Definition and Overview
Individuals aged 65 years old and above who have existing health problems or require general medical care are encouraged to consult a geriatric medicine specialist. The goal of the consultation is to ensure that the patient is as healthy as possible by introducing proper care techniques and addressing existing medical issues promptly to reduce the risk for severe medical problems that are linked to advanced age.
Who Should Undergo and Expected Results
A geriatric medicine consultation will benefit all elderly individuals over the age of 65 years old especially those who suffer from specific medical problems, which include the following:
- Alzheimer’s disease and other cases of dementia or memory problems
- Neurological problems
- Parkinson’s disease
- Difficulties with movement or walking
- Incontinence or constipation
- Mood and anxiety disorders
- Unexpected weight loss
- Cardiovascular disease
If there are any difficulties faced in caring for the patient at home, a consultation may also shed some light on proper care techniques that will not only ensure the patient’s health but will also make it easier for his family members to care for him.
At the end of the consultation, the doctor will provide:
- A detailed assessment of an existing condition
- Advice on managing the patient’s situation in general
- A referral for tests, if more information is necessary to make a diagnosis
How the Procedure Works
This type of consultation is provided by a geriatric medicine specialist. The appointment takes place in his office or clinic, and may take between one and two hours or longer if some tests are to be conducted. The consultation is, in most cases, initiated by the patient’s family or his primary care physician, both of whom may be present during the appointment.
The consultation typically begins with an evaluation of the patient’s medical history, existing symptoms and lab test results. Thus, the specialist should be provided with all the necessary information, such as medical and hospitalization records, discharge summaries, medication list and recent events about the patient’s health.
The patient’s frailty level will then be evaluated based on the following factors:
- Muscle strength or weakness
- Energy or exhaustion level
- Level of physical activity
- Walking speed
This frailty level will significantly influence the type and extent of care that the patient requires.
Guided by the available information, the specialist will provide his advice and suggestions, which will then be carried out or executed by the primary care physician, the patient’s relatives, a social worker or caregiver.
Possible Risks and Complications
A geriatric medicine consultation is an important step in ensuring that an elderly patient receives the right kind of medical and home care that he needs based on his specific situation or the state of his health. Since the consultation mostly involves an interview and a discussion, it is perfectly safe for all patients.
In fact, this consultation can help protect them from risks and possible complications that they are more susceptible to, given their age, especially when they do not receive the ideal type and level of care that they require. These risks include:
- Side effects from medications and medical procedures
- Post-surgical complications
- Blood clot
- Allergic reactions to anesthetics
As several cases that involve geriatric patients are related to accidental falls, geriatric medicine specialist also assesses major risk factors that are listed below to minimise these events that can lead to some form of injuries.
- Blood pressure fluctuations
- Weak muscles
- Lack of flexibility and endurance
- Poor balance and gait
- Slower reflexes
- Sensory difficulties, i.e. not seeing well and not hearing well
- Vision problems, e.g. cataracts and glaucoma
However, many accidents in the homes of elderly patients are also linked to several other seemingly minor factors, such as clutter, loose rugs and the lack of proper care facilities. A geriatric medicine consultation provides general reminders on such issues for the protection of the patient.
- Minaker KL. Common clinical sequaelae of aging. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 24.