Resources: Senior Health Issues at Hebrew SeniorLife

What is a Geriatrician

Geriatric medicine is a specialty that trains physicians to provide appropriate care for older adult patients. A geriatrician is a physician, usually trained in Internal Medicine or Family Medicine, who has additional training in geriatrics. To develop expertise in this field, physicians generally complete a fellowship, which is advanced training for one or more years and earn certification from the American Board of Physician Specialists.

Geriatric medicine generally focuses on people over 65 years of age. But the major focus is on older adults with multiple diseases and disabilities. These are often the most challenging medical patients, because they can’t be treated with a single intervention or drug, and every intervention carries additional risks that must be weighed against potential benefits.

Geriatrics doesn’t focus on a single organ or disease. The geriatrician is not a heart or kidney doctor, or a cancer or arthritis doctor. Instead, the geriatrician is a specialist in syndromes that affect elderly patients. These syndromes develop as the result of abnormalities in multiple organ systems. They include falls, urinary incontinence, confusion, physical decline, and depression. Geriatricians also are experts in diseases of old age such as Alzheimer’s Disease, Parkinson’s Disease, Prostate enlargement, osteoporosis, and hypertension.

The geriatrician is a well-rounded clinician with the ability to handle multiple interacting conditions, drugs, social situations, and psychological problems. The geriatrician understands how a patient’s social situation or physical condition might influence medical treatment. As examples; if a patient doesn’t have transportation, then keeping medical appointments is difficult; arthritis of the hands can make opening medication bottles a problem; and if a patient is confused, then following a treatment plan may be a challenge.

Geriatricians are more interested in preserving or improving physical and mental function than curing a disease. The goal of geriatric medicine is to allow elderly people to remain as independent as possible for as long as possible. Quality, not quantity of life becomes most important in old age.

Often quality of life can be improved by stopping (rather than starting) medications, promoting exercise or changing one’s living situation. The geriatrician needs to examine each person’s special characteristics, values and preferences to come up with appropriate recommendations. Sometimes, when a patient is severely disabled and approaching death, the most appropriate medical care is pain control, comfort, compassion, and family support.

In order to appropriately address all the medical, social, and psychological needs of older people, geriatricians work with teams of professionals, including nurses, social workers, therapists, nutritionists, and other consultants. 

The geriatrician does NOT attribute your problems to growing old.

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