Monday, January 9, 2017

What's a Geriatrician? And whom do they best serve?


Saturday mornings, I listen to two radio programs about senior care:  Leading Edge Medicine, hosted by Jerry Mixon, MD, and AgingOptions, hosted by Rajiv Nagaich. Each has its own distinctives.  Mixon's show emphasizes keeping healthy no matter one's age.  Nagaich's program focuses on the legal, financial and medical aspects of aging.

Last Saturday Aging Options featured Chad Boldt, MD, a renowned geriatrician.  Geriatricians specialize in treating older people, especially those with multiple chronic diseases. 

Could your parent or loved one benefit from a geriatrician? Here's a test.

1.  Does your loved one suffer from four or more chronic diseases?  An example would be someone who has diabetes, congestive heart failure, depression and chronic pain.  In 2010 37% of people on Medicare fit that description. Often these patients are 85 or older and have dementia,

2.  Does your loved one take lots of medications?  "Nobody should take 20 or more medications," says Dr. Boldt. More certainly doesn't mean better, since medications can interact negatively with each other.

3.  Does your loved one get confused when multiple specialists give instructions?  As people become more frail, they may not be able to understand and comply with instructions by several physicians.

A geriatrician specializes in the elderly, especially who are medically complex. This specialty requires extra training beyond that of a medical doctor.  And unfortunately, says Dr. Boldt, fewer doctors are entering this field than in the past.

So what questions do you ask a prospective geriatrician?  Nagaich suggest these:

1.  Are you a Certified Board Physician in Geriatrics?  There may not be a geriatrician in your area, however.  Many primary care physicians have experience in geriatrics.

2.  Are you accepting new patients?

3.  Will you take my insurance?

Nagaich also suggests that if possible, people look for doctor who has good experience but who is in his or her 50s.

Another way to provide specialized care to older, frail adults is through a team approach.  A physician with expertise in geriatrics oversees the care of patients who receive direct care from a specially trained Registered Nurse, plus other staff.  Dr. Boldt participates in a program called Guided Care, in which one doctor and one specially trained nurse work together to manage medications and give directions to patients and families.

Is your loved one a candidate for a geriatrician?



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