As I mentioned in my last post about health and aging, I’ve found over the past few years that many people aren’t quite sure of what geriatrics is, or how a geriatric approach might be relevant to their work in health or in aging.
This is understandable. After all, the term “geriatrics” is not widely used outside of healthcare. And even within healthcare, many doctors believe they are practicing geriatrics…when in fact they are just taking care of the elderly, in much the same way as they would take care of any adult.
And herein lies the rub. Geriatrics is not just about taking care of the health of aging people, it’s about how you provide such care.
The problem with explaining geriatrics as the health care of aging adults — or older adults — is that this definition is vague about what is different about this form of health care, and why it needs to be different.
So, I’ve been trying to find a way to be more specific about what geriatrics is, as I write for family caregivers and for the tech community.
Here’s how I explained geriatrics to an audience at the recent Health Technology Forum event about older adults.
A More Specific Definition of Geriatrics
I then presented a list of “issues that come up as people age.” This list emerged as I thought through two questions:
- What kinds of problems are very common when it comes to the healthcare of aging adults?
- What kinds of things trigger the need for a “geriatric approach”? By which I mean, what kinds of issues require healthcare professionals to provide care that is different from what we provided to people when they were younger?
Now, we could of course come up with still more issues that prompt a need for a geriatric approach, such as limited life expectancy. But for now, I’d say the five issues I list above are the underlying drivers of most of what I do as a geriatrician.
Who needs the geriatric approach? Who should practice the geriatric approach?
Here’s a message that I really think we in geriatrics should try to get out to the world:
Geriatrics is NOT just for geriatricians. (Or other specially trained health professionals, for that matter.)
To assess people for these issues, and to modify our help accordingly, is something we should all be doing, if our work is to support the health and wellbeing of others.
And many, many people are affected by the age-associated issues above.
In fact, most of these issues are not caused by old age per se. These issues affect a sizeable minority of younger people, often due to serious medical problems.
And even when these problems are brought on by “aging” — by which I mean a combination of gradual wear and decline in the body’s system, along with accumulating damage from less healthy lifestyle factors such as smoking, diet, and stress — it should be obvious that different people develop these problems at different ages.
Some unlucky people need a geriatric approach to healthcare as early as age 55. Others don’t. They are relatively unscathed even to age 95, and continue to live their lives much as they have done, although they are surely quite vulnerable in body and mind (which is why the prescribing of certain medications should be avoided, for instance).
What should we call these “things that happen as people get older”?
This question has been stumping me a bit. Physiologic vulnerability, multimorbidity, functional impairments, geriatric syndromes, chronic caregiver involvement: they are really influential when it comes to the health and healthcare of aging adults, but they are not exclusive to older age. (Well…maybe the geriatric sydromes are.)So I’m not sure what to call these issues. Ideas?
If you have feedback or suggestions as to how we can explain the geriatric approach, so that others can leverage it and implement it more widely, I’d love to hear from you in the comments below.