Geriatric medicine is a clinical specialty that focuses on the general and specific health needs of elderly people. These patients typically live with multiple health concerns, and their care needs can be complicated. Expert care for geriatric patients is available at Your Family Medical in Lewisville, TX.
What Is Geriatric Medicine?
A physician with a focus on elderly patients is called a geriatrician. While geriatric medicine is considered a specialty, the geriatrician actually looks after a wide range of health conditions and is very much a generalist. Older men and women experience a variety of physical and cognitive health issues as they continue to age. The geriatrician keeps an eye on all these health issues with an eye toward the past, present and future wellness of the patient.
In understanding the patient’s past history, the geriatrician must have an understanding of previous medical conditions or events that impact the patient’s current state of health, directly or indirectly. Besides providing treatment for current health problems, the geriatrician also works to prevent or reduce the risk of future disease and medical events.
Who Are Geriatric Patients?
A geriatric patient can most easily be described as an older person that lives with declining physical or mental functions. As the saying goes, age is only a number; many 80-year olds are in better shape and spirits than many 65-year olds. A typical patient for geriatric medicine is in their 70s and lives with some combination of chronic health conditions and physical or cognitive decline.
A Wave of Older Patients
People in the U.S. are living longer lives than ever. In 1950, the life expectancy for newborns was 68 years; today it is longer than 78. The percentage of our population aged 85 and older will more than double in the next 20 years. The number of people aged 90 and older in the U. S. has almost tripled since 1980.
Many factors account for this never-before-seen longevity. Advances in medicine, especially drugs such as antibiotics, have played a major part. Also, in comparison to the lives of previous generations, workplaces have become safer, environmental pollution has been lowered, and diets and lifestyles have improved. All these have helped create longer life expectancies than ever seen in history.
The Silver Tsunami
The astounding numbers of the senior population can be traced to the aging of the Baby Boomers. This generation, born in the 20 years between 1944 and 1964, started turning 65 around 2010. Over the next 10 years, these people will number more than 70 million Americans.
With a large aging population comes the problem of who will care for them. In most cases today, the elder’s family assumes a great deal of the caregiving load. According to AARP, there are more than 43 million family caregivers in the U. S. that actively look after senior family or loved ones. These unpaid individuals lead their own busy lives and often can’t stay ahead of health problems and declines in the elderly that they look after.
A geriatrician typically works with both the patient and the family caregivers to maintain health and wellness for the elderly. Beyond pure medical treatment and prescriptions, the geriatric doctor advises the family to ensure that the elder patient is getting proper medical attention, appropriate diet and activity, and is staying emotionally and socially engaged.
How Aging Changes the Body
As we age, our bodies and minds experience an organic decline in function. Even those who have always lived a healthy lifestyle suffer from the effects of aging. Sometimes age-related problems occur suddenly, as in a cardiac event or a stroke. Other issues are the result of cumulative wear, often through chronic conditions that progress over time, such as COPD or arthritis.
Common Physical Problems
The geriatric patient can experience a multitude of problems as they age. These can generally be divided into physical and cognitive (mind-based) issues.
Some of the more typical physical problems experienced by geriatric patients include:
As people age, their bone density changes. Muscles also lose their mass and strength, both on their own and as a result of less physical activity. Problems from chronic diseases, such as osteoarthritis and osteoporosis, become more difficult to live with. These cumulative conditions contribute to weakness and instability, which brings on a potentially dangerous state of frailty.
People’s ability to hear and see degrade with age. A young, healthy individual can hear sound frequencies up to 20 thousand vibrations per second. By middle age, this ability is already reduced by more than 20%. By the time people become senior, hearing loss can result in difficulty following conversations and confusion in noisy spaces.
Vision declines as much as hearing does. A senior’s eyes are slower to adapt to different levels of light. The eye’s lenses develop cataracts, which cloud the vision. Diseases like macular degeneration can curtail vision entirely. Partial or even complete blindness are not uncommon in the elderly, particularly when diabetes is present.
Changes in Digestion
Age-related changes in the gastric system, as well as the patient’s overall metabolism, alter bathroom habits in the elderly. This can have an outsized effect on overall health in the forms of constipation, dehydration and reduced activity. The impact of these changes should not be taken lightly. Most senior falls occur in the bathroom, and often in the middle of the night. Falls are the leading cause of lethal injury in seniors.
