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To Improve Healthcare For Older Adults, Look To Geriatrics

Primary care for older adults is broken. Most of it is grounded in an internal medicine, clinic-based chassis that ignores patients’ goals and strips them of their autonomy. Too often, this approach results in care that is reactive and inconvenient, and which often leads to inappropriate treatments and poor outcomes. That’s because primary care wasn’t designed for older adults. Geriatric care was.

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 The Decline in Geriatric Care Hurts Us All

Care for older people requires a degree of complexity that doesn’t exist in primary care aimed at other adults. Geriatricians are trained to handle overprescriptions and multiple chronic conditions. They contend with end-of-life care. And they must do this with patients who are not always cognitively or emotionally able to comply with their treatment. “It may take 15 minutes to just go through the medication list with a patient,” Dr. Farrell said. “To me, geriatrics is very intellectually fulfilling, but for some people, it can be overwhelming.”

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How gerontology, the study of aging, came to be

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How We Age—and How Scientists Are Working to Turn Back the Clock

Insights into the underlying mechanisms of aging are revolutionizing the hunt for longevity treatments.

More aging boomers, but fewer doctors to care for them

Many factors contribute to the declining number of geriatric specialists. Geriatrics fellowships require extra years of training. Despite their additional training, geriatricians are among the lowest paid physicians across all medical specialties. This is largely due to the fact that reimbursements for geriatrics services are lower, which translates to lower pay for the geriatrician. Further, the specialty also suffers from a general lack of prestige. These are all reasons why medical students aren’t as interested in pursuing geriatrics as a specialty.

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Older adults are often misdiagnosed. Specialized ERs and trained clinicians can help

Errors in diagnosis are relatively common among older people. The reasons are many: older adults may have multiple conditions, take many medications, and illnesses can look very different in older people than they do in younger ones. Older adults may show different symptoms or none at all. And sometimes health care workers assume that whatever is bothering the patient is “because of your age.” All this can lead to older patients being either under-treated or over-treated.

Principles of Gerontology

Gerontology is the scientific study of the processes and problems of aging from all aspects—biologic, clinical, psychologic, sociologic, legal, economic, and political. Geriatrics is the branch of medicine that deals with the diagnosis, management, and prevention of medical problems associated with senility and senescence.

Shaping the future of geriatrics and clinical gerontology research at NIA

As our knowledge of the underlying mechanisms of aging expand, we remain committed to our focus on clinical and translational research that has the potential to help older adults live longer, healthier, and more independent lives. One key area of interest is exploring the causes of healthy aging and age-related conditions over the lifespan. For example, the causes of anemia in a substantial proportion of older patients remain unclear, and this needs to be a focus of future research.

The Joys Of Geriatrics: 90-Year-Olds Sell Medical Students On The Specialty

The American Geriatrics Society estimates that the nation will need about 30,000 geriatricians by 2030 to serve the 30 percent of older Americans with the most complicated medical problems. Yet there are only about 7,000 geriatricians currently practicing. To meet the projected need, the society estimates medical schools would have to train at least 1,500 geriatricians annually between now and 2030, or five times as many as last year.

Resources

Gerontological Society of America

GSA is the oldest and largest interdisciplinary organization devoted to research, education, and practice in the field of aging.

The Gerontologist

The Gerontologist®, published since 1961, is a journal of The Gerontological Society of America that publishes applied, multidisciplinary research and analysis on social issues related to human aging. It informs the broad community of disciplines and professions involved in understanding the aging process and providing care to older people.