The Geriatrician's Unique Approach to Senior Health
A visit to a geriatrician is different from a standard doctor's appointment. These specialists focus on the complex needs of older adults, aiming to improve quality of life and maintain functional independence. A core component of this is the Comprehensive Geriatric Assessment (CGA), a multi-domain evaluation that goes far beyond a single health complaint. The goal is to get a complete picture of your health—physical, cognitive, and social—to create a tailored care plan. Preparing for this visit by understanding the types of questions you'll encounter can help you get the most out of your appointment.
The Five Pillars of a Geriatric Assessment
Geriatricians structure their questions around several key domains to assess your overall well-being. Expect the conversation to cover these essential areas.
1. Medical and Medication History
This is the foundation of the assessment. Be prepared to discuss your entire health history in detail.
- Past and Present Conditions: You'll be asked about current diagnoses (like hypertension or diabetes), past surgeries, and major illnesses.
- The "Brown Bag Review": A hallmark of geriatric care is a thorough medication review. You will be asked to bring every single medication you take—prescriptions, over-the-counter drugs, vitamins, and herbal supplements—in their original bottles. The geriatrician will ask why you take each one, the dosage, and who prescribed it. This helps identify unnecessary medications, potential drug interactions, and side effects.
- Health Habits: Expect questions about your diet, exercise, alcohol consumption, and any history of smoking.
2. Functional Status Assessment
This part of the assessment focuses on your ability to live independently. The questions are practical and relate to your daily life.
-
Activities of Daily Living (ADLs): These are the fundamental skills required for self-care. The geriatrician will ask if you have any difficulty with:
- Bathing or showering
- Dressing
- Eating
- Getting in and out of bed or chairs (transferring)
- Using the toilet
- Continence
-
Instrumental Activities of Daily Living (IADLs): These are more complex tasks necessary for living independently in a community. Questions will revolve around your ability to:
- Use the telephone
- Manage your finances
- Prepare your own meals
- Go shopping for groceries or clothes
- Do housework and laundry
- Manage your medications
- Get to places beyond walking distance (driving or using public transport)
3. Cognitive and Mental Health Evaluation
Assessing your cognitive function and mood is crucial for detecting issues like dementia or depression early.
- Memory and Thinking: You may be asked simple questions to screen for cognitive impairment, such as "Have you noticed any changes in your memory?" or "Do you have more problems with memory than most?" They may use a short screening tool like the Mini-Cog, which involves remembering three unrelated words and drawing a clock.
- Mood and Depression: It's common for geriatricians to screen for depression. They may ask questions like, "Over the past two weeks, have you felt down, depressed, or hopeless?" or "Are you basically satisfied with your life?" These questions help differentiate between normal aging and a treatable mood disorder.
4. Social and Environmental Assessment
Your living situation and support system are vital to your health. A geriatrician needs to understand your environment to ensure it's safe and supportive.
- Living Situation: They will ask where you live (house, apartment, senior living), who you live with, and if your home is safe (e.g., presence of stairs, grab bars, risk of falls).
- Support System: Questions will cover who helps you if you need it. This includes family, friends, and neighbors. They'll want to know who you rely on for help with daily activities and who would be available in an emergency.
- Goals of Care: An important part of the discussion is about what's most important to you. They'll ask about your health and life goals and what you want your healthcare to achieve. This includes discussing advance directives or living wills.
5. Multi-System Review
Finally, the geriatrician will ask about specific issues common in older adults.
- Falls: "Have you fallen in the past year? Do you worry about falling?"
- Sensory Input: "Do you have trouble with your vision or hearing?"
- Nutrition: "Have you lost weight without trying?"
- Continence: "Do you ever lose control of your urine?"
| Feature | General Practitioner | Geriatrician |
|---|---|---|
| Primary Focus | Often focused on a specific complaint or chronic condition management. | Holistic assessment of the entire person, including functional and social aspects. |
| Appointment Time | Typically shorter, around 15-20 minutes. | Often longer, especially for initial assessments (60-90 minutes). |
| Medication Review | Reviews medications related to the presenting problem. | Conducts a comprehensive "brown bag" review of all medications and supplements. |
| Team Approach | Usually works independently. | Often works as part of a multidisciplinary team (e.g., with social workers, therapists). |
| Key Goal | Treat acute and chronic diseases. | Maintain independence and improve quality of life. |
Conclusion
A visit with a geriatrician is a proactive step toward healthy aging. By asking detailed questions across multiple domains, these specialists work to understand your unique needs and goals. They focus not just on treating disease, but on preserving your function, independence, and overall quality of life. For more information on what to expect, you can visit the National Institute on Aging. Answering these questions openly and honestly is the best way to partner with your doctor and create a healthcare plan that works for you.