As we age, our blood vessels and arteries become stiffer. This results in more work for the heart to do in order to supply the body with adequate blood flow and circulation. To adapt to these changes, the heart increases its muscle mass because it has to pump harder. These alterations create new health risks in the way of high blood pressure and other cardiovascular problems. Medications taken in response to these changes can cause their own problems.
Common Cognitive Problems
The geriatric patient’s physical health problems are often complicated by declines in their mental (cognitive) ability. Just as aging blood vessels make things difficult for the heart, they make brain activity harder as well. Some of the more common cognitive problems experienced by the elderly include:
Loss of Balance and Coordination
The brain makes millions of micro-decisions every minute of our lives. It controls activities that we don’t even consciously think about, such as walking. As the brain slows down, the person’s ability to manage formerly automatic tasks demands active attention. Walking and talking at the same time may be effortless for a young person, but for many elders, it can be actively dangerous for fall risk.
Loss of Memory
Some decline in memory function is normal throughout the aging process. As we get older, words and memories become harder to recall. These initial changes aren’t usually severe enough to seriously impact the geriatric patient’s life. However, symptoms of memory loss may also be the result of an oncoming cognitive condition, such as Alzheimer’s disease. Nearly 6 million Americans suffer from this disease, for which there is no cure.
While progressive diseases such as Alzheimer’s are a genuine concern in the elderly, memory problems can happen for many reasons. Some common factors that geriatric doctors look at in assessing memory issues include depression, the side effects of medications, and cumulative damage from alcohol, smoking or long-ago injuries.
Geriatric Care: Not Just Medicine
It is important to look at geriatric medicine as group of solutions, not all of which are medical in nature. Naturally, the geriatric doctor treats illness as it occurs and assumes a lead role in overseeing patient medications. One of the most important risk factors for the elderly is a situation called polypharmacy, which is a negative interaction between drugs.
The geriatrician also must be on the lookout for signs of further physical or cognitive decline and be able to make referrals to medical specialists when appropriate. In many cases, proactive care can slow or even prevent the onset of larger problems. As an example, changed bathroom habits could point to the onset of a urinary tract infection. This disease is extremely common in elders, especially women. With proper medical attention, these infections be prevented instead of having to be cured.
Home Health Is Health Care Too
The geriatric patient’s daily routine, interactions and attitudes play important roles in their health and wellness. These are generally looked after by the family, but in many cases, professional home care is part of the equation. Many families live with a combination of part-time home health aides with family members pitching in.
Work for the geriatric patient at home may seem routine, but it is not insubstantial. Regardless of who is supervising the home care, there are a host of details that must be kept up every day without fail. This includes meal planning, medication schedules and keeping the elder socially engaged.
The mental aspect of geriatric care is crucial and has an effect on many other conditions that the elder lives with. For example, loneliness and social isolation are connected to stress and high blood pressure. Depression, which is a frequent result of social isolation, further erodes elder abilities and can speed the arrival of dementia and other diseases. Researchers have found that loneliness is just as lethal as smoking 15 cigarettes per day.
Who Is a Geriatric Patient?
There is no common denominator for the geriatric patient other than advanced age. Since everyone ages differently, people seek geriatric care at different stages of their lives. For some patients, appropriate care can be a simple matter of adjustments in diet, medication or physical activity. For others, long-brewing diseases that may have begun in youth may finally need medical attention.
When the elderly patient starts feeling poorly enough, they will often seek geriatric medicine on their own. However, many elders live with limited mobility or cognitive declines (“I forgot”) that often stifle efforts to seek care.
Further, many geriatric patients experience a sense of anxiety over the perceived effects of old age. The stigma of “feeling old” or being a nuisance to the family prevents them from seeing a doctor for something concerning, such as fatigue or confusion. Nobody wants to feel old and in decline, and many seniors hide their symptoms rather than talk about them with caregivers.
It is the job of both the geriatric doctor and the patient’s caregiving support network to identify wellness problems, create healthy routines for the patient, and provide a safe, comfortable living environment. Under these conditions, geriatric loved ones can live longer, healthier, happier lives.
Where Should I Seek Help?
Creating and maintaining a state of optimal health and wellness for geriatric patients is a specialty for us. If you are seeking specialized geriatrician services for yourself or a loved one, we can help. Contact Your Family Medical in Lewisville, TX today and schedule a consultation!