Making the Switch: When to Consider Seeing a Geriatrician


People over the age of 65 often wonder if they should start seeing a geriatrician instead of their regular primary care physician, as their health care needs tend to change and may become more complex as they get older. Dr. Suzanne Salamon, Associate Chief of the Division of Gerontology at Beth Israel Deaconess Medical Center, explains how a geriatrician can offer older adults the support they need to maintain good health.


What is a geriatrician?


A geriatrician is an internal medicine physician who has received additional training specifically in treating older adults. Geriatricians diagnose and treat age-related health conditions, and offer counseling to help prevent and manage health issues that can arise later in life, including memory loss, falls, frailty, and incontinence.



Why should someone over the age of 65 consider seeing a geriatrician?


Often as we age, the number of medical problems increases. And with this, the number of medicines we take also increases, along with side effects and drug interactions. While most internists and family practitioners can manage these issues, there are times when someone with experience in juggling multiple specialists, tests, medical records, and medications can be beneficial.


A consultation with a geriatrician can help if you (or a loved one) are managing multiple medical issues such as memory loss, urinary frequency or incontinence, Parkinson’s disease, falls, arthritis, or polypharmacy (too many pills). It can become overwhelming. Someone who is quite frail, having difficulty managing their activities of daily living or wishing to discuss “end of life” decisions may also benefit from consulting a geriatrician.


But not everyone over the age of 65 needs to see a geriatrician. The need depends more on the number and complexity of the person’s medical conditions than on chronological age. Your primary care physician can help you determine whether the switch to a geriatrician is right for you.



How can a geriatrician help a caregiver to the elderly?


Caregivers who need help developing a care plan for older parents or relatives can think of a geriatrician as the coordinator of their loved one’s health care team. That team might include a psychiatrist, a social worker, a nurse, and/or a physical therapist.


Geriatricians can also help caregivers decide whether the person’s present home is the best home at this time, or if more support is needed for safety.



What can a patient expect when they see a geriatrician for their regular physical/wellness exam?


It’s important for the patient or the caregiver to come prepared with a list of questions about a number of medical issues — even if they have not experienced trouble in these areas. First, of course, patients should be asking their doctor about the problems or conditions they are dealing with at the moment, as well as their current medications.


The most important medical issues seniors should ask their geriatrician about include:


  • Blood pressure
  • Cholesterol
  • Bone density
  • Colonoscopies
  • Weight
  • Hearing
  • Vision
  • Mood
  • Flu shots


These are all things that need to be continually looked at as one gets older. It’s really proactive for the patient or caregiver to ask about them before experiencing problems. Geriatricians can often help patients pick up on signs of these types of issues before they potentially become serious and more difficult to treat. As needed, we can refer patients to the other geriatric specialists we work with to help provide more advanced care or support.



How do the geriatric specialists at BIDMC work together to give patients the care they need when dealing with multiple medical issues?


Our Senior Health team at BIDMC consists of geriatric physicians and nurse practitioners, as well as geriatric psychiatrists and social workers, all of whom understand the physical, mental and emotional challenges of aging. Together, we provide patients a holistic approach to support healthy aging through primary and specialized care — treatment for everything from blood pressure management to depression, from pre-surgery screening to rehabilitation and long-term care.


In that regard, our Senior Health team at BIDMC also works closely with Hebrew SeniorLife for outpatient rehabilitation as well as short- and long-term care. Transitioning from a hospital to long-term care can be really tough for patients and families, but the relationship we have with Hebrew SeniorLife allows us to keep each other fully informed about the patient, and make sure everything is in place for a smooth transition from one area of care to another.


Our overarching goal is to help keep patients healthy and independent, and to ensure them, their families and caregivers a higher quality of life as they age. Whether we’re working with an inpatient or outpatient, there’s a whole family of doctors, nurses, therapists, and we’re all working together with that same goal in mind. Not only does the patient feel reassured that we’re all working together, but I, as their physician, also feel reassured.