What does the geriatric department deal with?: A Guide to Comprehensive Senior Care

By 2040, it is projected that there will be nearly 81 million adults over the age of 65 in the United States, a demographic shift that highlights the growing importance of specialized care for seniors. To address the unique and complex health needs of this population, the geriatric department provides comprehensive, person-centered services. Understanding what does the geriatric department deal with is essential for families navigating the challenges of healthy aging.

This article provides an in-depth exploration of the geriatric department's function, services, and team approach to care.

Quick Summary

The geriatric department provides comprehensive, specialized healthcare for older adults, managing multiple chronic conditions, complex medical needs, and age-related syndromes like falls, memory loss, and frailty to improve quality of life and independence through a holistic, team-based approach.

Key Points

• Holistic and Person-Centered Care: The geriatric department focuses on the entire individual, not just individual diseases, considering social, psychological, and medical aspects to provide personalized care.

• Team-Based Approach: Care is coordinated by an interdisciplinary team, including geriatricians, nurse practitioners, pharmacists, social workers, and various therapists, to address all aspects of a senior's health.

• Specialized Condition Management: Geriatric departments specialize in managing complex health issues common in older adults, such as dementia, falls, frailty, and urinary incontinence.

• Comprehensive Assessment: A thorough evaluation covers medical, functional, cognitive, and psychosocial factors to create a tailored care plan.

• Focus on Function and Independence: A key goal is to improve and maintain an older person's function and independence, enhancing their overall quality of life.

• Medication Optimization: Expertise is applied to manage complex medication regimens (polypharmacy), minimizing side effects and improving safety.

• Beyond Treatment: Care includes preventive measures, chronic disease management, and palliative support, covering the entire spectrum of an older adult's health journey.

The Core Philosophy of Geriatric Care

Geriatric medicine is not simply about treating older people; it is about addressing the specific health needs and challenges that arise with advanced age. A key principle is the holistic, person-centered approach, which places an individual's unique values, preferences, and goals at the forefront of their care. Rather than treating a single disease in isolation, geriatricians and their teams consider the interplay of multiple conditions, known as multi-morbidity, and how they impact a patient's overall function and well-being.

The 5Ms of Geriatric Care

A conceptual framework often used in geriatrics is the "5Ms," which helps guide and structure the department's priorities and clinical decisions:

• Multicomplexity: Addressing the complex interplay of a patient's conditions, risks, and functional status.
• Mind: Evaluating and managing cognitive and psychological health, including dementia, delirium, and depression.
• Mobility: Promoting and maintaining functional independence and addressing issues like falls and gait instability.
• Medications: Optimizing medication management, preventing adverse drug reactions, and addressing polypharmacy (the use of multiple medications).
• What Matters Most: Understanding the patient's individual goals, values, and care preferences.

The Multidisciplinary Team in Action

Effective geriatric care is often a team-based effort, with a variety of specialists collaborating to provide coordinated care. This approach ensures that all aspects of an older adult's health are addressed. The team may include:

• Geriatricians: Board-certified physicians with additional training in geriatrics.
• Geriatric Nurse Practitioners: Advanced practice nurses specializing in elderly care.
• Physician Assistants: Medical professionals who work alongside physicians.
• Social Workers: Licensed professionals who address social and emotional issues.
• Pharmacists: Specialists in managing and dispensing medications.
• Dietitians: Experts in nutrition for healthy aging.
• Physical Therapists: Specialists who help improve mobility and balance.
• Occupational Therapists: Professionals who help patients with daily living activities.
• Speech and Hearing Specialists: Specialists addressing communication, swallowing, and hearing problems.

Key Conditions and Syndromes Addressed

Geriatric departments specialize in evaluating and treating conditions and syndromes that are particularly common or impactful in older adults. These include:

1. Dementia and Cognitive Impairment: A primary focus is diagnosing and managing conditions like Alzheimer's disease and other forms of dementia.
2. Falls and Mobility Issues: Addressing the causes of falls and implementing prevention strategies to maintain independence.
3. Frailty: Managing the age-related decline in function and resilience, which increases vulnerability.
4. Urinary Incontinence: Offering solutions and management strategies for this common and often distressing condition.
5. Sensory Impairments: Managing vision and hearing loss that can significantly impact quality of life.
6. Chronic Disease Management: Providing specialized care for chronic illnesses such as diabetes, heart disease, and arthritis, which often present differently in older adults.
7. Medication Review: Conducting careful reviews to prevent negative drug interactions and adverse side effects, which is crucial for patients taking multiple prescriptions.

