Caring for Seniors: Geriatricians can help older adults live better
Jonathan DenbyRepublished from RemedyLife.com
Geriatricians can help older adults live better
By Jonathan Denby
haron A. Brangman, M.D., professor of medicine and division chief of geriatrics at SUNY Upstate Medical University in Syracuse, NY
Sharon A. Brangman, M.D., professor of medicine and division chief of geriatrics at SUNY Upstate Medical University in Syracuse, NY, explains the specialized services geriatricians provide to older adults and their families.
What does a geriatrician do?
A geriatrician is a medical doctor who is specifically trained to prevent and manage the unique health concerns of adults age 65 and older, according to the American Geriatrics Society (AGS). “A geriatrician is the opposite of a pediatrician,” says Sharon A. Brangman, M.D., professor of medicine and division chief of geriatrics at SUNY Upstate Medical University in Syracuse, NY, and a member of the AGS. “A geriatrician takes care of medical issues related to aging, helping sort out normal aging from what might be a disease process.”
What is the difference between a geriatrician and a gerontologist?
Gerontologists also specialize in aging, “but more from the social standpoint,” says Dr. Brangman. “These are people who know about statistical trends, demographic trends; they can be social workers or architects who specialize in aging.” Put another way: “Every geriatrician is a gerontologist,” says Dr. Brangman, “but only geriatriticians are medical practitioners.”
How is geriatrics different from what a primary care provider might offer?
“Geriatricians can wear two hats,” says Dr. Brangman. “We can be a primary-care doctor or internist, but we can also be specialists and work with a primary-care doctor to focus on issues that are particular to an aging adult.” For example, a geriatrician will look at dementia, depression, pressure sores, urinary incontinence and falls (while falls are not a medical condition, they have a huge impact on the independence and mobility of seniors, especially their ability to live alone). “We look at the entire person and their entire medical condition, and how it affects their everyday function, their relationship with their family and how they can live on their own.”
Who should seek a geriatrician?
“We focus on the ‘geriatric syndromes,’ common diseases and health problems associated with aging. In geriatrics we divide aging up into three categories,” Dr. Brangman explains. “We have the young-old, who are 65 to 74; the middle-old, who are 75 to 84; and the old-old, who are 85 and older.” Each age bracket has its own particular medical concerns. Although Dr. Brangman’s patients tend to fall in the “old-old” category, anyone who is at least 65 is a candidate for geriatric services.
What is a typical visit with a geriatrician like?
Although there are different models of service, a team evaluation of the patient is the most commonly used. “We generally do an overall assessment of the person. We frequently have their spouse or children come in with them. We ask them to bring all the medicines that they take from all their doctors,” she says, noting that it’s common for multiple doctors to be writing prescriptions without anyone checking for unnecessary overlaps, for example, or dangerous drug interactions. “The patient will speak with our nurse, and frequently our social worker, while some practices have nutritionists and other therapists who also do an assessment,” she says. Then the team puts together a picture of the patient’s health needs and develops a plan of care.
Should a caregiver consult a geriatrician?
“A lot of times caregivers do initiate the first visit,” says Dr. Brangman. For example, a middle-aged son or daughter may go for a visit and find that their mother or father is not doing very well. “They come home and see the house is not as neat, the refrigerator is empty, and their mom may have soiled clothing or be a little confused.”
What are the keys to healthy aging?
Most people do not begin thinking about healthy aging until they reach their senior years, according to Dr. Brangman. “But in order to age well, you have to start in middle age. And I always say aging well starts with good prenatal care. You really have to be thinking about your health all along and not say, ‘Well, I’ll abuse my body in my twenties and thirties and worry about it later.’ Because what you do in your twenties, thirties and forties will affect how well you age. The most common health problems in this country are heart disease, strokes and cancers. The way to help minimize their effects and to increase your chances of living a longer, healthier life is by eating fruits and vegetables and less meat, plus daily exercising. Of course, no smoking and moderate alcohol.”
And, Dr. Brangman points out, it’s important to feel connected to other people: “You also want to have some kind of meaningful activity. Most of my patients tell me how important it is for them to feel useful. You need to have good, healthy social connections, social interactions, community involvement. People who are isolated and spend most their time by themselves are more likely to be depressed and sit around and think about their aches and pains. So, we encourage people to be involved in the world around them.”
How can I find a geriatrician in my area?
The AGS Foundation for Health and Aging has lots of educational material, tips sheets on health for caregivers as well as for older patients. “It’s a good resource for adult children who are trying to help their parents figure out their health care and what they might need,” says Dr. Brangman. Log on to their website (healthinaging.org) or call their toll-free number (800) 563-4916.
Another possible source: “Many medical schools with a geriatrics program have a health-clinic component,” says Dr. Brangman. Or, ask your primary-care physician if there is a geriatrician in the area.
Are geriatrician services covered by insurance?
“Most geriatricians accept Medicare, the primary insurance for older adults,” says Dr. Brangman. “So most people should be covered.” Most private insurance companies cover geriatric services as well.
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