What is Geriatric Care?
Geriatric care, or geriatrics, is the branch of medicine specifically dedicated to the health and well-being of older adults. It is a recognized medical specialty that focuses on preventing, diagnosing, and treating diseases and disabilities common in later life. Unlike general adult medicine, geriatrics acknowledges that older bodies have unique physiological changes and often present with multiple overlapping health issues. A physician who specializes in this field is called a geriatrician.
Geriatricians are experts in managing the complex health landscape of aging. This includes not only treating specific diseases but also focusing on maintaining functional independence, cognitive health, and overall quality of life. They often lead an interdisciplinary team that may include nurses, pharmacists, social workers, and therapists to provide comprehensive, person-centered care.
The Role of a Geriatrician
A geriatrician is a medical doctor (MD or DO) who first becomes board-certified in either internal medicine or family medicine and then completes an additional fellowship of one to two years focused exclusively on geriatric medicine. This advanced training equips them with expertise in:
- Managing Multiple Chronic Conditions: Many older adults have several chronic diseases at once, such as diabetes, heart disease, arthritis, and osteoporosis. A geriatrician coordinates care to manage these conditions holistically.
- Addressing Geriatric Syndromes: These are common, complex health states in older adults that don't fit into discrete disease categories. They include issues like frailty, falls, incontinence, delirium (sudden confusion), and memory loss.
- Polypharmacy (Managing Multiple Medications): Seniors often take numerous medications prescribed by different doctors. Geriatricians are skilled at reviewing medication lists to eliminate unnecessary drugs, reduce side effects, and prevent harmful interactions.
- Promoting Functional Ability: A key goal is to help patients maintain their ability to perform activities of daily living (ADLs) like bathing and dressing, and instrumental activities of daily living (IADLs) like managing finances and transportation.
Geriatrician vs. General Practitioner: A Comparison
While many older adults receive excellent care from their primary care physician (PCP), a geriatrician offers a different level of specialized expertise. The choice often depends on the patient's overall health complexity. The American Geriatrics Society suggests that about 30% of people over 65 could benefit from a geriatrician's care.
Here is a comparison to help understand the differences:
| Feature | General Practitioner (PCP) | Geriatrician |
|---|---|---|
| Patient Population | Treats patients of all ages. | Specializes in adults typically 65 and older. |
| Training | Board-certified in family or internal medicine. | Board-certified in family/internal medicine PLUS a fellowship in geriatrics. |
| Approach to Care | Manages acute and chronic illnesses. | Holistic focus on quality of life, function, and managing multiple complex conditions. |
| Appointment Length | Typically standard appointment times. | Often longer appointments to address multiple, complex issues. |
| Team Collaboration | May refer to specialists. | Often works as the leader of an interdisciplinary care team. |
| Common Focus | Preventive care, treating common illnesses. | Geriatric syndromes, polypharmacy, cognitive decline, end-of-life care. |
The Comprehensive Geriatric Assessment
A hallmark of geriatric care is the comprehensive geriatric assessment (CGA). This is a multi-dimensional diagnostic process to determine an older person's medical, psychological, and functional capabilities to develop a coordinated, integrated plan for treatment and long-term follow-up. A CGA typically evaluates several domains:
- Medical Health: Review of all medical conditions, medications, nutritional status, vision, and hearing.
- Functional Status: Assessment of ability to perform ADLs and IADLs. This often includes observing gait and balance to evaluate fall risk.
- Cognitive & Mental Health: Screening for cognitive impairment (like dementia) and mood disorders (like depression).
- Socio-environmental Situation: Evaluating the patient's living situation, social support system, and access to community resources.
The Growing Need for Geriatric Care
The demand for geriatricians is rapidly outpacing supply. The U.S. population is aging, and by 2034, adults over 65 will outnumber children for the first time in the nation's history. However, the number of physicians choosing to specialize in geriatrics is declining. This shortage underscores the importance of a team-based approach and the need for all healthcare providers to have some training in geriatric principles. To learn more about this vital specialty, a great resource is the American Geriatrics Society.
Conclusion
Geriatric care is unequivocally a medical specialty, distinguished by its specialized training, holistic approach, and expertise in managing the unique complexities of aging. For older adults, particularly those with multiple health conditions, frailty, or complex medication regimens, partnering with a geriatrician and their care team can lead to better health outcomes, preserved independence, and a higher quality of life.
