by Gregg Warshaw, M.D. (NAPSA)—Just as children have unique health care needs and can benefit from seeing a much as possible, the number of drugs their patients are taking. Health, rather than age, really determines whether someone physician with training in pediatrics, older adults have unique health care needs and may bene- one whois as old as or even older than your mother, but has fewer health problems, isn’t taking multiple medications and is able to manage daily activities, may be just fine with a primary care physician. Q: I'd like my grandfather to see a geriatrician but I just called twoin the city wherehe lives and pediatrician or a primary care fit from seeing a geriatrician. Geriatricians are physicians who have advanced training and specialize in the care of the elderly. This, however, doesn’t mean that everyone who’s 65 or older needs to see a geriatrician. Caregivers often ask me questions like the two below, about whether an —_—_————_ older loved one Dr. Warshaw should, in fact, see a geriatrician and,if so, whereto find one. Q: Two years ago my mother, who’s 86, had a small stroke. She’s since had a couple of ministrokes and a small heart attack, and has fallen several times. She used to have mild memory problems but these have worsened andher judgment is sometimespoor. She’s also become very depressed. My mom is taking at least half a dozen medications for these problems, which worries me. Is it time to take herto a geriatrician? A: Older adults like your mother, who have multiple chronic health problems such as cardiovascular disease, memory problems, depression and a history of falls, can benefit from seeing a geriatrician. The health problems you mention are among a group of interrelated, age-associated disorders called “geriatric syndromes.” Geriatricians and other geriatric health care providers are trained to recognize and treat these syndromes and to care for older people, like your mom, who have multiple chronic conditions or arefrail. Geriatrics professionals also have expertise in caring for patients taking multiple medications. Since drugs and interactions among medications can cause unwanted side effects, including falls and memory problems, geriatricians try to limit, as needs to see a geriatrician. Some- neither is accepting new patients right now. Can you help? A: Unfortunately, there’s a shortage of geriatricians in our country. Over the next two decades, the numberof older Americanswill nearly double, to 70 million. But the numberof geriatricians practicing in the U.S. is expected, at best, to stay steady, at 7,500. The results of a survey recently published in the Journal of the American Geriatrics Society (JAGS) finds a growing consensus among leaders in geriatrics that geriatricians should focus on the sickest, frailest older adults. Pri- mary care physicians should care for healthier seniors, those responding to the survey agreed. Having geriatricians focus on the frailest, most complex older patients makes sense, a companion study in the JAGSseries suggests. This study finds that the care provided by geriatricians and generalists differs, with geriatricians evaluating patients for complex geriatric problems and taking steps to avoid medication errors slightly more often than generalists. If your grandfather needs a geriatrician, the American Geri- atrics Society’s Foundation for Health in Aging (FHA) can help you find one. The FHA offers a free referral service that helps people find geriatricians nearby. Just call (800) 563-4916 or visit the Foundation Web site at www.healthinaging.org. Gregg Warshaw, M.D., is the Martha Betty Semmons Professor of Geriatric Medicine and Director of Geriatric Programs at the University of Cincinnati College of Medicine.
