You know how some people age with grace? That’s not an accident. The best way to ensure you’re on the lookout and poised for prevention is to find yourself or your senior loved one a geriatric care provider.
“The same way that a child goes to a pediatrician, as you age, you want someone who specializes in gerontology,” says Jeanne Mihalik, an advanced practical nurse and nurse practitioner who treats patients at Atlantic Health System’s Center for Healthy Aging. “There are certain diseases and illnesses that are more common among the aging population that the professionals at a gerontology practice are going to be more attuned to.”
The more efficiently and aggressively you can prevent or slow the progress of these various illnesses, the longer you or your aging loved one will be able to stay active and independent. Read on for expert insight on what to expect from geriatric care.
Who needs geriatric care?
Everyone over age 65 should be looking for a geriatric practice.
“It may feel early,” says Mihalik. “People are much more youthful now — you don’t see 65-year-olds who look like the Golden Girls anymore. But you start at that young age so that [your provider has] time to get to know you and understand your medical history well in advance of anything actually going awry.”
One reason you may want to switch from a family practice to a geriatric specialist is the amount of time they can provide you or your older loved one to assess changes that might end up being simple or complicated to manage.
For example, changes in gait (how you walk) and balance can signal a complicated issue, like dementia, or something easy to handle, like low blood pressure. But a family doctor can’t assess this in a standard 10 to 15-minute visit, which many of these practices are limited to, explains Dr. Kathryn Brandt, chair of primary care at the University of New England College of Osteopathic Medicine. A specialist such as a gerontologist will have more like 25 to 30 minutes to spend per patient versus a general practitioner.
“The same way that a child goes to a pediatrician, as you age, you want someone who specializes in gerontology. There are certain diseases and illnesses that are more common among the aging population that the professionals at a gerontology practice are going to be more attuned to.”
— Jeanne Mihalik, an advanced practical nurse and nurse practitioner, Atlantic Health System’s Center for Healthy Aging
Look at it like this: Pediatricians are doctors who get extra training in order to understand the usual phases of a child’s development, common illnesses (like coxsackievirus and pinkeye), safe medications and vaccination schedules. Same with gerontology: Gerontologists are doctors with extra training on what happens to an aging body, common conditions (like hypertension and diabetes) and safe medications.
In addition to having more time and recognizing common symptoms of aging, a gerontologist is well-versed in the conditions that become more pronounced in the aging population. For instance, a geriatrician is trained to recognize and treat the following conditions in tandem with one another:
- Heart disease
- Hypertension
- Osteoporosis
- Hearing and vision loss
- Diabetes
- Certain cancers
In addition to preempting and addressing serious health concerns, geriatric care can bolster your own or your loved one’s wellness. Per the American Geriatrics Society, the goal of geriatric care is “to improve the health, independence and quality of life for all older people.”
“The standard of care for the geriatric population is known as ‘the Four Ms,’” says Brandt. “Mobility, medication, matters and the mind.” These are the priorities for a doctor treating the aging population:
Mobility
By looking at how you move, the doctor can determine whether you or your loved one are at a fall risk and act quickly — by getting you physical therapy, for instance — to strengthen anything that’s starting to wear down.
Medication
“A lot of geriatric care is actually subtracting medicine,” says Brandt. “With age come changes in how your body handles side effects, for instance. I had a patient with insomnia, and we figured out it was because she was taking her diuretic at night, so she was getting up to pee.”
Change the time that med is taken, and a cascade of problems is solved. Someone needs to look at your medications with a critical eye and see which may no longer be good for you or your loved one.
What matters to you
If a physician takes a one-size-fits-all approach, patients will zone out. Nobody wants to hear about all the things you don’t do right, and nobody can do all the things you’re supposed to do. “A physician’s priorities aren’t always the same as a patient,” says Brandt, who gives the example of someone who wants to have an indulgent Sunday dinner with their family but who needs to watch their blood sugar. “I should be treating you with that in mind.”
Mind
Catching cognitive decline early is key; you can get your ducks in a row, figure out who will get POA if you can’t make decisions for yourself, complete a living will and start eating better and exercising to stave off the progression of the disease. It’s a terrifying prospect, but if we can decrease the stigma, more people will take these steps to make their later years less onerous for themselves and their loved ones.
