A Look at Geriatric Medicine

September 26, 2018

Our elder population is growing at a more rapid rate than ever before; now at 14% in the US, it’s projected to rise to 22% by the year 2050. The healthcare needs of this growing segment are keeping pace with the population, and are in many ways unique to that demographic. It makes a sense, then, that the specialty of geriatric medicine is rapidly expanding its reach in the medical arena. And seniors choosing to see a geriatric specialist makes sense on its own; just as babies and children have endemic medical issues that correspond to pediatric medicine, our senior population has a unique array of medical characteristics that make a geriatric practice a smart choice.

Why geriatric medicine?

While of course each patient has a unique health history, our elder population shares several key attributes associated with aging that differentiate their healthcare needs from the general population. These include:

  • Metabolic changes: Aging steadily slows our metabolic rate, which affects everything from weight gain to insulin resistance to the way we process medication. Seniors, therefore, have specific needs associated with metabolism, including diet, blood pressure regulation, chronic illness, even determining the right level and mix of prescription drug therapies.
  • Homeostenosis: The term stenosis refers to a narrowing; homeostenosis in the elderly refers to seniors’ decreasing ability to adapt to changing environments. Their bodies are increasingly unable to combat stressors like trauma, infection, and acute illness. Something as basic as a routine urinary tract infection, for example, could land mom in the hospital with dizziness and disorientation, while it would be easily treatable with antibiotics in a younger person.
  • Cognitive challenges: We’ve talked a great deal in these pages about the cognitive issues unique to seniors. Memory impairment is one that makes taking a patient history uniquely challenging, which is why geriatric medicine’s team approach is so well suited to this population. Not only do practitioners often confer as a group to fill in the missing pieces – physicians, social workers, physical therapists — senior caregivers are also often relied upon as key contributors to treatment plans.
  • Comorbidities: A significant proportion of elderly patients are dealing with two or more conditions at the same time – in fact, this is true of almost one third of people 85 and older. Whether it’s diabetes and heart disease, dementia and cancer, this high instance of comorbidity presents unique treatment challenges to physicians having to address multiple and often conflicting conditions.

What is unique about geriatric practitioner training?

In addition to conventional medical training, geriatricians are required to spend a certain number of skill-building hours in assisted living communities, adult daycare facilities, long-term acute care hospitals, inpatient rehabilitation communities, and skilled nursing placements. Their training places special emphasis on smart approaches to complex pharmaceutical treatments (the “start low and go slow” approach) as well as getting comfortable working in teams. They’re also trained in assessing functional status (Dad’s ability to live on his own, for example) and discerning social factors in health and wellbeing, like housing and nutrition.

Another key factor worth mentioning is simple: geriatricians enjoy working with older adults. In fact, they’re considered among the most satisfied of all specialists working in medicine.  For more information, or to find a qualified geriatrician in your area, head to the Health in Aging website.