There are some common questions that come up for aging adults and their families including:
- What age is geriatric?
- What is geriatric care and why should I see a geriatric doctor?
- What is geriatric care management?
- What is geriatric rehab, and how does it differ from geriatric wellness?
Many older adults and their families ask these questions as they prepare to age happy & healthy. There are often unknown, hidden gems of resources available to older adults which aren’t frequently utilized. Enjoy this overview of a few of the resources available to aging adults.
What age is geriatric?
Geriatric is defined as “of, relating to, or appropriate for elderly people,” by the Merriam-Webster Dictionary. What age is geriatric? Well, that depends on who you’re asking! Gerontology is primarily focused on individuals 65 years and older, although the true definition of “geriatric,” often varies. Geriatric specialists are often well versed in Medicare, the primary insurance for many older adults.
What is geriatric care and what is a geriatric doctor?
Geriatric care frequently includes medicine, provided by most often by family practitioners, internists and other gerontologists. Geriatrics is a type of specialist who primarily works with older adults and is knowledgeable about common conditions that effect aging adults. Aside from extensive knowledge about diagnoses and medical processes, geriatric medicine practitioners are often aware of community resources that may be of assistance for the geriatric population. Geriatric specialty care providers frequently have connections with care coordinators, physical and occupational therapists, mental health counselors and other professionals who can be helpful in providing geriatric care. Gerontologists may assist patients in accessing services such as home health, outpatient therapies or skilled rehab. Skilled in working with the geriatric populations, geriatric care specialists often refer older adults to other specialists for chronic disease management.
What is geriatric care management?
Geriatric care management or geriatric care coordination is a much-needed service provided to older adults and their families. A geriatric care coordinator is an accomplished expert providing services to the geriatric population. Geriatric care management can assist aging adults and their families by attending physician appointments, facilitating services and coordinating between specialty doctors. Frequently older adults have multiple chronic conditions requiring the care of multiple specialties such as nephrology, neurology, ophthalmology and more.
Unfortunately, specialists often have limited access to one another which can contribute to medication errors and miscommunication. Geriatric care management can assist to ensure all medications are updated and facilitate progress toward the patient’s goals. A care coordinator frequently acts as an advocate for the patient and family, remembering to ask pressing questions and taking thorough notes.
Geriatric care managers and care coordinators frequently attend appointments with older adults. This can be helpful, as often an adult child or other caregiver has other commitments during working hours. Studies show that older adults retain 14% of verbal information provided in medical appointments, with a primary focus on diagnostic results rather than treatment plan. Research suggests aging adults retain more – 80% of information provided with visual aids and pictographs. A care coordinator can take detailed notes during appointments and are particularly focused on the treatment plan. Individuals practicing geriatric care management are familiar with medical terminology and able to easily relay important details following a session.
Geriatric care management can often be exponentially helpful to older adults experiencing multiple hardships over a short period of time, such as a fall or unexpected medical event. In these circumstances it is crucial that an aging adult and their families cease this spiral. A geriatric care coordinator can provide recommendations for resources to improve an older adult’s independence and quality of life. One of these common recommendations is to geriatric rehab and wellness.
What is geriatric rehab?
Geriatric rehab and geriatric wellness are a specialty areas providing care to the geriatric population. Rehabilitation most often includes occupational therapy, physical therapy and speech language pathology (speech therapy). Geriatric rehab is primarily focused on restoring strength and independence following a functional decline, fall or other unexpected medical event. A functional decline may be as small as having to take more rest breaks or losing balance more frequently. A more significant event noting a functional decline would be increased falls, pain or substantial weakness preventing independence with walking and activities of daily living.
An occupational therapist providing geriatric rehab considers all pieces that may affect an older adult’s abilities to live safely and independently. An individual’s physical skills, cognition and emotional wellness can affect how he or she participates in their daily occupations. No, not only his or her career or job, but anything that occupies a person’s time. We all have some basic functions we need to complete regularly, such as eating, toileting, dressing and bathing. We each have our own responsibilities too including laundry, cleaning, cooking and managing medications. Of course, we all need time to rest and re-charge too! Some things we may do in our free time include participating in hobbies or other leisurely activities.
Let’s do an example together. Have you ever considered all of the skills required for vacuuming?
To successfully complete this activity, an individual needs to have good balance, arm strength and endurance to keep themselves upright and move the vacuum simultaneously. We need cognitive skills including the ability to attend to the task, memory or recall to know what areas we’ve already completed or still remain, and adequate cognition for safety awareness. A vacuum with a cord could easily become wrapped around the feet or present a hazard with the electrical components.
What about mental health and emotional wellness? How do those factor into our vacuuming task? If we do not feel emotionally well and are experiencing depressive symptoms we may be less inclined to start a task such as vacuuming. If we are experiencing anxiety, we may be feeling too overwhelmed to add another task to our plate.
As you can see, there are many skills that factor into what most of us would consider a simple task. The skills required for vacuuming are many that can be impacted by the challenges of aging. Strength, balance and endurance are factors that often change as we age. A change in any of these skills may qualify an individual to receive physical and occupational therapy services. If you or a loved one has concerns, start with a visit to your primary care provider or geriatrician.
Age-related cognitive decline is possible, but cognitive decline hindering independence is often exacerbated by diagnoses including Alzheimer’s or dementia. The Alzheimer’s Association has published 10 early signs & symptoms. Often, it is caregivers and family members who are first to notice changes in memory and cognition. Discussing these changes can a challenging task, as many older adults fear a decline in cognition may impede their ability to live independently. The Cleveland Clinic provides valuable insight into starting these conversations on their website. A visit with your geriatric care specialist may result in a referral to a neurologist, occupational therapist and/or speech language pathologist.
Emotional factors such as depression are relatively common in the aging population, starting at 1-5% of community dwelling adults and increasing to 13.5% of those requiring home healthcare. However, depression is not a normal part of aging. If you or a loved one is experiencing a change in mental health, visit your healthcare provider’s office. In cases of emergency, call 911 or the national suicide hotline 1-800-273-8255.
What is geriatric wellness?
A physician specializing in geriatric care may encourage multiple wellness programs for older adults. Lifestyle adjustments have shown to significantly prevent and improve chronic disease. The Cleveland Clinic identifies multiple lifestyle changes to slow memory changes, including aerobic exercise, socialization, finding a sense of purpose, quality sleep and a healthy diet.
In comparison to geriatric rehab, geriatric wellness has a greater focus on prevention. Wellness services often includes extensive education in preventing functional decline both physically and cognitively. Geriatric wellness is a type of specialty provided by trained professionals in order to maintain health and wellness during the aging process. Have you ever felt like, oh I could exercise if I had someone to hold me accountable? Geriatric wellness includes the accountability by offering individualized support from a trained professional. This can be support in an exercise, cognitive or emotional wellness program. Before starting any wellness program, start with a conversation with your primary care provider. Be sure to ask about any precautions or complications you should be aware of in starting a wellness program. Keep an ongoing list of any precautions or recommendations from your physician. If there are several precautions, do your research on finding the right wellness provider for you. It may make most sense to start with a medical provider such as an OT or PT prior to transitioning to a professional like a certified personal trainer.
Aging presents with unique needs, which often requires the help of a full care team. If you have questions, please contact us here.