“A lot of geriatric care is actually subtracting medicine. With age come changes in how your body handles side effects, for instance.”
— Dr. Kathryn Brandt, chair of primary care at the University of New England College of Osteopathic Medicine
The basics of geriatric care
When you first see your new geriatrician, you’ll get a Comprehensive Geriatric Assessment (a CGA) for your doctor to take stock of your health at its baseline. This way, they’ll know what your chart looks like when all is well.
Your gerontologist will look through your medical history and evaluate your health up to this point. From there, you will likely receive the tests listed below. Some will involve your geriatrician, some will be done with other professionals connected to the practice. Geriatric practices offer a multidisciplinary approach to care (meaning that they have specialized nurses, occupational therapists, physical therapists, social workers and other practitioners who can address specific health concerns). Together, they make up a team of professionals working together to monitor every aspect of your care.
A functional assessment
A functional assessment, conducted by an occupational therapist (OT) and a physical therapist (PT), will tell you where you need extra support to avoid falls or perform your ADLs (activities of daily living), such as bathing or dressing. The OT can come to your home, recommend supports like shower railings, and suggest strategies or alternatives for how to do things as your body changes. For instance, if you’re becoming a little less steady, your PT might have you do balance-training exercises to strengthen the muscles that help keep you from falling. If your eyesight is getting a little less sharp, an OT might recommend lights for you to install in hallways and entryways so you don’t miss a step.
A cognitive assessment
This will most likely be done by your doctor but it might also be conducted by a speech-language therapist (SLP). Either way, the test is meant to assess your neurologic functioning. This is so, so important, even though it is a terrifying possibility that nobody wants to think about. The fact is that with early detection, you can implement strategies to slow down the progression of cognitive loss and allow yourself time to get your ducks in a row.
A social worker will ask you about your family, friends and other support systems who can help you stave off depression (which worsens any cognitive loss you or your senior loved one may have). You or your loved one might also be able to collaborate with the social worker on paperwork related to your healthcare needs, such as Medicare and supplemental insurance or a living will. They might also be able to tell you about specific programs or resources like Meals on Wheels, transportation services, or where the local bridge club meets.
A care plan
Finally, your team will come together and come up with a care plan for you. This means they’ll each share their findings and identify particular challenges, then map out interventions and suggest which should take priority. “You’re not married to this plan,” Mihalik says. “Your team will come up with suggestions, and you’ll make the decisions based on their blueprint and what it says about what’s up with you now and what to watch for going forward.”
Common geriatric care interventions you or your older loved one might be prescribed
There’s a never-ending list of ways your geriatrician’s office can look out for you. Here are just some of the things they’ll be able to help you with:
Medical management
Everything about each patient is overseen by one office, offering a holistic (whole-body) continuum of care and coordination of services, not different pieces viewed by individual specialists who don’t look beyond their field.
Rehab
If, despite your best efforts, you are injured in a fall, or if you have a scheduled surgery and need time to recover, the geriatric office can be the point-person between the hospital, rehab and in-home care services. At critical moments, a geriatric practice can coordinate between multiple care settings.
Mental health
It’s very common for older adults to get “the blues” or even fall into depression. Geriatric practices know how critical mind health and mood management are for someone experiencing life changes due to aging.
Palliative care or hospice
It can be very hard to gauge exactly when to turn to comfort or end-of-life services. People are often afraid of them, thinking of them as “giving up.” A geriatric practice can bring in experts to explain and invoke their services if you both think they’re needed.
Where to find geriatric care
If you’re looking for a geriatric care practice of your very own (and by this point, we really hope you are!), consider using search tools on the following sites:
- The American Geriatrics Association
- Health in Aging
- Aging Life Care Association
- You can also look in your Medicare directory or your supplemental insurance directory for geriatric medicine.
The bottom line on geriatric care
“The best thing you can do to ensure a happy and healthy aging process for yourself or your loved one is to find a geriatric care provider as soon as possible,” says Trish Colucci Barbosa, a board-certified registered nurse and the president and principal care manager at Peace Aging Care Experts in New Jersey. By being proactive, you or your aging loved one can head off a potential health crisis and stay strong.
