Institute at 412-623-2700.
Editor's Note: This article was originally published on , and was last reviewed on .
Age Ageing. Effectiveness of in-hospital geriatric co-management: a systematic review and meta-analysis. Link
Expert Opinion on Drug Safety. Preventable ADRs leading to hospitalization — results of a long-term prospective safety study with 6,427 ADR cases focusing on elderly patients. Link
Journal of Geriatric Oncology. The effect of a geriatric evaluation on treatment decisions and outcome for older cancer patients – A systematic review. Link
Health in Aging. Medications work differently in older adults. American Geriatric Society. Link
University of Pittsburgh. Division of Geriatric Medicine. Link
UPMC. Division of Geriatrics. Link
UptoDate. Geriatric Health Maintenance. Link
UPMC geriatric medicine seeks to enhance the lives of older adults through clinical care and research. We are nationally recognized for our expertise; our multidisciplinary team specializes in care for seniors. We diagnose and treat a wide variety of conditions affecting seniors, including medical, physical, cognitive, psychological, and social. Our hope is to provide the best care in people’s later years. We can help on an inpatient or outpatient basis, for short-term or long-term conditions.