The Role of the Geriatrician
A geriatrician is a medical doctor (M.D. or D.O.) who is board-certified in internal or family medicine and has completed additional fellowship training in geriatrics.
This makes them experts in the unique ways that illnesses and medications affect the aging body, and they are especially adept at managing complex, multiple health conditions, also known as polypharmacy. Unlike a general practitioner who sees patients of all ages, a geriatrician focuses exclusively on the needs of older adults, typically those over 65, particularly those with multiple chronic illnesses or significant frailty.
Why a Geriatrician May Be Necessary
While a primary care physician can manage the health of many older adults, a geriatrician is often recommended when:
- An older adult is managing multiple complex and chronic conditions.
- There is a notable functional decline, such as issues with mobility, falls, or cognitive changes.
- Polypharmacy (taking many different medications) is an issue, and a thorough review is needed to prevent dangerous interactions and side effects.
- The family is experiencing significant stress related to their caregiving role.
The Difference Between Geriatrics and Gerontology
While often confused, geriatrics and gerontology are distinct fields that approach aging from different perspectives.
- Geriatrics is the medical specialty focused on the treatment of illness and the promotion of health in older adults. A geriatrician is a medical doctor providing direct, clinical care.
- Gerontology is the broader, multidisciplinary study of the aging process itself, including its biological, social, psychological, and public policy aspects. A gerontologist may conduct research or educate, but does not provide medical treatment.
Understanding this distinction is key to finding the right kind of specialist for your needs.
Assembling the Multidisciplinary Geriatric Care Team
Optimal care for older adults often involves more than just a single physician. Geriatricians commonly lead a team of specialists to provide a holistic, comprehensive approach to care.
The Geriatric Nurse Practitioner (GNP)
Geriatric Nurse Practitioners are advanced practice nurses with specialized training in the care of older adults. They can perform physical exams, diagnose and treat illnesses, and prescribe medications, often working closely with geriatricians in a variety of settings, including hospitals, clinics, and long-term care facilities.
The Geriatric Pharmacist
With older adults often on multiple medications, a geriatric pharmacist is an invaluable expert. They have specialized knowledge of how medications affect the aging body, and they can help optimize medication regimens to improve health outcomes and minimize side effects.
The Geriatric Social Worker
Geriatric social workers counsel older adults and their families on the many non-medical aspects of aging. This includes addressing psychosocial concerns, navigating emotional changes, and connecting families with crucial community resources and support systems.
The Aging Life Care Professional (Geriatric Care Manager)
Also known as a geriatric care manager, this professional is typically a licensed nurse or social worker who coordinates and manages all aspects of an older adult's care. This is particularly helpful for families living far apart, as the care manager can arrange services, make home visits, and act as a liaison between family and healthcare providers.
The Comprehensive Geriatric Assessment (CGA)
One of the most important tools used by geriatric specialists is the Comprehensive Geriatric Assessment, a multidisciplinary process for evaluating a frail older person's overall health. It goes beyond a standard physical exam to assess medical, psychosocial, and functional limitations, including:
- Functional Status: Evaluating activities of daily living (ADLs) and instrumental activities of daily living (IADLs), such as dressing, eating, managing finances, and cooking.
- Cognitive and Psychological Health: Screening for memory issues, depression, or anxiety.
- Social and Environmental Factors: Assessing living situation, social support, and safety hazards.
- Medication Management: A detailed review of all prescription and over-the-counter medications.
Key Specialist Comparison
| Specialist | Focus | Key Function | Best for |
|---|---|---|---|
| Geriatrician | Medical | Diagnosing and treating complex age-related illnesses; coordinating care. | Complex medical conditions, polypharmacy, and managing chronic diseases. |
| Gerontologist | Study of Aging | Researching biological, social, and psychological aspects of aging. | Informing public policy and educational programs, not direct medical care. |
| Geriatric Nurse Practitioner | Clinical & Direct Care | Performing exams, diagnosing conditions, prescribing medications. | Ongoing primary care, health maintenance, and chronic disease management. |
| Geriatric Care Manager | Holistic Coordination | Assessing needs, arranging services, and providing family support. | Coordinating all aspects of care for complex situations or long-distance families. |
| Geriatric Pharmacist | Medication Management | Optimizing drug regimens to minimize side effects and interactions. | Patients taking multiple medications. |
How to Find the Right Aging Specialist
Finding the right specialist for an aging patient requires careful consideration and research.
- Start with Your Primary Care Physician: Your current doctor can offer referrals and can help you determine if a geriatric specialist is necessary.
- Use Reputable Directories: Organizations like the American Geriatrics Society provide online locators for finding certified professionals. Healthinaging.org also offers a comprehensive search tool.
- Check Credentials and Experience: Verify that any potential specialist is board-certified and has experience with your loved one's specific health challenges.
- Consider Accessibility: Evaluate the specialist's location, office hours, and communication practices to ensure they align with your family's needs.
- Assess Communication and Philosophy: Meet with the specialist to discuss their approach to care and ensure their philosophy aligns with the patient's and family's goals. A strong specialist will prioritize effective communication and patient education.
Conclusion
When confronting the complex health issues that often accompany aging, understanding who specializes in aging patients is the first step toward better health outcomes. From the expert guidance of a geriatrician managing complex medical needs to the holistic coordination provided by a geriatric care manager, a network of specialized professionals can support older adults. By leveraging this expert care, families can ensure their loved ones receive comprehensive, compassionate, and effective support that prioritizes their long-term well-being and quality of life.
