Understanding Geriatricians: Their Role, Training, and Importance in Elderly Care

A doctor who specializes in treatment of older adults is known as geriatrician ⁽¹⁾. This doctor can also give integrative care along with diagnosing different medical conditions and helps the elderly in living a good quality of life with the least amount of dependence on others ^{(1, 2).}

Getting old is challenging and presents a unique myriad of mental, emotional, physical and social challenges. Research shows that by the age of 80 years, about 90% of adults in America will experience a minimum of one chronic health condition ^(3).

There is no particular age to start consulting a geriatrician, as each elderly individual’s requirement and conditions is different. However, you can start seeing a geriatrician if you are ^{(4, 7):}

• Take multiple or different types of medications.
• If you are suffering from different health conditions or diseases.
• If you are experiencing a disability or reduced mobility.
• If you want to provide additional help to your family members, caregivers and friends.

Geriatric doctors or a geriatrician helps the elderly or older adults who are usually between the ages of 65 and above in staying healthy, functional and happy. However, geriatrics as a subject is now becoming an increasingly rare specialty.

According to the American Geriatrics Society, there are about more than 8,200 full-time practicing geriatric doctors in the United States. As the lifespan of the population is increasing, the demand for geriatricians is also set to increase than the supply by about 50% in the year 2030.

A geriatrician is a doctor specializing in taking care of elderly people, their health, diagnosing any health conditions and treating them.  A geriatrician also performs cognitive, functional and physical assessment for developing the best healthcare plan for the elderly people. The functional status of a person or a patient refers to their ability to perform certain tasks on their own without any help such as:

• Bathing and dressing.
• Eating and drinking
• Controlling bladder and bowel movements.
• In taking medications.
• Managing your finances.
• Shopping and doing household work.

Cognitive and Physical Assessment ⁽⁵⁾: The cognitive assessment done by the geriatric doctor consists of looking for signs of conditions like insomnia, dementia and depression.

A medical and physical exam is also done to look for the risk of conditions that older adults are at increased risk for, such as: malnutrition, incontinence, osteoarthritis, osteoporosis; vision and hearing loss; diabetes, hypertension; balance issues or fall injuries.

Merging Care: Geriatricians look after the general health of the elderly patient and also help in managing the healthcare team of the patient that consists of: neurologists, pharmacists, nurses, family members, social workers, physical and mental therapists. All these individuals help in prioritizing treatments if the patient is suffering from multiple conditions. All the people involved in the healthcare management of the patient along with the geriatric doctor are knowledgeable of complex drug interactions and the side effects and hence can help in chalking out a healthy and safe medication plan for the elderly patient.

Geriatricians help the patient in staying active, healthy and connected. Geriatricians also help the patient in developing positive self-perceptions about aging ⁽⁶⁾. Studies have shown that negative attitudes regarding aging can cause significant effect on the physical and mental well-being of the elderly patient ⁽⁶⁾. One example is that ageism from healthcare professionals can restrict the quality and quantity of medical information, treatments and services provided to the older people.

Likewise, individuals having negative self-perceptions about aging can also:

• Think they need not be seen by a doctor and hence avoid seeking help of any sort.
• Irrationally justify their illnesses, pains and aches.
• They can be less likely to take part in positive activities, such as socializing or exercising.

All these things can be managed by talking with a geriatrician on how to best navigate these difficult transitions in the family life, living or work environment.

Geriatricians are fully trained medical doctors for treating, managing and diagnosing any medical conditions in elderly patients. The journey of a geriatric doctor consists of:

• Getting a medical degree upon completion of 4 years of course at a college or university.
• Completing the 3 to 5 years in a full-time residency program, which is accredited by the Accreditation Council for Graduate Medical Education
• Getting passed in the Geriatric Medicine Certification Examination which is founded and administered by the American Board of Internal Medicine.
• Getting an unrestricted medical license for practicing medicine in America or Canada.

Some of the factors that can be taken into consideration when looking for a good geriatrician are:

Training: Ask the prospective geriatric doctors the amount of experience they have in treatment of older individuals and if they have a board certification in this specialty.

Communication: It is important to know how the patient is going to receive communication from their geriatric doctor; whether it is via text, phone call or e-mail regarding appointment reminders or if the doctor’s office provide tele-health appointments along with in-person visits and the manner in which the prescription refills are done.

Access to Care: How easily accessible is the geriatrician? Can they give same-day visits if required? The office hours along with the parking facilities available and traffic in the area to the hospital should be taken into consideration when selecting geriatrician. Also, staff available for answering after-hours calls by the geriatric doctor is also an important consideration. The hospital to which the geriatric doctor is affiliated should be known and the method of communication of hospital to the doctor in case of admission of the elderly patient is important.

Health Insurance Coverage: If the patient has health insurance, then contact your insurance provider to see if the geriatric doctor you are interested in is covered in the plan. In case of not having health insurance or if the plan does not cover the specific geriatrician which you would like to visit, then reach out to the doctor’s office to ask about the payment plans or if there is any reduction in the fees for self-payers.

Environment and Personality: The manner of interaction by the geriatric doctor with their healthcare team and with the patient is important. The manner of the staff towards the patient is also important in deciding upon the doctor whether they are kind or patronizing towards the elderly. Does the geriatrician answers all the questions by the patient directly and thoroughly or gets impatient? All these things should be considered before deciding on the doctor.

Asking the medical philosophy of the geriatric doctor, their goals for the health of the patient helps in ensuring that all these are in alignment with the patient’s expectations.

Geriatricians are medical doctors specializing in diagnosing and treating medical conditions affecting the older individuals. Geriatric doctors are an excellent resource for older people who may be suffering from different medical conditions and are taking multiple medications and need supportive care. The need for geriatricians is increasing day by day as few doctors are opting for this specialty and with the increasing lifespan; the demand for geriatric doctors is more than the supply.

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