If you’re considering a career in geriatric medicine, you’re not alone. Despite their common age, the elderly often display symptoms that don’t correspond with their actual medical condition. For instance, an elderly person’s fall may not be the result of pneumonia, but could be due to a problem with balance. Geriatric medicine encompasses the work of primary care physicians, urgent care doctors, medical students, social workers, and other caregivers.
Become a geriatrician
As the Baby Boomers age and the population continues to grow, health care services for the elderly will become a significant part of society. Many employment forecasts cite this burgeoning demographic as a reason to become a geriatrician. In the next 10 years, there will be an estimated 7% growth in the number of geriatricians. Geriatricians are found across many academic fields and are primarily supervised by family doctors.
A geriatrician’s job also involves closely monitoring the effects of medications. Aside from monitoring side effects, geriatricians must also be on the lookout for potential drug interactions. Because of this, geriatricians are expected to act as a patient’s advocate. When they don’t, they may commit malpractice. Additionally, geriatricians deal with issues that are legally binding, such as end-of-life care.
In addition to training, a geriatrician must possess excellent communication skills. Working closely with multiple people, geriatricians must be able to convey the patient’s current health and any potential health problems to the team. Patience is another essential skill. Some patients require a slow approach, and it is important to show patience while dealing with them. However, geriatricians often enjoy helping people in need.
In addition to their medical expertise, geriatricians also work in hospice settings. Because of this, they must have a broad understanding of psychiatry and physiology to properly diagnose and treat their conditions. As such, they also need to understand relationships with patients. They often have a challenging caseload, but this doesn’t stop them from achieving their career goal. A typical geriatrician’s day is a little different from an academic one. Academic geriatricians work with a mix of clinical service at an affiliated hospital, as well as didactics.
Work closely with other disciplines
During their third year of medical school, medical students complete a geriatric medicine course. Fellows gain experience in various aspects of geriatric medicine, including functional status assessments and geriatric syndromes. The course also includes opportunities to participate in interprofessional teams that emphasize team-based care. In addition, fellows will have a chance to collaborate with specialists from other disciplines, including nurses.
The formation of MDTs is a vitally important aspect of comprehensive geriatric assessment. MDT meetings should be coordinated and effective to produce the best patient care. Training together as a multidisciplinary team can increase the performance of the team and patient outcomes. MDTs should be facilitated to enhance leadership skills and communication. Throughout clinical practice, MDT meetings should be evaluated to ensure that teamwork is working effectively.
Nurses in geriatrics play an important role in promoting and facilitating patient-centered care. Nurses play a critical role in coordinating communication between patients, family members, and medical staff. They work closely with social workers, pharmacists, and other disciplines in healthcare. Geriatricians also collaborate with other disciplines such as social workers, psychologists, and other physicians to provide the best care for patients.
Palliative care and geriatric medicine have many parallels. Both disciplines have similar patient populations and approach to care. Participants from both fields reported the benefits of collaboration. For example, palliative care would contribute knowledge on general palliative care, ethical decision-making, and prognosis. While geriatric medicine would bring expertise in geriatric assessment, frailty, comorbidities, and metabolism.
Focus on quality of life
Quality of life (QoL) has long been ignored in healthcare, even though it is often the most important determinant of patient health. Drug treatment guidelines typically do not consider QoL. Instead, they are focused on specific diseases and their treatment, which has the potential to reduce a patient’s quality of life. Additionally, the healthcare system rewards practitioners who follow prescribed drug therapy guidelines, thereby creating incentives to prescribe the most expensive and effective drugs.
The number of older people continues to rise dramatically in the United States, making comprehensive health maintenance screening of the elderly an increasingly important task for primary care physicians. Older patients’ assessment must include specific categories, such as sensory perception and injury prevention. Patients also have an increased risk of falls, postural hypotension, balance and gait impairment, polypharmacy, and sedative-hypnotic medications. In addition, many common interventions may have specialized implications in this population.
In addition to medical interventions, physician-patient relationships should be emphasized. Physicians must consider the patient’s social environment and relationship status when prescribing geriatric medicine. Many physicians have not considered these issues before, and as a result, have created an environment where older patients are often neglected. This environment has been a source of stress and frustration for patients, and physicians need to learn how to honor these patients’ needs and respect their autonomy.
Older adults tend to take more medication than other populations. This increased medication burden leads to decreased adherence, adverse drug reactions, and increased risk for falls and cognitive impairment. Ineffective medication management can lead to an unnecessary burden on elderly patients. Hence, an annual medication review is an important quality indicator for elderly patients. This can help improve quality of life and reduce medication costs. This can be done through multiple approaches, such as utilizing the Beers criteria or the STOPP criteria.
Symptoms of delirium
If you suspect your loved one is experiencing delirium, there are a few things you can do to reduce the risk. First, identify the underlying medical condition. If a medication is causing delirium, seek medical treatment as soon as possible. If a patient is taking benzodiazepines, they may be able to be cured without further medical intervention. For other cases, a caregiver may be able to prevent the symptoms by making sure the individual takes proper sleep and has access to glasses and hearing aids. In addition, family members should be there to provide reassuring presence and information to the patient.
If your loved one is living in an assisted living facility, you should call your primary care physician to discuss possible causes and solutions for the condition. In some cases, dementia is the cause of delirium, which can be life-threatening. However, this condition is often preventable. If you suspect that a loved one is experiencing delirium due to a medication, you should call their doctor and request a consultation.
If your loved one has been taking several medications, you should monitor for signs of anticholinergic toxicity or an overdose of other medications. If delirium persists, you should monitor your patient’s creatinine clearance and consider other medical solutions. Medications with anticholinergic effects should be avoided or replaced with those with lower anticholinergic potency. In addition to medications, you should also consider non-pharmacological interventions.
A patient experiencing delirium should be evaluated for any of these signs. The symptoms of delirium are usually similar to those of other medical conditions, such as depression, and include a diminished capacity for attention and cognition. Generally, delirium is caused by underlying conditions, but in some cases, an acute illness or medication can worsen them. Patients who are not already diagnosed with a brain disorder may need a lengthy recovery time before returning to normalcy.
When treating older adults, a doctor who practices geriatric medicine may help them understand their disease and offer a range of treatment options. A geriatrician will evaluate the patient’s ability to perform ADLs, as well as his or her social support, as well as their living conditions. They can also prescribe the right type of medicine based on the patient’s condition and overall health status.
Most geriatric patients suffer from one of four major medical issues. These include decreased physical mobility, loss of muscle mass, and impairment of intellect. As a result, even mild medical problems can worsen pre-existing problems. In addition, muscle tissue deteriorates with age, so patients with a low muscle mass or mobility may lose coordination due to mild fevers. Additionally, patients may have cognitive disorders such as dementia or Alzheimer’s disease.
Chronic pain in the elderly is a common complaint. As the population grows older, the incidence of musculoskeletal pain disorders is increasing. A variety of geriatric patients experience pain associated with cancer-mediated diseases, including neuropathic pain and osteoarthritis. A physician in this specialization can choose from a number of different pain-control treatment options for these patients. To make the most of geriatric pain management, it is important for the physician to start treating these patients with the lowest doses possible. The lower the dose, the lower the risk of adverse effects.
In general, patients whose disease is age-related may maintain a primary care physician and a geriatrician. In some cases, patients see multiple doctors, including specialists. Sometimes geriatricians serve as the sole primary care physician and refer them to other specialists. However, if the patient’s condition is causing them pain, a geriatrician can be the primary care provider.