Why should I consult a geriatrician if I am an older adult?

If the patient appears to have one or more geriatric syndromes -- complex conditions that typically involve multiple body systems -- referral to a geriatrician with special training in diagnosing and managing these syndromes may be indicated. Common geriatric syndromes include dementia, delirium, incontinence, sensory impairment, malnutrition, osteoporosis, social isolation, falls, immobility, pressure ulcers and problems caused by being on many interacting medications.

Many acute conditions present differently in older patients, Sonja Rosen, M.D., a geriatric specialist at UCLA Medical Center, Santa Monica, notes, particularly if there are comorbidities. An older patient with an infection, for example, may not have a fever or an elevated white blood cell count. A patient who is cognitively impaired might seem only lethargic when he or she is experiencing a stroke or heart attack.

It is important for older patients to have a physician who looks at the big picture. “Sometimes a patient will go from one specialist to another, without one person who is monitoring everything,” Dr. Rosen says. “Someone has to be the quarterback, helping to decide what is necessary and making sure all aspects of the patient’s health and well-being are addressed in a coordinated way.”

Dr. Anne Fabiny, MD
Geriatric Medicine Specialist

Geriatricians have expertise in dealing with many chronic conditions -- such as heart ailments, high blood pressure, diabetes, and disabilities -- common in older patients. They are trained to consider the needs of the whole person and focus on function and quality of life. Some geriatricians routinely make home visits to see how a patient lives and what changes could improve safety, nutrition, function, and mobility. Usually, they recognize the importance of allowing family members to attend appointments and can be counted on to coordinate care with specialists.

Geriatricians are also well aware of deleterious effects that medications can have on older people. According to a study published in BioMed (BMC) Geriatrics, it's common for the elderly to receive prescriptions for inappropriate medications. Older people often have numerous health problems for which they are prescribed multiple medications. The more medications a person takes, the higher the risk of drug interactions and adverse side effects. The elderly are especially vulnerable, because of age-related changes in body composition -- for instance, they have less muscle mass and their bodies' process drugs differently than younger people's do. Even over-the-counter medications may contribute to this problem, and the effects can be cumulative.

A comprehensive geriatric evaluation can offer wide-ranging advice that vastly improves a person's quality of life and ability to live independently. That might include recommendations to change or discard medications, consult with a physical therapist or occupational therapist, adapt the home, pursue neuropsychological testing, or add home care services. Medicare or Medicaid will pay for the evaluation. Some private insurance plans also provide coverage if the primary care physician makes a referral.

Dr. Aruna V. Josyula, MD
Geriatric Medicine Specialist

Anyone 65 years or older could benefit from a consultation with a geriatrician. A consultation should also be considered if you have any of the following:

  • multiple medical problems
  • medications
  • memory issues

A consultation can also be helpful if family members or friends caring for older adults are under considerable stress.

Geriatric care occurs across multiple settings. In the office, a geriatrician can provide services both as consultant and as a primary care provider. The needs of the community and the older person largely determine what type of services a geriatrician will provide. There needs to be a discussion between the person, his or her doctor and the geriatrician to determine what will be in his or her best interests.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.