We know that as we age and grow, our bodies require different care and management. You wouldn't take your child to see an adult primary care physician (PCP), so why do we not consider the same things for our 65+ populations? In children, we specifically search out and select pediatricians, but very few adults switch over to a geriatrician as they age. Many do not even know they can - or should.
Who is considered an "older adult"? Although tough to accept as a milestone of need for geriatric care, any adult who has reached 65 or older should consider a geriatrician. According to the U.S. Department of Health and Human Services, the number of people age 65 and older is projected to reach 80.8 million by 2040 and 94.7 million by 2060, making them the fastest-growing demographics in the United States. The U.S. Census projects that by 2034, the number of older adults will surpass the number of children for the first time ever.
What exactly is a geriatrician versus my PCP? A geriatrician is a medical provider who has specialized training and expertise in managing the care of older adults. They see the "bigger picture" of the individual's life, including the dynamics of interactions between multiple medical conditions, and when and how to treat medical ailments that are caused by these other medical issues. They understand the physical and physiological changes of the body's changes in drug and medication absorption, circulation, and metabolism, and help to manage and reduce the interacting side effects of medications. Geriatricians and geriatric providers also understand the typical aging curves and can help differentiate between delirium, dementia, and depression, and quickly access the chain of support care.
Why Should I Change? We all know looking for a physician is not easy or desirable. We feel physician loyalty - the PCP who has been following since we were 20 "knows us best," or we "really like their bedside manner." Although that may be true for you, the training and understanding a geriatrician has compared to a PCP can greatly impact the aging process and quality of life of an older adult for the remaining 10 -30 years of their lives (that's a long time!). According to Harvard Medical School (2019), geriatricians are key in supporting aging adults. They recognize the importance of family in decision-making and include their input and help individuals and families actively coordinate with other specialists. Most importantly, they understand the harmful effects medications (even ones the individual may have been on "forever") have on older people, and how adverse drug interactions can present as dementia or depression. In short, "a geriatrician has the specialized expertise to evaluate an individual's medications and recommend changing or stopping certain drugs to avoid potential problems" (Harvard Health Publishing, 2019).
How to Pick a Geriatrician: Now that you're convinced to seek out geriatric-specific care, how do you go about doing it? Check with your insurance company first (which likely is Medicare). They may be able to direct you to providers. Once you have identified a provider, consider asking them about their training in geriatric care, including any medical affiliations they may have. Find about their office hours, how easy it is to get ahold of them, and how they manage emergencies. See what they say about other utilizing support providers, such as cardiologists, pulmonologists, and therapy professions, including how they collaborate and refer. Ask about clinic visits, if they are in-person or telehealth only, if they offer house-calls, and if they allow family members to attend clinic appointments. Lastly, and most importantly find out their clinical philosophy and see if it aligns with your goals of care, including prevention and social-emotional support options.
In short, a medical provider, who understands the dynamics of the older adult can significantly improve an individual's quality of life, health. and happiness, leading to a longer and more productive "third act." And at the end of the day, isn't that what we all want?
Harvard Health Publishing, Harvard Medical School. (January 26, 2019). Why choose a geriatrician?. Retrieved on October 16, 2021, from https://www.health.harvard.edu/staying-healthy/why-choose-a-geriatrician
John's Hopkin's Medicine. (n.d.) Specialists in Aging: Do You Need a Geriatrician?. Retrieved on October 16, 2021, from https://www.hopkinsmedicine.org/health/wellness-and-prevention/specialists-in-aging-do-you-need-a-geriatrician
U.S. Census Bureau. (August 21, 2021). National Senior Citizens Day: August 21, 2021. Retrieved on October 16, 2021, from https://www.census.gov/newsroom/stories/senior-citizens-day.html
U.S. Department of Health and Human Services, Administration for Community Living. (May 25, 2021). Projected Future Growth of Older Population. Retrieved October 16, 2021, from https://acl.gov/aging-and-disability-in-america/data-and-research/projected-future-growth-older-population