What’s a Geriatric Specialist
July 16, 2018
If you’re involved in helping an older friend or loved one with the management of their health care, you’ve probably heard the term “geriatric care” or “geriatric specialist” at some point in the process. This is a special type of primary care doctor, also called a geriatrician, who handles the general care of an older patient. They may have a certification from the Board of the American Geriatrics Society or another professional organization.
Because older people have physiological difference than younger patients, they may require different treatment. While someone not well-trained in this physiology won’t know the difference between an illness and a sign of typical aging, a geriatric specialist would. They can factor lifestyle or health choices (such as whether someone smoke or drank) into their observations of how well organs are doing their job, for example, and what steps should be taken to treat or even prevent future illness.
Most older patients are on many prescriptions. Someone with several complicated, chronic conditions may be taking a dozen or more separate drugs at any one time. Because of all the side effects and contraindications many of these medicines can involve, it sometimes requires a very skilled doctor to understand and manage them all.
Geriatricians are especially adept at recognizing which ailments should be treated as a priority, since many conditions may complicate the treatment of other conditions.
Keeping the heart and lungs running, for example, may be more important than treating a beginning stages case of diabetes. They can assess which medications are the best for improving breathing and circulation, without further aggravating insulin or blood sugar levels. A good geriatrician can manage a team of specialists, as well. Even though they are trained to detect and treat many of the conditions of older patients, many of these ailments will still need the care of specialists.
For patients who already see specialists as part of their care routine, switching to a geriatrician from a regular general practitioner shouldn’t change this. In fact, they should expect their new doctor to continue with the existing care plan of their specialists and monitor and advise as needed.
When is a Geriatrician a good Idea?
There is no set age when a person might switch from a regular primary care doctor to a geriatrician, but there may be signs that it’s time to consider one. Among them are the geriatric “giants,” which include: instability, incontinence, immobility, and impaired cognitive function. You may also consider one when vision or hearing issues become unmanageable.
When Hospitalizations become Common
It’s best to start seeing a geriatrician before problems arise, as a general rule of prevention. Unfortunately, many older patients switch to a geriatric specialist only after having complicated or life-threatening illnesses or accidents that have occurred as they have gotten older. A simple case of the stomach flu, for example, can lead to severe dehydration or low sodium levels – both of which can lead to death if not treated aggressively. Falling more often because of vision issues is another example of how a minor condition can spiral into something with terrible outcomes for an older patient. A geriatric specialist understands the delicate balance of an older person’s systems and is prepared to monitor the smallest things – especially when a patient is just coming out of the hospital.
If Dementia Sets In
Finally, some people choose to have their loved ones see a geriatric specialist when they notice signs of memory loss, confusion, and dementia. While not specifically trained to handle cognitive disorders, most geriatric specialists have patients in various stages of late-onset dementia and are prepared to help loved ones continue to arrange for and provide care during these most difficult years. They can facilitate the support services needed to make sure the patient is safe and living their best life possible. If and when a decision is made to place a patient in a care facility, the doctor can usually remain as part of the health plan for the senior loved one in conjunction with the skilled nursing care they receive in their new community.
Searching for the Right Doctor
Many doctors have chosen to meet the requirements of an organization such as the American Geriatrics Society and are listed on their website. Interestingly, some of the best geriatricians don’t market themselves solely as such. They may simply label their practice as a general physician’s office and note that they offer geriatric services. Likewise, those that only see older patients may not always be the best for your loved one. If you have a specialist that you know and trust – such as a GI or heart doctor – let them know that you’re searching for someone to manage your senior’s care through their later years. They can usually recommend someone that they already have a good working relationship with, and this is often someone who has earned their trust and respect.
Always make sure that whichever doctor you choose is part of your loved one’s insurance network and (if possible) choose someone that’s in the same hospital or clinic network as the majority of your senior’s specialists. It’s much easier for doctors to communicate with electronic records shared in-network through these partnerships. Even something as simple as sending blood work results can become a nuisance if you have to make a formal request to have it sent to another hospital network.
Getting your Senior’s Approval
Unless you have managed to get legal authority to make medical decisions for your older loved one, the choice to switch doctors is still ultimately theirs. They may resist changing physicians, even at the urging of a specialist, if they have developed a personal bond with their existing doctor or don’t want to cause what they perceive as hurt feelings. If at all possible, talk with specialists who support your plan and have them discuss the benefits of having a more personalized care plan for someone of their age. Explain how having a doctor who understands the aging process is important to ensure timely and competent treatment of even the most common ailments. They only get one life – after all. See that they understand how important it is to nurture it through the best care possible!
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