Comprehensive Geriatric Assessment: A Unique Evaluation

Unlike a standard medical check-up, a comprehensive geriatric assessment is a thorough evaluation of an older person's overall health and function. It is a cornerstone of geriatric practice and informs a personalized care plan. This assessment typically includes:

1. Medical Evaluation: Reviewing medical history, chronic conditions, and medications.
2. Functional Assessment: Evaluating the patient's ability to perform activities of daily living (ADLs) and instrumental activities of daily living (IADLs).
3. Cognitive Assessment: Screening for memory loss, confusion, and other cognitive changes.
4. Psychological Assessment: Screening for depression, anxiety, and mood disorders.
5. Social Evaluation: Assessing social support, living situation, and engagement.
6. Nutritional Assessment: Checking for potential malnutrition or dietary needs.
7. Risk Assessment: Evaluating risks for falls, polypharmacy, and other common geriatric issues.

Geriatricians vs. Gerontologists: A Comparison

Feature	Geriatrician	Gerontologist
Training	Medical Doctor (MD) specializing in the medical care of older adults.	Non-medical professional with a degree in the study of aging.
Focus	Diagnosing, treating, and managing medical diseases and disabilities in older adults.	Addressing the social, psychological, and biological aspects of aging.
Role	Serves as a primary care physician or a consultant for specific medical issues.	Provides supportive services, such as care coordination and counseling.
Prescriptive Power	Can prescribe medication and order medical procedures.	Cannot prescribe medication.
Setting	Hospitals, clinics, long-term care facilities, and private practices.	Various settings, including social service agencies, mental health clinics, and aging services organizations.

Conclusion

In summary, what does the geriatric department deal with is far more than just treating older patients. It encompasses a unique and comprehensive approach to healthcare that prioritizes the complex needs of aging individuals. By addressing everything from chronic diseases and medication management to cognitive and social well-being, geriatric teams work collaboratively to enhance independence and improve the overall quality of life. For families and individuals facing the complexities of aging, a geriatric department offers invaluable expertise and support.

For more information on health issues facing older adults, you can explore the resources available at the HealthinAging.org website.

Frequently Asked Questions

When should someone consider seeing a geriatric specialist?

It is often a good idea to see a geriatric specialist if an older adult has multiple chronic health conditions, experiences issues with memory or mobility, struggles with a complex medication regimen, or requires better coordination of their care.

What is the difference between a geriatrician and a gerontologist?

A geriatrician is a medical doctor who diagnoses and treats diseases in older adults, while a gerontologist is a non-medical professional who studies the aging process and provides supportive, non-medical services.

How does a geriatric department help with memory loss?

The department assesses cognitive function to diagnose conditions like dementia, manages symptoms, and develops care plans that may include medication, therapies, and support for patients and their families.

What is a comprehensive geriatric assessment?

This is a detailed, multi-dimensional evaluation that covers an older person's medical conditions, functional abilities, cognitive state, mental health, and social situation to create a personalized care plan.

Does a geriatric department deal with medication management?

Yes, medication management is a core function. The team reviews a patient's prescriptions to reduce the number of medications, prevent drug interactions, and minimize side effects, which is crucial for older adults.

What services are included in a geriatric department?

Services include disease diagnosis and treatment, comprehensive assessments, chronic condition management, falls prevention, mental health support, nutritional counseling, and coordination of care with an interdisciplinary team.

Is geriatric care only for very old or frail people?

No, while geriatric departments focus on older adults (typically 65+), not all older people require this specialized care. Care is sought when an individual has complex medical needs that require the expertise of a geriatric team to improve function and quality of life.

Can a geriatric department provide palliative or end-of-life care?

Yes, palliative care is a component of geriatric care, focusing on relieving symptoms, improving comfort, and providing emotional support to patients with serious illnesses and their families, often involving end-of-life care planning.