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Older Americans Month: What is a Geriatrician?

In Brief

  • A geriatrician is a physician who, in addition to completing a residency in internal medicine or family medicine, has also completed additional training in geriatric medicine.
  • That extra training in geriatrics focuses on promoting and maintaining the health, function and quality of life of older patients. This additional training also provides an older-adult-specific perspective on preventing and treating disease. 
  • If you have a primary care doctor with whom you have a great relationship, the prospect of changing that physician may not be appealing. In that case, it can be helpful to utilize a geriatrician as a consultant.
  • The Crozer-Keystone Center for Geriatric Medicine also offers the Geriatric Evaluation and Management (GEM) program, which fully assess a geriatric patient’s medical issues and the impact of these issues on all areas of life and function.

One of the most important decisions we make regarding our healthcare is the primary care physician we choose to be the first line of contact in our health management.  Ideally, your primary care physician is someone who knows you, has an excellent command of medical knowledge and practice techniques, and has access to specialists who can further assist you when a specific issue arises. It should also be someone with whom you are comfortable and can work with together as a team to attain the best medical outcomes for you. 

For older adults, this is especially important. As we age, some very basic things about our body – how we process medication, the likelihood of having more than one chronic condition, different needs in terms of maintaining/improving our function – change quite a bit from when we were 20 or 35 years old. And these differences are about to become an even bigger issue in medicine. According to the National Institute on Aging, the number of Americans aged 65 and older was 39 million in 2008; that number is expected to grow to 70 million by 2030. For these reasons and more, it can be very beneficial to have a primary care physician who specializes in your age group. For people over the age of 60, that specialist is a geriatrician. 

A geriatrician is a physician who, in addition to completing a residency in internal medicine or family medicine, has also completed additional training (a fellowship) in geriatric medicine. That extra training in geriatrics focuses on promoting and maintaining the health, function and quality of life of older patients. This additional training also provides an older-adult-specific perspective on preventing and treating disease. 

A perfect example of where this extra training can make a big difference is medication management. A 65-, 70- or 80-year-old body processes medication much differently than a 25- or 30-year-old body. A physician who understands these differences is better able to analyze which medication may have an unwanted side effect, or if multiple medications are interacting in a negative way in an older adult. And other conditions – like urinary incontinence, memory issues and balance problems – occur more often in older adults and for different reasons than they do in younger patients. Having a geriatrician on board can make a big difference in the assessment and treatment of these conditions. 

Geriatricians also have unique experience in problems such as memory loss and cognitive impairment. Contrary to popular belief, memory loss is not a normal part of aging. While diseases like Alzheimer’s are becoming well known (and currently there are between 2.4 million and 5.1 million people in the United States suffering from Alzheimer’s disease, according to the National Institute on Aging), it is far from the only cause of memory loss. 

If a patient starts to show signs of cognitive impairment, a geriatrician does a full medical workup that often includes blood work to rule out a metabolic cause or mineral imbalance; a brain scan (CT scan or MRI) to examine any physical changes in the brain that may indicate a reason for the impairment; as well as cognitive testing to measure and identify the nature of the cognitive problem. If the diagnosis is Alzheimer’s disease or another type of dementia, your geriatrician will often be able to work with you in terms of next steps, planning for the future, and referrals to other resources to support you and your family. 

If you have a primary care doctor with whom you have a great relationship, the prospect of changing that physician may not be appealing. In that case, it can be helpful to utilize a geriatrician as a consultant. Just like you see a cardiologist for heart issues or a dermatologist for skin issues, a geriatrician can also function as a specialist who can work with your primary care doctor when any number of geriatric-specific issues crop up.  Again, issues like memory impairment, difficulty walking or increasing falls, changes in urinary continence, or even a medication evaluation are things that geriatricians are able to assess and treat and provide feedback on to your primary care physician. 

The Crozer-Keystone Center for Geriatric Medicine also offers the Geriatric Evaluation and Management (GEM) program. The Geriatric Evaluation and Management Program offers a one-of-a-kind geriatric assessment provided by a board-certified geriatrician, a nurse, a social worker and a geriatric psychiatrist or psychologist to not only fully assess the patient’s medical issues, but also to assess the impact of these issues on all areas of life and function. This team is also often able to make recommendations and linkages to community supports as well as other specialists to assist patients and their caregivers with creating the best quality of life possible, all while working with the primary care physician. 

Finding the right physician/physician team is always important, no matter what your age.  For older adults, a geriatrician can offer a great deal for their unique needs. 

To contact the Crozer-Keystone Center for Geriatric Medicine, call (610) 499-7180 or visit www.crozer.org, click on Seniors, then Crozer-Keystone Center for Geriatric Medicine.

To learn more about Crozer-Keystone’s Senior Health Services department and the wide range of program and services it offers, including Crozer-Keystone Village, visit http://srhealthservices.crozer.org or call the Senior Support Line at 1-800-CKHS-KEY (1-800-254-7539). 

Jennifer Marshall is a social worker and coordinator of the Geriatric Evaluation and Management Program for the Crozer-Keystone Center for Geriatric Medicine at Crozer-Chester Medical Center. 

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