Geriatric Medicine- Successfully Addressing Challenges in Senior Care

What is Geriatrics?

Geriatric medicine is a medical specialty dedicated to caring for the elderly. By maintaining independence, retaining functions, and assuring quality of life to the greatest extent possible, it attempts to enhance health in elderly individuals.

Early sickness identification and treatment are crucial for elderly patients to maintain health and prevent deterioration of condition.  A doctor who focuses on treating elderly patients is known as a geriatrician or geriatric physician.

What is a Geriatrician? What do they do?

A geriatrician is a primary care doctor who specializes in treating older adults. They provide integrative care, diagnose a variety of conditions, and help you maintain a high quality of life.

Aging can bring a unique mix of physical, mental, emotional, and social issues. There is no age limit for seeing a geriatrician. Each person's situation and requirements are unique. However, you might consider seeing a geriatrician if you:

are living with multiple conditions or diseases take multiple medications want to help provide additional assistance to your caregivers, family members, and friends have reduced mobility or another disability

Geriatric doctors help older adults — typically those ages 65 and older — stay functional, healthy, and happy.

So, whether you're nearing retirement age or have been managing a health problem that often affects the elderly, there may be strong reasons to explore locating a geriatrician in your community.

Diagnose and treat various conditions

A geriatrician will conduct functional, cognitive, and physical examinations to determine the optimal treatment approach for you

Functional status relates to your capacity to accomplish particular things on your own. For example:

  • eating and drinking
  • bathing and dressing
  • controlling bowel and bladder movements
  • taking medication
  • shopping and doing household work
  • managing your finances

A cognitive assessment involves looking for signs of conditions such as dementia, insomnia, and depression.

A physical and medical history examination assesses your risk for conditions older adults may experience, such as:

  • incontinence
  • osteoporosis and osteoarthritis
  • hearing and vision loss
  • malnutrition
  • fall injuries or balance issues
  • hypertension
  • diabetes

Difference between Normal Medical care and Geriatric care

Diagnostic procedures and cure-focused treatments are part of standard medical care. However, the idea of curing may not be fully effective in senior patients who are already afflicted with various diseases.

Therefore, the optimal strategy would be to treat patients holistically, taking into account all of their needs, including symptom relief, maintaining functions and quality of life, nutrition, nursing care, and psychosocial elements of care.

Some older patients could have trouble expressing their symptoms. They frequently forget things or may believe it to be a natural aging process.   A skilled geriatrician is capable of successfully eliciting and managing concerns of elderly patients

Along with identifying and treating illnesses, geriatricians place more attention on the preferences and values of their patients. Treatments will therefore be more patient-centered and goal oriented to reduce unrealistic expectations and frustrations that may arise during treatment.

Atypical Presentation of diseases

As a person ages, there occurs decline in functions of different organ systems. As a result, at times of illness, first organ affected may be the weakest system. Elderly person may suddenly  deteriorate on exposure to minor stress like a fever/loose stool since they have limited functional reserves to cope up with the stressful event. 

An elderly person with pneumonia may present with confusion and restlessness rather than classical fever with cough. Atypical presentation of diseases are common in elderly patients.    

Early detection and treatment of diseases is crucial for a successful outcome

Geriatric Syndromes: Common And Often Related Medical Conditions in Elderly

Geriatric syndromes are a group of disorders that are frequently found in senior persons and are brought on by both underlying medical issues and the natural changes that come with aging.

Every older adult can be found to have geriatric syndromes, differing in severity. When experiencing a significant sickness or a stressful event like surgery or hospitalization, it becomes problematic.

Diseases constituting geriatric syndromes are often related. One may worsen another and finally result in gross deterioration of function and cognition

Sleep Problems in Old Age

Sleep disturbances are one of the major health complaints of older adults which is often distressing to patients and their care givers

Common causes of sleep disorders include age related changes that affect sleep quality, frequent awakenings due to noise, underlying diseases like depression, diabetes, urinary problems, breathlessness, neuropathy etc

Not recognizing and appropriately treating sleep disorders may result in deterioration in quality of life, development of psychiatric disorders, worsening of memory problems and increased risk of morbidity and mortality

Psychiatric Problems In Elderly Patients

Acute confusion or Delirium is the most common psychiatric problem which is associated with increased risk of morbidity and mortality in older patients. The causes for delirium includes infections, electrolyte abnormalities, polypharmacy, hearing/ vision impairment, history of alcohol use etc

Dementia is a very common problem among older people. It is a chronic disease with progressing course. It gradually affects the functioning of a person and progresses to a state where a person needs assistance in fulfilling his basic needs

Depression is another problem which occurs in elderly people as a result of social ,economic and disease conditions. Once recognized depression can be very effectively treated in elderly patients. Treatment should be done under supervision of an experienced psychiatrist.

Falls In Elderly

Falls are a common problem in elderly patients which results in high morbidity and mortality. Cause for falls are multi factorial and needs assessment to prevent occurrence. A fall is often said to be the “Beginning of End” in geriatric age group.  A fall may occur due to a  mechanical cause like tripping or as a result of underlying medical condition like diabetes, hypotension, stroke, Parkinson disease, dementia etc which results in impaired perception. Simple interventions can reduce the events of falling.

Problem of Polypharmacy in Elderly: Are you taking a Lot of  Medications?

Polypharmacy is more common in elderly people due to chronic diseases and multiple medications. Problem with polypharmacy includes overdose, side effects, complications of diseases

Tips to avoid Polypharmacy:

> Be under the care of a Primary care Doctor (whom you trust)

> Do not hesitate to clarify your doubts regarding medication use with doctor before leaving the clinic

> You should be aware of the medications you are taking and why (you can ask the Doctor/ Pharmacist who can help you)

> Avoid un necessary medications like over the counter drugs without knowledge of your doctor

> If you suspect any newly added medication is causing trouble, get in touch with your doctor at the earliest

> It is advisable to take your MEDICATION BOX on every Doctor visit, so as to make sure you are on right medications

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