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Dr. Andrew Rynne
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Recent Answers by Geriatrics Specialist

Psychiatrist, Child

My 86 year old father has a hard lump that has turned black and the blackness is spreading near his ankle bone. I told him he may have hit it and perhaps it was a hemtoma. He has kept it elevated...

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What is Geriatics?

1. Who Is a Geriatrician?

A geriatrician is a physician who specializes in the diagnosis and treatment of the diseases and conditions common in people age 65 years and older. A geriatrician is an expert at identifying age-related physical and mental conditions and helps assess, treat, prevent, and manage disability and disease in the older adults. Geriatricians can help improve functioning and quality of life in older people by addressing multiple illnesses, recommending therapeutic home adaptations, reducing side-effects of drugs and risk of adverse drug events, and providing assistance and support. To become a geriatrics specialist, after graduating from medical school, a doctor completes a residency in internal or family medicine, followed by a fellowship in geriatric medicine.
Geriatricians provide comprehensive, long-term primary care to older adults. Geriatricians are trained to oversee the myriad health conditions and multiple medications older adults often deal with. They treat conditions that affect all areas of the body, including the gastrointestinal, respiratory, reproductive, urinary, nervous, and circulatory systems. They also focus on preventive care and health promotion. Your geriatrician can also help you with issues related to newly acquired disabilities, provide tips on arranging your home to ensure comfort and independence, and teach you exercises to help with strength and balance so you can remain active longer and avoid falls. You may also want to see a geriatrician for end-of-life issues and advance health care directives (living will).

2. When Should I See a Geriatrician?

Your primary care provider may refer you to a geriatrician if you are above 65 years of age and dealing with multiple and/or complex chronic conditions, age-related conditions such as osteoporosis, or take multiple medicines that cause different side effects. You may also decide to see a geriatrician on your own. A geriatrician usually works with a team that includes other doctors, specialists, nurses, physiotherapists, nutritionists, and social workers.

You may need to see a geriatrician for health issues and symptoms that may include:

• Inability to care for yourself including bathing, toileting, dressing, and feeding
• Unsteadiness, loss of balance, dizziness and vertigo, or history of falls
• Breathing difficulties, nasal or chest congestion, wheezing, hoarse voice
• Lung-related problems
• Sleep problems
• Problems with hearing or vision
• Chronic conditions such as COPD, heart disease, diabetes, high blood pressure, osteoporosis, and more
• Digestive disorders
• Muscle pain, muscle weakness, and gait disturbances
• Joint pain, swelling, redness, stiffness, or loss of motion
• Fractures due to osteoporosis
• Tremors, rigid muscles, slow movements
• Fecal or urinary incontinence
• Unexplained bruises, lesions, ulcers, and itchy rashes or blisters with pain or tingling sensation (shingles)
• Severe or chronic pain anywhere in the body
• Fatigue
• Memory problems including an inability to carry out simple tasks at home, confusion with time, place and people, misplacing things, or forgetting recent events or conversations
• Behavior and personality changes
• Mental health issues such as depression, changes in mood, withdrawal from work or social activities
You may also want to see a geriatrician if you are a caregiver to an older adult and want advice, suggestions, assistance, or support in caregiving.

3. What Tests Does a Geriatrician Perform or Recommend?

The diagnostic tests recommended by a geriatrician are similar to what a general practitioner would request and would depend on your symptoms. Some of these tests may include:

• Blood tests
• Urine test
• Stool test
• Imaging tests including x-rays, MRI, CT scans
• Electrocardiogram

Based on the test results, your geriatrician may ask you have further tests or you may be referred to another specialist for diagnosis and treatment.

4. What Questions Should I Ask a Geriatrician?

You may want to ask a geriatrics specialist online or in person these kinds of questions:

• What do my symptoms indicate?
• What is my diagnosis? Do I need any follow-up tests?
• Should I see another specialist for my condition?
• What is best treatment for my condition? Are there other options for treatment? Will I need surgery?
• What are the side effects of the treatment or procedure?
• What do each of my medicines do, and why do I need them? Are there side effects I need to be aware of?
• Are there food or drug interactions I should be aware of with the medicines I take?
• Do I need to take all of my medicines or are there other treatment options?
• What is the prognosis? What happens if I don’t do anything?
• Is there any dietary restriction while I am on treatment? Will a dietary changes help my condition?
• Which is the right amount of physical activity for my age? Which exercises would you recommend to improve my muscular strength, joint movements, bone health, cardiovascular health, and overall fitness?
• What can I do to prevent falls, diseases, and infections?
• How can I modify my home to prevent accidents? What precautions should I take if I live by myself?
• What are my options if I cannot take care of myself anymore?
• What are the emergency signs I need to watch out for?
• Do I need screenings for cancer, hearing or vision loss, dental problems, or any other conditions?
• What should I consider when I decide on my living will or advance-life directives?
• Is there a support group for my family or caregivers?
• When is my next appointment?