Do I Need a Geriatrician?


by Neeja Bhardwaj, MD, MPH, Bon Secours Geriatric Care 

A geriatrician is a physician who has completed medical school and done a residency in either Internal Medicine or Family Medicine. The doctor also completes an additional subspecialty fellowship training studying conditions specific to aging, including geriatric assessment and rehabilitation, preventive medicine, management of patients in long-term care settings, and psychosocial, ethical, legal, and economic issues pertinent to geriatric patients.

What is Geriatrics?

Geriatrics is the subspecialty of Internal Medicine primarily concerned with the health and well-being of elderly adults. These physicians have completed studies focused on conditions specific to aging, management of patients in long-term care facilities and the psychosocial aspect of aging. Geriatricians pay extra attention to situations of special concerns such as frequent falls, dementia, memory loss and other cognitive changes that can occur when people age. Geriatricians look at all aspects of patients who are 65 and older in conjunction with the patient’s primary care physician, but spend more time with the patient on conditions specific to aging so all around the patient receives quality coordinated care.

What is the difference between Geriatricians versus a Primary Care Physician?

Many people get confused about the difference between a geriatrician and a primary care physician. Geriatricians diagnose, treat and manage diseases and conditions that require a special approach when dealing with older adults. They give special attention to situations of special concern, including falls, incontinence, preoperative assessment and post-operative management, cerebrovascular disease, dementia, sensory impairment and other cognitive and affective changes that occur with aging.

Your primary physician might refer you to a geriatrician when a problem associated with aging requires special attention. In some cases, a family member might recognize a need for a geriatrician and suggest you consult one. A Geriatrician specialist works as a team with your primary care physician to help take the best care of a geriatric patient. Because of their special training, geriatricians typically provide care for frail older people who have the most complicated medical and social problems. However if you are not a frail elder, a Geriatrician can help maintain you keeping the best health possible in conjunction with your primary care physician by getting a thorough geriatric assessment each year.

Why should a person over the age of 65 see a Geriatrician?

A person over the age of 65 that may be showing cognitive changes such as wandering at night, hallucination may be experiencing early signs of dementia or delirium. A Geriatrician can make sure the patient is getting the appropriate care needed to treat these conditions that might be overlooked. Another reason a person might go to see a Geriatrician would be if they start falling frequently and have difficulty with daily activities that used to be simple to do. An elderly person might be struggling with issues in their life that affect their independence and a Geriatrician can help the elderly patient better understand and assess the patient about why these changes might be happening.

Another very common problem that Geriatricians deal with is polypharmacy. It is not uncommon for a typical elderly patient navigating through the system to receive 1-2 prescriptions from their cardiologist, another 3-4 from their primary care physician and 2 more from their orthopedic surgeon due to knee surgery a few weeks ago. Before you realize it, an elderly patient can be on 8 or more medications without completely understanding the interactions between each one or even if they really need to be taking that many medications. If you see a Geriatrician, he/she will be able to take the time and discuss with the patient the interaction of all these medications and evaluate whether or not it is required to take all medications in communication with your primary care physician along the way.

No matter what at the end of the day, the aging process is different for everyone. The range of experiences as one gets older can be one filled with the joys of grandchildren and not having to work full time with travel, adventure and excitement. For some, the aging process can mean numerous health challenges and years filled with pain and lack of energy. Knowing who you need to see as you age no matter whether you are full of energy and excitement or aches and pains is a critical step to aging because it takes the worry and fear out of the unknown.

Contact you primary care physician and ask about seeing your local Geriatric Physician as an additional resource to help you navigate through the world of aging.