Understanding Geriatric Medicine
What is 'geriatric medicine'?
Geriatrics is a subspecialty of medicine that deals with the treatment and care of older people.
What is 'gerontology'?
Gerontology is the study of aging, the biology of aging, the sociology of aging, the psychology of aging, the economics of aging, and basically all aspects of the aging process. So it's the study of aging.
What kind of training does it take to become a geriatrician?
Usually, someone is trained either in family medicine, or internal medicine; perhaps psychiatry and then does a two year fellowship, perhaps even a three year fellowship in geriatric medicine or geriatric psychiatry.
What are the origins of geriatric medicine?
It goes back about a hundred years. Geriatrics really started in Great Britain, actually in Scotland. There were several doctors who were pioneers in geriatrics, going back to 1910, 1920. There were also pioneers in America dating back to the 1920's, 1930's, and 1940's. There was Doctor Lord at Johns Hopkins here in America. In 1950 and 1960 the first geriatric program was officially established at the Long Island Jewish Hospital.
At what age should I see a geriatrician?
It's an interesting question: when does geriatrics begin? If you ask an internist, they'll say I can take care of an older patient and that there is no real age that I should give the patient up. But we find in geriatrics that when the internists find that their patient has too many diseases, are taking too many medicines, having too many complications, at almost any age, they then become a geriatric patient. For example, in my clinic I see patients who are 58, I see patients who are 99. That's the span. It's really up to the doctor to refer someone who they think may have problems related to aging that they don't want to deal with. We are the experts in problems of aging.
How can a geriatrician help me?
Why are the medical needs of senior citizens different?
What is the projected need for geriatric care in the future?
The needs for geriatrics are enormous! We have today four million individuals, for example, over age 85. We may have in the next upcoming decades, thirty or forty million people in this age group. Why is 85 so important? Because the average 85 year old is either in a nursing or assisted living facility, or lives at home with assistance. So again, think about thirty million people and their needs for transportation, their needs for medical care, their needs for social care, housekeeping and shopping, etc. These needs within geriatrics are going to be enormous.
What is an 'osteopathic physician' or a 'DO'?
A doctor of osteopathy trains almost identically to an M.D. . The only difference is they receive another 100 to 200 hours of education on spinal manipulation. So they receive the same training as an M.D., but have the extra boost of spinal manipulation. Osteopathic physicians are accredited just as medical schools are, and they become interns or residents, and they become specialists, just like physicians.
What is a 'geropsychiatrist'?
A "geropsychiatrist" is someone that specializes in the area of psychiatry, as it relates to older patients. And again a special knowledge base is really required, because the problems of older people maybe very different. Let me give you an example. Schizophrenia, is very common in young people, but you don't usually see it start in old age. Geriatric depression is very different from depression at age twenty. Therapy's are very different. Are you going to send someone to a psychologist at age 75 or 85? Probably not. You're looking for short term directive therapy such as cognitive therapy or drug therapy.
What kinds of health care professionals make up a geriatric medical team?
A geriatric medical team is a very important concept; the geriatrics. We do things as a team, not as an individual. It's not just the doctor. It's the doctor, the nurse or the nurse practitioner. It's the dentist, it's the pharmacist, it's the occupational therapist, it's the physical therapist, it's the speech therapist, it's the social worker, and there are many other members of the team as well. But that's just the core of this huge team of people that really provides geriatric care.
When should a caregiver send an older person to see a geriatrician?
When an older person starts having multiple problems, is taking many drugs, and has many medical issues, that's the time for them to see someone who has specialized training in geriatrics.
What does it mean to 'die of old age'?
You really don't die of old age, you die of a specific disease or condition. But as you get older, you get much more susceptible to things that are going to kill you, so your odds of dying actually increases exponentially with aging. If you are 25 or 35 or 45, the odds are that you are not going to die that year, but if you are 95 or 100 the odds are pretty good that you may die that year.
What is the best source of information on geriatric medicine?
A great source is the American Geriatric Society. This is an organization comprised of Geriatricians from across the country, and lead by people who head up Geriatric programs at major universities.
Are the diseases geriatrics treat changing?
