Geriatrics is medicine for the elderly. As a specialization, it’s actually quite complex since elderly patients are more likely to have multiple concurrent diseases, and require individualized treatment plans.
Last week I had the opportunity to spend the afternoon in a Geriatric Day Clinic. Patients are referred from hospitals after having an acute event (like a heart attack, or a stroke), or by their Family Doctors when it is noticed that the patient is having difficulty coping at home. The goal of the day clinic is rehabilitation, and the care-providers working there strive to give patients whatever help they may need to remain functional and active. Many elderly people only need a few well-chosen interventions to keep them living independently and out of long-term care facilities.
Geriatric care is necessarily multi-disciplinary. The clinic is composed of a really neat spectrum of professionals:
- Physiotherapists: can prescribe exercises to recover muscle strength and range of motion
- Occupational therapists: can teach patients how to maintain their activities of daily living with possible physical or cognitive impairment e.g. how to take a shower without needing to stand up for too long
- Recreational therapists: spend time with the patients and find ways to stimulate their interests
- RNs: educate patients about their conditions, advocate for patient concerns, and provide much of the primary care required
- Social workers: can refer elderly people to services that are available in the community to help them, such as meals on wheels, grocery deliveries, etc.
- Pharmacists: review medications and optimize wherever possible. This is especially important for the elderly who can be on as many as 20 or more medications!
- MDs: Assess physical and cognitive status. Make treatment recommendations.
A patient of the Geriatric Day Clinic may visit with a few, or even all of these professionals! Once every two weeks these team members all come together to have a shared discussion of what each patient particularly needs, and to set goals for care.
